Melanoma Skin Cancer

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What Is Skin Cancer - Melanoma? TOPICS

What is melanoma skin cancer?

Melanoma is a cancer that starts in a certain type of skin cell. To understand melanoma, it helps to know about the normal structure and function of the skin.

Normal skin

The skin is the largest organ in your body. It does many different things, such as:

  • Covering the internal organs and helps protect them from injury
  • Serving as a barrier to germs such as bacteria
  • Preventing the loss of too much water and other fluids
  • Helping control body temperature
  • Protecting the rest of the body from ultraviolet (UV) rays
  • Helping the body make vitamin D

The skin has 3 layers: the epidermis, the dermis, and the subcutis (see picture).

Epidermis

The top layer of skin is the epidermis. The epidermis is very thin, averaging only about 1/100 of an inch thick. It protects the deeper layers of skin and the organs of the body from the environment.

Keratinocytes are the main cell type of the epidermis. These cells make an important protein called keratin that helps the skin protect the rest of the body.

The outermost part of the epidermis is called the stratum corneum. It’s composed of dead keratinocytes that are constantly shed as new ones form. The cells in this layer are called squamous cells because of their flat shape.

Living squamous cells are found below the stratum corneum. These cells have moved here from the lowest part of the epidermis, the basal layer. The cells of the basal layer, called basal cells, constantly divide to form new keratinocytes. These replace the older keratinocytes that wear off the skin’s surface.

Melanocytes, the cells that can become melanoma, are also found in the epidermis. These skin cells make a brown pigment called melanin, which gives the skin its tan or brown color. Melanin protects the deeper layers of the skin from some of the harmful effects of the sun. For most people, when skin is exposed to the sun, melanocytes make more of the pigment, causing the skin to tan or darken.

The epidermis is separated from the deeper layers of skin by the basement membrane. This is an important structure because when a skin cancer becomes more advanced, it generally grows through this barrier and into the deeper layers.

Dermis

The middle layer of the skin is called the dermis. The dermis is much thicker than the epidermis. It contains hair follicles, sweat glands, blood vessels, and nerves that are held in place by a protein called collagen, which gives the skin its elasticity and strength.

Subcutis

The deepest layer of the skin is called the subcutis. The subcutis and the lowest part of the dermis form a network of collagen and fat cells. The subcutis helps the body conserve heat and has a shock-absorbing effect that helps protect the body’s organs from injury.

Benign skin tumors

Many types of benign (non-cancerous) tumors can develop from different types of skin cells.

Tumors that start in melanocytes

A mole (nevus) is a benign skin tumor that develops from melanocytes. Almost everyone has some moles. Nearly all moles (nevi) are harmless, but having some types can raise your risk of melanoma. See the section “What are the risk factors for melanoma skin cancer?” for more information about moles.

A Spitz nevus is a kind of mole that sometimes looks like melanoma. It is more common in children and teens, but it can also be seen in adults. These tumors are generally benign and don’t spread. But sometimes doctors have trouble telling Spitz nevi from true melanomas, even when looking at them under a microscope. Therefore, they are often removed, just to be safe.

Other benign tumors

Benign tumors that develop from other types of skin cells include:

  • Seborrheic keratoses: tan, brown, or black raised spots with a “waxy” texture.
  • Hemangiomas: benign blood vessel growths often called cherry or strawberry spots, or port wine stains
  • Lipomas: soft growths made up of fat cells
  • Warts: rough-surfaced growths caused by a virus

Most of these tumors rarely, if ever, turn into cancers. There are many other kinds of benign skin tumors, but most are not very common.

Melanoma skin cancers

Melanoma is a cancer that begins in the melanocytes. Other names for this cancer include malignant melanoma and cutaneous melanoma. Because most melanoma cells still make melanin, melanoma tumors are usually brown or black. But some melanomas do not make melanin and can appear pink, tan, or even white.

Melanomas can occur anywhere on the skin, but they are more likely to start in certain locations. The trunk (chest and back) is the most common site in men. The legs are the most common site in women. The neck and face are other common sites.

Having darkly pigmented skin lowers your risk of melanoma at these more common sites, but anyone can develop this cancer on the palms of the hands, soles of the feet, and under the nails. Melanomas in these areas account for more than half of all melanomas in African Americans but fewer than 1 in 10 melanomas in whites.

Melanomas can also form in other parts of your body such as the eyes, mouth, genitals and anal area, but these are much less common than melanoma of the skin.

Melanoma is much less common than basal cell and squamous cell skin cancers, but it is far more dangerous. Like basal cell and squamous cell cancers, melanoma is almost always curable in its early stages. But it is much more likely than basal or squamous cell cancer to spread to other parts of the body if not caught early.

Other skin cancers

Skin cancers that are not melanomas are sometimes grouped as non-melanoma skin cancers because they develop from skin cells other than melanocytes. They tend to behave very differently from melanomas and are often treated in different ways.

Most non-melanoma skin cancers are basal cell or squamous cell cancers. They are by far the most common skin cancers, and actually are more common than any other form of cancer. Because they rarely spread (metastasize) to other parts of the body, basal cell and squamous cell skin cancers are usually less concerning and are treated differently from melanoma. These cancers are discussed in our document Skin Cancer: Basal and Squamous Cell.

Merkel cell carcinoma is an uncommon type of skin cancer that can be hard to treat.

Still other types of non-melanoma skin cancers are discussed in our documents Kaposi Sarcoma and Lymphoma of the Skin.


Last Medical Review: 10/29/2013
Last Revised: 09/05/2014