Warning Signs
The ABCDE Warning Signs of Melanoma
Every mole on your body should be checked regularly against the ABCDE criteria below. Any mole that meets one or more of these criteria should be evaluated by Dr. Sierro at your next visit. Any mole that meets multiple criteria should be evaluated the same week. Do not wait for your annual appointment if you notice a mole changing.
A Asymmetry
One half does not match the other when you draw a line through the center.
B Border
Edges are ragged, notched, scalloped, or blurred rather than smooth and even.
C Color
Multiple shades of brown, black, tan, red, white, or blue within the same mole.
D Diameter
Larger than 6mm — about the size of a pencil eraser. Some melanomas are smaller.
E Evolution
Change in size, shape, or color, or any new symptom like itching, bleeding, or crusting.
Evolution is the most important warning sign. Any mole that is changing — even if it looks otherwise normal — should be evaluated promptly. Melanomas that are caught at the earliest stage of change have the best outcomes. A mole that bleeds without being scratched or picked, itches persistently, or looks different from how it looked six months ago should never be watched and waited. Call Dr. Sierro at Kare Skin Health Center immediately. Call (310) 998-5533.
Melanoma Staging and Treatment at Kare Skin Health Center
The treatment of melanoma is determined by its stage, which is based on how thick the tumor is within the skin, whether it has spread to nearby lymph nodes, and whether it has spread to distant organs. Dr. Sierro stages every melanoma from the pathology report before planning treatment and coordinates referrals for advanced-stage disease where systemic therapy is needed.
Melanoma-In-Situ (Stage 0)
Melanoma confined to the outer layer of the skin without invasion into the dermis below. Treated with surgical excision using a 0.5cm margin of surrounding normal skin. Highly curable at this stage with surgical removal alone. In selected cases on the face or hands, Mohs surgery may provide more precise margin assessment.
Thin Invasive Melanoma (Stage I)
Melanoma that has grown into but not through the dermis. Treated with surgical excision using 1cm margins for lesions up to 1mm thick. The five-year survival rate for stage I melanoma exceeds 97 percent. Dr. Sierro coordinates plastic surgery reconstruction for excision sites on the face, neck, and cosmetically sensitive areas.
Intermediate Melanoma (Stage II)
Thicker melanomas with higher risk of lymph node spread. Excision with 2cm margins is standard. Sentinel lymph node biopsy is recommended to assess whether melanoma has spread to the regional lymph nodes without yet being detectable on imaging. Dr. Sierro coordinates the surgical and oncological team for stage II management.
Advanced Melanoma (Stage III and IV)
Melanoma that has spread to regional lymph nodes (stage III) or distant organs including the lungs, liver, and brain (stage IV). Treatment involves systemic therapy — BRAF inhibitors, MEK inhibitors, and immunotherapy — often combined with surgical management. Dr. Sierro coordinates oncology referrals and remains the patient's primary dermatologist through all phases of treatment.
The Kare advantage for melanoma patients: Dr. Sierro and the Kare plastic surgery team work in the same practice. Patients who need excision of melanoma in a cosmetically sensitive location receive coordinated care from diagnosis through reconstruction without being sent to a separate surgical facility. Margin-confirmed excision is performed first, and reconstruction is planned around the pathology result to ensure the cancer is fully removed before any cosmetic correction is made.
Authority Resources at Kare Skin Health Center
Frequently Asked Questions
Where can I get melanoma treated in Santa Monica?
Kare Skin Health Center at 804 7th Street in Santa Monica near Montana Avenue offers expert melanoma diagnosis and treatment by board-certified dermatologist Dr. Tiffany Sierro. Dermoscopic mole evaluation, skin biopsy, melanoma staging, surgical excision, and coordinated plastic surgery reconstruction for cosmetically sensitive sites. Annual skin cancer screening available. Call (310) 998-5533. We serve patients from Santa Monica, Beverly Hills, Brentwood, Pacific Palisades, Malibu, and all of Los Angeles.
How is melanoma diagnosed?
Melanoma is diagnosed by skin biopsy. Dr. Sierro first evaluates every suspicious mole with dermoscopy — a handheld device that illuminates and magnifies the subsurface structure of the lesion to identify atypical features before biopsy is recommended. When dermoscopy reveals concerning features, a biopsy is performed under local anesthesia and the tissue is sent to a pathology laboratory. The pathology report confirms or rules out melanoma, identifies the melanoma subtype, measures the Breslow thickness, and provides the information needed to plan the complete excision and any additional staging workup. Call (310) 998-5533.
Does melanoma have to be surgically removed?
Yes. Surgery is the primary treatment for all localized melanomas. The entire tumor must be removed with a surrounding margin of normal skin whose width is determined by the thickness of the melanoma. There is no topical cream, injection, or laser that substitutes for surgical excision of invasive melanoma. For melanoma-in-situ the margin is 0.5cm, for thin invasive melanomas it is 1cm, and for thicker melanomas it is 2cm. Advanced melanomas that have spread to lymph nodes or organs require systemic therapy in addition to surgery. Dr. Sierro performs excision for localized melanomas and coordinates the complete care pathway for more advanced-stage disease. Call (310) 998-5533.
Related Resources at Kare Skin Health Center