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Jan 21, 2024

Can Skin Cancer Be the Same Color as Your Skin?

stefanamer / Getty Images Melanoma, a common type of skin cancer, can develop

stefanamer / Getty Images

Melanoma, a common type of skin cancer, can develop within an existing mole, but it may also just look like the color of your skin.

Amelanotic melanoma is a rare type of melanoma that looks colorless or takes on a red, pink, or purple tint. This occurs because it lacks melanin, the pigment that gives most melanomas their dark appearance.

It can be mistaken for other skin lesions with similar characteristics like a pimple, benign mole, cyst, wart, or scar. Since amelanotic melanoma can resemble other marks on the skin, its misdiagnosis rates can be as high as 89%.

Amelanotic melanoma is often diagnosed only when it's more advanced because it's harder to recognize, according to Elizabeth Berry, MD, assistant professor of dermatology at Oregon Health & Science University.

Early diagnosis is critical to improving prognosis, so learning how to spot colorless melanoma can help detect unusual changes in your skin.

The ABCDE rule is a handy guide to help you recognize and remember the early signs of skin cancer to watch out for: asymmetry, border irregularity, color variation, diameter of about 6 mm, and evolution.

Jennifer N. Choi, MD, a dermatologist at Northwestern Medicine, told Verywell that people usually find out they have amelanotic melanoma when they’ve developed symptoms like bleeding, itching, or continuous growth of a wart or cyst that didn't heal. Sometimes, a dermatologist can detect suspicious features during a total body exam.

Amelanotic melanoma tends to prompt a medical exam once it becomes symptomatic, Choi said. It doesn't necessarily mean it has spread by that point, but it can be more advanced or deeper in the Breslow depth—the depth of melanoma that is measured under the microscope—by the time of diagnosis due to the delay in medical examination, she added.

Amelanotic melanomas can occur anywhere on the body. The most common sites are the areas most frequently exposed to the sun, such as the head and neck, back, and lower legs. However, like pigmented melanomas, Choi said amelanotic melanoma can occur in unusual sites as well, like the bottom of your foot.

Susan Massick, MD, a dermatologist at The Ohio State University Wexner Medical Center, told Verywell that monthly skin self-exams could help alert you to unusual changes. Make sure you pay attention to lesions that are new, growing, bleeding, ulcerating, and frequently crusting, scaling, or itching.

Around half of melanomas are self-detected, so if you find any concerning lesions, get them checked out by a dermatologist. It's important to self-screen, but don't self-diagnose and don't ignore changing lesions, Massick said.

Seek medical care sooner for spots that grow quickly, become painful, or start to bleed.

Although amelanotic melanoma usually doesn't meet the typical ABCDE criteria, they are "ugly ducklings," which means they don't look like any other growth on a person's skin, Berry said.

"I tell my patients that if a pink bump comes up and does not resolve within four to six weeks like a normal pimple or insect bite should, they should show that bump or spot to a medical provider," Berry said.

The Ugly Duckling sign is another early recognition strategy aside from the ABCDEs. Most moles on your body may resemble one another, while melanomas stand out in comparison. It is reported to be an effective sign for melanoma detection across different skill groups, experts and non-clinicians alike.

In addition to self-screening, you can also do regular full-body skin exams or seek telemedicine services. For instance, the Oregon Health & Science University offers Virtual Skin Cancer Spot Checks, allowing patients to submit photos of one to two moles and receive medical advice.

In the United States, there is a 99% five-year survival rate for patients whose melanomas were detected early, so any abnormal skin growth is worth getting checked out.

How thick and deep the melanoma is at diagnosis can determine how aggressive it will be, what the best treatment is, and what clinical outcome and prognosis to expect, Massick said. The treatment of amelanotic melanoma is similar to that of pigmented melanoma.

Berry advises individuals to "seek medical care sooner for spots that grow quickly, become painful, or start to bleed."

Dermatologists recommend you perform regular skin self-exams to detect any changes on your body. If you find a new, growing, bleeding, or crusting lesion, get it checked out by a dermatologist. Amelanotic melanomas are more difficult to spot, so pay attention to your body and don't ignore changing lesions.

Alshaghel MM, Almahairi L, Arian R, et al. Amelanotic nodular melanoma misdiagnosed as a benign skin lesion: A rare case report from Syria. Ann Med Surg (Lond). 2022;74:103316. doi:10.1016/j.amsu.2022.103316

Skin Cancer Foundation. Melanoma warning signs.

American Academy of Dermatology Association. Skin cancer.

Garrison ZR, Hall CM, Fey RM, et al. Advances in early detection of melanoma and the future of at-home testing. Life (Basel). 2023;13(4):974. doi:10.3390/life13040974

By Carla DelgadoCarla M. Delgado is a health and culture writer based in the Philippines.