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Melanoma is the most common skin cancer in children, although it is still rare. When caught early, doctors can treat it more easily. Melanoma is associated with an overall high survival rate and a good outlook, particularly among children. This article explains childhood melanoma, including its risk factors, symptoms, and treatment. What is childhood melanoma Share on PinterestNSimages/Getty ImagesMelanoma is a type of skin cancer that forms in the melanocytes. The melanocytes make the pigment melanin, which colors the skin. Melanoma spreads rapidly to other cells. Melanomas can appear anywhere on the skin. While adult melanoma is often brown or black, melanoma in children tends to be whitish, yellowish, or pink. Doctors diagnose about 400 cases of melanoma in people under the age of 20 each year. This accounts for about 1% of all new melanoma cases. It can occur in young children but is most common in adolescents aged 15–19. Learn more about melanoma here. Risk factors for childhood melanoma Some common risk factors of childhood melanoma include:fair complexion, including blue or green eyes, blonde or red hair, or lighter skin tonespresence of several molesfamily history of unusual moles or melanomaexposure to sunlight or artificial sunlightpresence of several different conditions such as a weakened immune system, xeroderma pigmentosum, or hereditary retinoblastoma Symptoms of childhood melanoma Several symptoms could indicate melanoma in children. They include:changes in skin color development of a satellite mole, which is a smaller mole near an existing molea mole that has an unusual shape or irregular borders and is asymmetricala mole or wart-like bump that itches, bleeds, or oozesa skin lesion that changes appearance or contains multiple colors Learn more about melanoma symptoms and how to identify them. Diagnosing childhood melanoma If caregivers notice an unusual mole or other skin changes, they should take the child to a doctor. They may refer the child to a specialist for diagnosis if they suspect melanoma. The diagnostic process will involve a medical review of the child and family’s health history. The doctor will likely perform a physical examination, focusing mainly on the child’s skin. Most doctors follow the ABCDE rule for evaluating skin lesions or moles:A is for asymmetry: One-half of the lesion is unlike the other half.B is for border: The lesion has an irregular, wavy, or poorly-defined border.C is for color: The lesion has multiple colors.D is for diameter: Most melanomas are at least 6 millimeters, about the size of a pencil eraser, when doctors diagnose them but can be smaller.E is for evolving: The lesion looks different from other spots on the skin and is changing in appearance. If doctors suspect melanoma, they will order a biopsy of the lesion. Different types of biopsies include:Shave biopsy: A doctor uses a razor to remove the growth.Punch biopsy: A doctor uses a tool to take a small sample of tissue from the abnormal growth.Excisional biopsy: A doctor removes the whole area of abnormal growth.Incisional biopsy: A doctor uses a scalpel to remove part of the growth. Learn more about biopsies here. Tests to show whether cancer has spread Like other cancers, doctors classify melanoma in stages. Advanced melanoma can spread to nearby lymph nodes and tissues or distant areas. A doctor may order tests to check for signs that the melanoma has spread. These tests include:Magnetic resonance imaging (MRI): MRI produces a detailed image of different body parts.Computerized tomography (CT) scan: The CT imaging scan produces a detailed picture of the body.Chest X-ray: This checks for cancer cells in the lungs, heart, or other areas.PET scan: PET uses a small amount of radioactive glucose to look for malignant cells that appear brighter on the scan.Sentinel lymph node biopsy: This is a biopsy of the lymph node to which melanoma is most likely to spread.Lymph node dissection: This involves examining the lymph nodes after removing them.Ultrasound: Ultrasound uses sound waves to produce a picture of the body. Learn about the difference between MRI and CT scans here. Treatment Children with melanoma have several treatment options. They include standard treatments and those undergoing clinical trials. Standard treatments have Food and Drug Administration (FDA) approval, while clinical trials test new treatment options that may become new and better standard treatments. Some common treatments for melanoma include:Immunotherapy: Immunotherapy uses medications to teach the immune system to target and attack cancer cells.Chemotherapy: Doctors recommend chemotherapy if cancer has spread to nearby tissue or lymph nodes.Surgical removal: This involves removing the cancer and nearby lymph nodes.Radiation therapy: Doctors may use radiation therapy when cancer has spread to lymph nodes. Caregivers interested in their child joining a clinical trial can talk with a doctor. They could also search for a clinical trial through the National Cancer Institute’s website. Outlook Melanoma is often an aggressive skin cancer. However, children tend to have a better outlook compared to adults. The 5-year survival rate refers to the proportion of people alive 5 years after receiving a diagnosis. The overall 5-year survival rate for childhood melanoma is 90%. For cancer that spreads to the lymph nodes, around 60% of children will be alive 5 years after diagnosis. In a 2019 study examining survival rates over 18 years, researchers found an overall survival rate of 92%. Another study from 2017 found that the overall survival rate was 87–95%. The study also noted that younger children had an overall poorer outlook than older children. Children treated for melanoma have a higher chance of disease later in life. Regular medical checkups are necessary into adulthood. Summary Melanoma is the most common skin cancer in children but is still rare. It is more likely to occur in children with fair skin or a family history of melanoma. Melanomas can appear anywhere on the body and may look like a mole. Doctors use the ABCDE rule to help diagnose melanoma. Treatment options focus on removing cancer and preventing its spread. The overall survival rate for children is around 90%. Last medically reviewed on June 29, 2022Cancer / OncologyMelanoma / Skin CancerPediatrics / Children's HealthMedically reviewed by Mia Armstrong, MD — By Jenna Fletcher on June 29, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageAntioxidants: helpful or harmful for melanoma? After a 2014 study implicated antioxidants in lung cancer progression, a new study suggests these molecules hasten melanoma development.READ MOREWhat to know about skin cancer on Black skin Although skin cancer is less common in Black individuals, it is often diagnosed late and is more deadly. 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