What to Know About Amelanotic Melanoma

Medically Reviewed by Stephanie S. Gardner, MD on February 21, 2024
4 min read

Amelanotic melanoma is a rare type of skin cancer. These varieties of skin melanomas are difficult to detect and can often be confused as benign skin lesions. They then become diagnosable later when they have progressed more. It is important to understand more about them and how to spot them earlier.

Melanoma is a serious type of skin cancer that starts when the cells that create pigment in your skin develop cancer. Typically, melanomas form on your skin, but they can also form in your eyes and occasionally in your nose or throat.

It is not clear what causes melanoma generally. However, exposure to UV rays from sunlight or tanning lamps or beds can increase your chances of developing melanomas. Limiting your exposure to UV rays helps your chances of not getting melanomas. You also are more likely to get melanoma if you are age 40 or older.

Melanocytes are the skin cells that create the pigment, or color, in your skin. Amelanotic melanoma begins when these skin cells grow out of control.

Amelanotic melanoma cells are unable to produce more pigment, so the actual amelanotic melanoma lacks pigment, or color. The cause of the melanocyte cells that lead to amelanotic melanoma is not known. Many scientists believe that it is genetic. 

More common melanoma can often appear as a strange-looking skin growth that has unusual pigmentation. They can also present as changes to your previously existing moles. A good way to understand what to look for is to remember ABCDE:

  • A for asymmetrical shape
  • B for irregular border
  • C for change in color
  • D for diameter
  • E for evolving 

If you think you have melanoma, you should seek medical care right away. Early-stage melanomas are treated through a surgery to remove the affected skin areas.  

Amelanotic melanoma symptoms include:

  • Patches of your skin that change in size and have strange coloration (they do not always have to be colored for amelanotic melanoma).
  • Moles or spots on your skin that grow or change shapes. They can also be sore, bleed, ooze, or crust over. 
  • Open sores that take more than three weeks to heal. 

Around 30 percent of all melanomas come from pre-existing moles. Therefore, it is essential you pay attention to all moles you have, even if they do not have pigment. This is primarily because there is a 99 percent chance of survival if you treat melanoma early. 

Amelanotic melanoma can be challenging to diagnose as, so often, they lack pigment. Additionally, the classic ABCDE criteria is not always accurate for diagnosing amelanotic melanoma. Many people tend to overlook amelanotic melanoma. 

In order to diagnose any sort of melanoma, your doctor will do a biopsy of the area, removing skin for a lab evaluation. A report will look at the following qualities of the melanoma:

  • Thickness
  • Loss of skin surface
  • Rate of your cells are dividing 
  • The presence of specific cancer spreading cells

Based on these factors, your doctor can make a diagnosis, along with determining the stage of the cancer. They are:

  •  Stage 0. This is a melanoma that is just on the outer layers of your skin
  • Stage 1.  These types of melanomas are under one millimeter of thickness and have grown beyond the surface skin layer. 
  • Stage 2. Melanomas in this stage do not yet have ulcers but may generate them. They are thicker than 1 millimeter.
  • Stage 3. The melanomas have spread to lymph nodes or the surrounding areas. 
  • Stage 4. These are melanomas that have advanced to spreading to further parts of the body.  

Treatments for melanoma that has spread beyond the skin are typically:

  • Surgery for your lymph nodes. If your melanoma has spread to the nearby lymph nodes of your melanoma, you might need surgery to remove the affected parts of your lymph nodes. Usually, you will also get other treatments before or after this surgery. 
  • Immunotherapy. This is a type of drug treatment that boosts your body’s ability to fight the cancer cells. A lot of times, you will receive this before or after lymph node surgery. If a melanoma can’t be removed with surgery, you will get this injected into your body. 
  • Targeted therapy. These are specific drug treatments that are targeted for certain weaknesses within the cancer cells found in your body. 
  • Radiation therapy. This is a treatment that uses energy beams to kill cancer cells. Radiation therapy can be used for melanomas which aren’t able to be removed with surgery. 
  • Chemotherapy. This is a drug therapy that kills cancer cells. It can be administered through injections or pills. 

Amelanotic melanoma treatment is identical to the methods used to treat other melanomas. Typically, your treatment team will employ a variety of methods, but this varies greatly depending on your specific situation.