Melanoma Prevention, Detection, and Treatment: What You Need to Know in 2026

More than 100,000 people in the U.S. will be diagnosed with invasive melanoma this year. That’s more than double the number from 20 years ago. But here’s the thing: if caught early, your chance of surviving is over 99%. If it spreads? That number drops to 35%. The difference isn’t luck. It’s knowing what to look for, when to act, and how to protect yourself.

What Melanoma Really Is

Melanoma starts in melanocytes - the cells that give your skin its color. It’s not the most common skin cancer, but it’s the deadliest. About 1 in 50 people in the U.S. will get it in their lifetime. And unlike basal cell or squamous cell cancers, melanoma can spread fast - sometimes in weeks.

There are four main types:

• Superficial spreading melanoma - makes up 70% of cases. It grows sideways along the top layer of skin before going deeper. Often shows up as a new or changing mole.
• Nodular melanoma - 15-30% of cases. Grows quickly downward. Looks like a raised bump, often black or dark red. Can appear where no mole existed before.
• Lentigo maligna melanoma - 10-15%. Usually on sun-exposed areas like the face or arms in older adults. Starts as a flat, irregularly shaped patch.
• Acral lentiginous melanoma - 2-8%. Most common in people with darker skin. Appears on palms, soles, or under nails. Often missed because it doesn’t look like a typical sun-related mole.

Half of all melanomas have a BRAF gene mutation. That’s important because it opens up targeted treatment options. But even if you don’t have that mutation, new immunotherapies are still working.

How to Prevent Melanoma

Ninety percent of melanomas are caused by UV radiation - from the sun or indoor tanning. That means most cases are preventable. But prevention isn’t just about sunscreen.

Here’s what actually works:

• Avoid tanning beds completely. People who use them before age 35 raise their melanoma risk by 58%. That’s not a small number. It’s a red flag.
• Wear broad-spectrum SPF 30+ every day. Even in winter. Even if it’s cloudy. UV rays penetrate clouds. And UVA rays - the ones that age your skin and damage DNA - are present all day, every day.
• Seek shade between 10 a.m. and 4 p.m. That’s when UV rays are strongest. Don’t wait until you’re burning to get out of the sun.
• Wear protective clothing. Hats with wide brims, UV-blocking sunglasses, long sleeves. A regular white t-shirt only blocks about 50% of UV rays. Special sun-protective fabrics with UPF 50+ block over 98%.
• Teach kids early. Skin damage from childhood builds up over time. The CDC found only 14% of high schoolers use sunscreen regularly. That needs to change.

There’s a myth that darker skin tones are immune. They’re not. Acral melanoma doesn’t care about your skin color. It shows up on the soles of feet, under nails, or between toes. And it’s often diagnosed late because people - and doctors - don’t look there.

How to Detect Melanoma Early

Early detection saves lives. The ABCDE rule is the gold standard - and it’s simple enough for anyone to use.

• A - Asymmetry: One half doesn’t match the other.
• B - Border: Edges are ragged, blurred, or notched.
• C - Color: Multiple shades of brown, black, red, white, or blue.
• D - Diameter: Larger than 6mm - about the size of a pencil eraser.
• E - Evolving: Changing in size, shape, color, or texture. Or it starts to itch, bleed, or crust.

But ABCDE isn’t enough on its own. You need to know your skin. Do a full-body self-check once a month. Take 10-15 minutes after a shower. Use a mirror. Check your scalp, between your toes, your back, your buttocks. Take photos of new or changing spots. Compare them month to month.

Apps like UV Index by QSun can alert you when UV levels are high. But they don’t replace looking at your skin. One Reddit user found a 0.4mm melanoma because the app reminded him to check a spot he’d ignored for months. That’s the kind of moment that changes everything.

High-risk people - fair skin, 50+ moles, family history - should see a dermatologist every 3 to 6 months. But here’s the problem: the average wait for a dermatology appointment is nearly 30 days. In rural areas, it’s over two months. That’s why teledermatology is growing. In 2024, 61% of dermatology practices offered virtual visits. Accuracy is 87% - close to in-person. But Medicare pays less for virtual visits. That’s holding back access.

How Melanoma Is Treated

Treatment depends entirely on how far it’s spread.

• Stage 0 (in situ): Only in the top layer of skin. Surgery with a 0.5-1 cm margin around the mole is usually all you need. Cure rate: nearly 100%.
• Stage I-II: Deeper in the skin. Wider excision (1-2 cm) plus a sentinel lymph node biopsy (SLNB) if the tumor is over 0.8 mm. SLNB checks if cancer has reached nearby lymph nodes. If it hasn’t, you’re likely cured with surgery alone. Five-year survival: 97% for Stage IA.
• Stage III: Cancer reached lymph nodes. Surgery plus adjuvant therapy - drugs like nivolumab, pembrolizumab, or ipilimumab - to kill any leftover cells. These are immunotherapies that help your immune system find and destroy cancer. Side effects can be serious, but they’re manageable. Survival rates jump from 40% to over 70% with these drugs.
• Stage IV: Spread to distant organs. This is where things get complex. Two main paths: immunotherapy or targeted therapy.

Immunotherapy (like nivolumab + ipilimumab) works for more people. In the CheckMate 067 trial, 52% of patients were still alive five years later. Side effects? About 14% had severe reactions.

Targeted therapy (like dabrafenib + trametinib) only works if you have a BRAF mutation - about half of all melanomas do. It works faster - tumors shrink in weeks. But side effects are worse: 57% get serious issues like fever, rash, or liver problems. And resistance often develops after a year or two.

Both cost $150,000-$200,000 a year. Insurance helps, but out-of-pocket costs still hit $28,500 for some. That’s why so many patients on Reddit talk about financial toxicity. Treatment can bankrupt you even with coverage.

In early 2025, the FDA approved two new tools: an AI-powered dermoscopy tool called DermEngine’s VisualizeAI (93.2% accurate) and a personalized mRNA vaccine (mRNA-4157/V940) that cuts recurrence risk by 44% when combined with pembrolizumab. These aren’t cures yet - but they’re turning melanoma into a chronic, manageable disease for more people.

Why Some People Are Left Behind

Not everyone has equal access. In Mississippi, there’s only 1 dermatologist for every 100,000 people. In Massachusetts, it’s 7.8. That gap means people in rural or low-income areas are 22% more likely to be diagnosed with late-stage melanoma.

Black patients make up just 2% of melanoma cases - but 12% of those diagnosed at Stage III or IV. Why? Because lesions on darker skin are often mistaken for bruises, scars, or fungal infections. One patient, DJohnson_MD, had a spot on his foot called a “bruise” for over a year. It was Stage III acral melanoma.

And while the CDC spent $1.8 billion treating melanoma in 2024, they spent $0.02 per person on prevention. That’s not a mistake. It’s a failure.

What You Can Do Today

You don’t need to be a doctor to save your life. Here’s your action plan:

1. Apply broad-spectrum SPF 30+ every morning. Reapply every 2 hours if you’re outside.
2. Do a full-body skin check once a month. Use mirrors. Take photos.
3. Know your ABCDEs. If something looks new, changing, or weird - get it checked.
4. If you’re high-risk (fair skin, many moles, family history), see a dermatologist every 3-6 months.
5. Never use a tanning bed. Not even once.
6. Teach your kids. Make sun safety part of your daily routine - like brushing your teeth.

Survival isn’t about being lucky. It’s about being informed. Melanoma is beating us - but only if we let it. The tools to stop it are already here. We just need to use them.