Feet are possible melanoma sites. Foot melanoma is often called acral lentiginous melanoma (ALM) or simply, acral melanoma. Signs may include new or changing growths, including lumps and moles. Pain is possible but not always present.
Melanoma skin cancer can start anywhere on your body, including areas that don’t often see the sun like the soles of your feet.
Learning to identify the signs of melanomas may lead to early diagnosis, which improves the outlook.
Monthly cancer self-exams that include the soles, in-between toes, toenails, heels, and the rest of the foot and ankle are highly encouraged.
Using the ABCDE rule, you can look for signs of foot melanoma (or any other skin melanoma) in a new or existing mole on your foot:
- Asymmetry: If you draw an imaginary line through the middle of the mole or skin mark, one half of it will be unlike the other one. This includes size, shape, border, or color.
- Border: A melanoma spot may not have a well-defined border. Maybe it looks blurred, or it may appear irregular or of a different color.
- Color: The mole or spot may have areas of different tonality instead of being a single shade throughout. You may see areas that appear black, red, blue, white, or different shades of brown within the mole. The one exception is amelanotic melanomas, which may have the same color as your skin or be pinkish, reddish, purple, or clear. Dark melanomas may be challenging to diagnose in people with darker skin tones, so it’s important to pay attention to the other signs.
- Diameter: Although not always the case, melanomas tend to be larger than 6 millimeters in diameter, about the size of a pencil eraser.
- Evolving: A melanoma spot often tends to change over time. This may mean it grows in size or changes shape, or both. It may also change coloring, start to itch, or begin to bleed.
Foot or acral melanoma may appear anywhere, including:
- soles
- in between your toes
- under your toenails
- heels
- ankles
The cancerous spots underneath the nails may look like purple, brown, or black bruises. You may also notice dark streaks that grow vertically in the nail.
Unlike nail injuries where the nail eventually grows out, these streaks don’t go away if they’re melanoma. You may also experience nail brittleness, as well as nails that crack easily.
Other possible signs of melanoma in the feet include:
- lesions that don’t heal
- unexplained bleeding from a mole or sore
- painful or itchy moles or spots
- oozing or scaling moles or spots
Read more about general skin cancer symptoms.
Melanoma, in general, may spread quickly. Multiple factors, including individuality, are at play.
Periodic self-exams may help to identify foot melanoma during early stages. Prompt treatment decreases the chance of melanoma spreading to other parts of your body.
At first, the melanoma will develop in the top layer of your skin only (epidermis). This may be anywhere on your foot. As the mole changes, it may get thicker and start extending internally beneath the skin. However, at this point, the cancer hasn’t spread yet.
If left untreated, melanoma can spread to your lymph nodes or to another spot on or near your foot.
Advanced or stage 4 melanoma — the most serious form of melanoma — means that the cancer has spread to distant parts of your body, including internal organs. This is called metastasis.
Learn more about melanoma staging here.
The most common cause of melanoma is unprotected exposure to ultraviolet (UV) rays.
For areas that don’t see the sun often, like the soles of your feet, melanoma may be associated with
Other
- having many moles
- being of lighter skin color
- having a personal history of skin cancer
- having a family history of skin cancer, especially melanoma
- being immunocompromised
- living with xeroderma pigmentosum
- being a female under age 30
- being a male over age 50
Not every person with melanoma has these risk factors, and not all people with one or more risk factors will develop melanoma.
For example, people with dark skin also develop melanoma and other forms of skin cancer.
ALM accounts for about
If you identify an unusual spot on your foot, a visit to the dermatologist is highly advisable. They will examine all areas of your body, including your feet. If they detect a mole or growth, they may determine you need a biopsy to rule out skin cancer or explore other causes for your symptoms, like toenail fungus.
A biopsy requires scraping off a small part of the mole and sending the tissue to the lab for evaluation.
In a few days, they will have the biopsy results and your healthcare professional will discuss the next steps with you, including staging the cancer.
Treatment options for foot melanoma depend on the stage of cancer at the time of diagnosis. Early diagnoses improve the outlook.
Early diagnosis may lead to your healthcare professional opting for surgery. Depending on your symptoms and cancer stage, they may cut out the mole and some skin surrounding it. This method is called an excision, and it’s commonly performed in a dermatologist’s office.
More advanced cases of foot melanoma may require excision as well as one or more of the following:
- Chemotherapy: Chemical therapy that requires multiple sessions to kill the cancer cells in your body.
- Immunotherapy: A treatment that stimulates the immune system so your body can attack cancer cells.
- Lymphadenectomy: A surgery that removes affected lymph nodes.
- Radiation therapy: A treatment that uses radiation to shrink tumors in several sessions.
Learn more about advanced melanoma treatment here.
Foot melanoma may start in a new or existing mole. It may appear as a spot that’s not symmetrical, has different skin tones or shades, doesn’t have well-defined borders, may be larger than 6 millimeters, and changes over time. It may also bleed, itch, and hurt.
Performing a visual self-exam may help you identify melanoma during early stages, which improves treatment outcomes and outlook.