Melanoma Diagnosis and Treatment in Sarasota
Melanoma is the most serious of the common skin cancers. It accounts for a small share of skin cancer diagnoses but a much larger share of skin cancer deaths, which is why every dermatologist takes it seriously. The good news is that when melanoma is caught early, it is highly curable with a straightforward outpatient procedure. Most of our patients who are diagnosed early are back to normal life within a few weeks.
At Sarasota IDO, our board-certified dermatologists diagnose and treat melanoma at both our Sarasota and Bradenton offices. Living in Florida, with year-round UV exposure and a large population of patients who spent decades outdoors, we see melanoma regularly. Our approach is direct: quick diagnosis, prompt treatment, careful long-term follow-up, and clear communication about what comes next.
What Is Melanoma?
Melanoma is a cancer that starts in melanocytes, the cells that give skin its pigment. It usually appears as a new dark spot on the skin or as a change in an existing mole. Because melanocytes exist all over the body, melanoma can appear anywhere, including places that get little sun such as the palms, soles, under nails, and on mucous membranes.
Melanoma is different from the other two common skin cancers, basal cell carcinoma and squamous cell carcinoma, in one important way: it has a real ability to spread to lymph nodes and other organs if it is not caught early. That is why we treat every suspicious pigmented spot as worth investigating, and why we do not delay biopsies once a spot has been flagged.
How Melanoma Differs From BCC and SCC
- Basal cell carcinoma grows slowly, rarely spreads, and shows up as a pearly bump or non-healing sore.
- Squamous cell carcinoma grows faster than BCC and has a small potential to spread, usually appearing as a rough scaly patch or a firm red bump.
- Melanoma can spread through the lymphatic system and bloodstream if it is not treated early, and it typically appears as a new or changing dark spot.
If you want a fuller picture of how these three cancers compare, see our skin cancer care page.
Warning Signs and Symptoms
The most useful tool for recognizing melanoma at home is the ABCDE method. Watch any mole or new spot for:
- A — Asymmetry. One half does not match the other. Benign moles are usually symmetrical.
- B — Border irregularity. Edges that are ragged, notched, scalloped, or poorly defined.
- C — Color variation. More than one color in the spot, especially mixes of brown, black, tan, red, white, or blue.
- D — Diameter. Larger than a pencil eraser (about 6 mm), although melanomas can be smaller.
- E — Evolving. Any change over weeks or months — growing, darkening, itching, bleeding, or crusting.
Also pay attention to what dermatologists call the “ugly duckling” sign: a mole that looks different from all your other moles. Moles on the same person tend to look similar. One that stands out from the rest deserves a closer look.
Other symptoms that should prompt an urgent visit:
- A new dark spot appearing on an adult, especially after age 40
- A mole that suddenly begins to itch, bleed, or feel painful
- A pigmented spot under a fingernail or toenail that is not from an injury
- A dark line running lengthwise on a nail
- A mole that changes noticeably between routine skin exams
* If you have a spot that is changing quickly, do not wait for your annual exam.
Call us and we will get you in soon. Early melanoma is nearly always curable.
How Is Melanoma Diagnosed?
Diagnosis follows a predictable path.
Clinical exam and dermatoscopy. During a skin exam, we look at concerning spots with the naked eye and with a dermatoscope, a magnifying tool that reveals pigment patterns and structures below the surface. Dermatoscopy improves the accuracy of melanoma detection and helps us decide which spots need a biopsy.
Biopsy. If a spot is suspicious, we biopsy it. For pigmented lesions concerning for melanoma, we generally recommend an excisional biopsy or a deep shave biopsy that captures the full depth of the lesion. This is important because the depth of the melanoma (called Breslow thickness) is one of the most important measurements for planning treatment. The biopsy is done in-office under local anesthesia and takes only a few minutes.
Pathology. The tissue goes to a dermatopathology lab. A dermatopathologist examines it under a microscope and issues a report describing whether melanoma is present, how deep it goes, how the cells look, and other features that guide treatment.
Results and staging discussion. We call you personally with results, usually within about a week. If the diagnosis is melanoma, we explain what the pathology shows, what stage it appears to be based on the biopsy, and what the next steps look like. We do not send diagnoses like this through the patient portal without a conversation.
Additional workup if needed. For thicker or more advanced melanomas, we coordinate additional evaluation. This may include imaging or referral for sentinel lymph node biopsy, which is a procedure done by a surgical oncologist to check whether melanoma cells have reached the nearest lymph nodes.
Staging Basics
Melanoma stage describes how advanced the cancer is, considering thickness (Breslow depth), surface ulceration, and any spread to lymph nodes or distant sites. Stages range from 0 (in situ, confined to the outermost layer of skin) through IV (metastatic).
Most melanomas we diagnose at IDO through routine screening are early-stage. Detailed staging is finalized after surgery, and for anything beyond early stage we work closely with medical and surgical oncology colleagues.
We keep staging conversations grounded in what it means for you specifically — treatment plan, follow-up schedule, and outlook.
Treatment Options at Sarasota IDO
Treatment depends on the stage of the melanoma, its location, and your overall health. Common approaches include:
Wide local excision. This is the standard treatment for most early-stage melanomas. We remove the melanoma along with a margin of surrounding healthy skin and close the site with sutures. Margin size depends on the thickness of the melanoma and follows national guidelines. Most excisions are done in-office under local anesthesia.
Mohs micrographic surgery. In select cases, especially for melanoma on the face or other cosmetically sensitive areas, Mohs surgery may be considered. Not every melanoma is a Mohs candidate, and we discuss whether it applies in your case.
Sentinel lymph node biopsy referral. For melanomas above a certain thickness or with high-risk features, sentinel lymph node biopsy is often recommended. We refer to a trusted surgical oncologist and coordinate the timing so it happens alongside your wide local excision.
Oncology collaboration for advanced disease. If melanoma has spread beyond the skin, treatment involves systemic therapies such as immunotherapy or targeted therapy, managed by medical oncology. We work in tandem with local oncology teams and stay on for dermatology follow-up and skin surveillance.
Reconstruction when needed. When melanoma is removed from the face, especially near the eyelids, nose, or lips, reconstruction may be needed. Our practice includes an oculoplastic surgeon, so eyelid and facial reconstruction happens with the same team that treated the melanoma.
What to Expect at Your Visit
First visit. If you are seeing us for a specific spot, we start with a conversation about how long it has been there, whether it has changed, and your sun and family history. We examine the spot with a dermatoscope and typically look at the rest of your skin as well. If a biopsy is needed, we can usually do it the same day.
Biopsy visit. We numb the area, take the sample, and bandage the site. You leave with wound-care instructions.
Results call. Within about a week, we call to discuss the pathology. If melanoma is confirmed, we walk through the plan: excision timing, whether sentinel lymph node biopsy is recommended, and what follow-up looks like.
Excision. Wide local excision usually takes 30 to 60 minutes in the office under local anesthesia. Larger or facial cases may take longer. You leave with sutures, wound-care instructions, and a follow-up appointment for suture removal about 1 to 2 weeks later.
After Diagnosis: Next Steps
A melanoma diagnosis is the start of a longer relationship with our team. Standard next steps include:
- Complete removal with appropriate margins
- Sentinel lymph node biopsy referral if indicated by the pathology
- Oncology referral for anything more advanced than early-stage disease
- Surveillance skin exams on a regular schedule to catch any recurrence or new primary melanomas
- Education about self-checks, sun protection, and family screening
Follow-up frequency typically starts at every 3 to 6 months for the first few years, then annually if things stay stable. Patients with a history of melanoma have a higher risk of developing another one, so lifelong dermatology follow-up is standard.
Prevention and Skin Care
You cannot prevent every melanoma, but you can lower your risk and improve your odds of catching one early.
- Use broad-spectrum sunscreen SPF 30 or higher every day, reapplied every 2 hours outdoors
- Wear UPF clothing, wide-brimmed hats, and UV-protective sunglasses
- Avoid tanning beds. They increase melanoma risk, especially in people who start young.
- Seek shade during peak UV hours (roughly 10 a.m. to 4 p.m. in Florida)
- Do monthly self-exams using the ABCDE method
- Keep annual professional skin cancer screenings on the calendar
- If you have a family history of melanoma, ask about starting screenings earlier
Prevention plus early detection is how survival rates have improved so much over the past few decades.
Who Is at Risk?
Anyone can develop melanoma, but risk is higher for people with:
- Fair skin, light hair, or light eyes
- Family history of melanoma
- Personal history of melanoma or other skin cancers
- Many moles, especially atypical (dysplastic) moles
- Immunosuppression, including organ transplant recipients and patients on certain long-term medications
- History of blistering sunburns, particularly in childhood or adolescence
- Extensive sun exposure or history of tanning bed use
- Age 50 and older, though melanoma also occurs in younger adults
Melanoma is one of the more common cancers in adults under 40, particularly among people with a history of tanning bed use. Age alone is not a good reason to skip skin exams.
Why Choose Sarasota IDO for Melanoma?
We approach melanoma the same way we would want our own family cared for. Dr. Ilya Lim, MD, FAAD is a board-certified dermatologist, Fellow of the American Academy of Dermatology, and board-certified in Micrographic Dermatologic Surgery (Mohs). Dr. Shauntell J. Solomon, DO is a board-certified osteopathic dermatologist and fellowship-trained Mohs surgeon (Larkin Community Hospital, South Miami) who joined us from Skin and Cancer Associates in South Florida. Both physicians see pigmented lesions and melanoma regularly, and both are qualified to perform Mohs surgery when it is the right approach for a given case.
Our practice is set up for continuity. Diagnosis, treatment, and long-term follow-up happen with the same team. When facial reconstruction is part of the plan, our oculoplastic surgeon is in the same office, so patients do not have to shuttle between practices or repeat their history.
We are located at 1617 S. Tuttle Ave, 3rd Floor in Sarasota and at 5266 Office Park Suite 203 in Bradenton, and we work with local oncology teams when systemic treatment is needed.
Meet our providers: Dr. Ilya Lim, MD, FAAD and Dr. Shauntell Solomon, DO.
Frequently Asked Questions
Is melanoma curable?
Early-stage melanoma is highly curable with surgical removal. Cure rates drop as the disease advances, which is why finding melanoma early is the single most important thing we do.
How fast does melanoma grow?
Some melanomas grow slowly over years, while a subtype called nodular melanoma can grow within weeks to months. That variability is why any spot that is changing noticeably should be evaluated soon, not later.
Can melanoma appear on skin that has never been in the sun?
Yes. Melanoma can develop on the palms, soles, under fingernails or toenails, and on mucous membranes. These subtypes are less common but very real, and they can be missed if patients assume only sun-exposed skin is at risk.
Do you biopsy suspicious moles the same day?
Usually, yes. If you come in with a spot and we agree it needs a biopsy, we can typically do it the same visit.
Will I need chemotherapy for melanoma?
Traditional chemotherapy is rarely first-line for melanoma today. When systemic treatment is needed, it is usually immunotherapy or targeted therapy, managed by medical oncology.
How often do I need follow-up after a melanoma diagnosis?
This depends on the stage and features of your melanoma. In general, expect skin exams every 3 to 6 months for the first few years, then annually. Some patients have imaging or bloodwork as part of oncology follow-up.
Does insurance cover melanoma treatment?
Medically necessary treatment for melanoma, including biopsy, excision, and Mohs surgery, is typically covered by health insurance and Medicare. Coverage details vary by plan.
Should my family members be screened if I have melanoma?
First-degree relatives (parents, siblings, children) of melanoma patients have a higher lifetime risk and should have regular skin exams. Let your family know about your diagnosis and encourage them to schedule an exam.
Related Services
- Skin Cancer Screening — annual full-body exams
- Skin Cancer Care — our overall approach to skin cancer
- Mole Removal — evaluation and removal of concerning moles
- Mohs Micrographic Surgery — precision surgery for select facial cases
Book Your Consultation
If you have a mole or spot that is changing, if you have a family history of melanoma, or if you have already been told you may need melanoma treatment and want a board-certified dermatologist to lead your care, we can help. We see patients at both our Sarasota and Bradenton offices.
Sarasota: 1617 S. Tuttle Ave, 3rd Floor — (941) 559-7999 | Bradenton: 5266 Office Park, Suite 203 — (941) 559-7999
*This information is educational. It does not replace an in-person evaluation by a board-certified dermatologist. If you have been diagnosed with melanoma or are worried about a specific spot, please schedule a visit.