Signs and Symptoms of Melanoma

National Skin Cancer Awareness Month may be behind us, but with summer stretching ahead, now is a better time than ever to think about the impact of skin cancer and importance of sun protective behaviors. Melanoma is the deadliest form of skin cancer, accounting for most skin cancer-related deaths. The American Society of Clinical Oncology estimates that more than 100,000 adults will be diagnosed with this disease in 2020 alone, with the number of cases having increased significantly during the past 30 years. The following are some of the most common signs and symptoms of melanoma that our Charleston, SC, Germain Dermatology team reminds patients to look out for during self-checks.

Melanoma occurs if the cells that give the skin color (melanocytes) begin to develop abnormally. The only way to know for sure if the skin lesion you’re concerned about is cancerous is to have it checked by a dermatologist. As symptoms of cancer vary widely, it can be difficult tell whether a mole is cancerous or not without careful scrutiny and—in many cases—a biopsy.

With that said, the ABCDE method offers some simple guidelines for what to watch for at home. Melanoma may present with one or more of these characteristics, so finding a mole that fits any of these criteria can be cause for concern:

  • Asymmetry: The shape of one half isn’t identical to the other.
  • Border: Watch out for irregular or “blurry” borders, with pigment spreading to surrounding skin.
  • Color: Normal moles are typically a solid black, brown, or tan color. Melanomas are usually black or brown but may be mottled and can show uneven pink, blue, red or white.
  • Diameter: Many melanomas are larger across than a typical pencil eraser.
  • Evolving or Elevation: Be wary of moles changing over time or displaying new symptoms, such as bleeding.

Any new, unexpected growths or changes to existing spots on your skin should be closely monitored—especially if they develop different textures, weeping/bleeding, or itching. Another symptom sometimes associated with melanoma is partial loss of sight or growing dark spots forming on the iris.

This summer, you can practice sun safety by protecting your skin from dangerous rays. Stay out of sun when it is strongest (between 10 a.m. and 2 p.m.), apply high-SPF sunscreen frequently (even on overcast days), and wear protective sunglasses and head covers.

Find out more about prevention and treatment of melanoma and other forms of skin cancer from Germain Dermatology in Charleston, SC. Talk to us today by calling (843) 881–4440 or send us a message.

5 Skin Cancer Risk Factors to Consider

Ensuring the long-term health and beauty of your skin means always being diligent about sun protection—yes, even during the cool, mild weather associated with early spring in Charleston, SC. Skin cancer treatment and prevention are both important to our team at Germain Dermatology. Fortunately, this disease, which occurs due to the uncontrollable development of mutated skin cells in the surface layer of the skin, is highly preventable.

While skin cancer can appear anywhere on the body, it typically occurs on parts that receive the most sun exposure, such as the scalp, face, lips, neck, chest, hands, and arms. Note that growths can also show up on parts that are usually covered up.

Anyone who is concerned about skin cancer should consider the following risk factors.

Excessive Sun Exposure

Skin cancer risk rises with unprotected, prolonged or intense exposure to harmful UV radiation from the sun or artificial sources. Not wearing sunscreen or protective clothing increases your risk. People who live in hot climates or high altitudes are more susceptible. Cumulative skin damage from multiple blistering sunburns significantly raises the risk of melanoma, the deadliest form of skin cancer.

Skin Type

Skin cancer can occur on all skin tones and ethnicities. However, people who naturally have very fair skin that usually burns instead of tanning, red or blond hair, and light eyes are more prone to getting sunburned and developing skin cancer. These people typically freckle or redden easily.

Abnormal Moles

Having a large number of moles or unusual moles (dysplastic nevi) are factors that may be linked to skin cancer. Patients should monitor their skin for any spots or blemishes that look different from other moles and new growths.


Your family history will also be a strong influence on your skin cancer risk. People who have close family members like parents or siblings who have had skin cancer should be more vigilant about protecting their skin.

Weakened Immune System

Some diseases, infections, and medications can cause a suppressed immune state that makes developing skin cancer more likely.

Want to learn more about skin cancer warning signs, prevention, and treatment? The Germain Dermatology team would be more than happy to address any questions or concerns you have. Visit us in Charleston, SC, call 843-881-4440 to speak directly with us, send a message online, or use our online booking tool to get in touch.

When does a mole become suspicious looking? What do you do?

Your skin remembers sun exposure from the time you were a baby. It accumulates and shows up in later years.

Dr. Germain recommends people begin routine check ups in their 20s, especially if there is a family history of skin cancer. 

Patients visiting the dermatologist for the first time will go through a full-body screening.

“We check them from head to toe,” Dr. Germain says they also teach patients how to do a self-check by “standing in front of a full-length mirrors with no clothes on, look at the front of them, back of them, underarms, private area, palms, soles, everywhere.”

Don’t forget to check your head. Have your hair dresser check when you go to the salon next. What should be looking for?

Dr. Germain says spots that are brown, black, red, or flesh-colored. Women should also be checked when they visit their OB/GYN.

“Anything that is changing, growing, bleeding, not healing,” Dr. Germain says should be checked by a doctor.

Other skin cancer signs and symptoms include areas that itch and stand out.

Video story courtesy of WCBD-TV and reporter Laura Smith.

Call us for your skin check in Summerville or Mount Pleasant (843)881-4440.

Precancerous Mole- Now What? ~ Germain Dermatology

What do atypical (or pre-cancerous) skin biopsy results mean? Many patients wonder if this should be cause for concern or just a warning sign.  When interpreting atypical biopsy results it is important to understand the facts related to your specific health history, as not all diagnoses of atypical mean the same thing. 

Medically speaking ‘atypical’ moles biopsied during a skin exam (most commonly a shave biopsy) are unusual-looking benign (noncancerous) moles. In atypical/precancerous results a pathologist sees abnormal features under the microscope but not enough to clinically diagnose the results as melanoma

If the doctor removed all the margins of the atypical area (meaning the edges of the sample showed no precancerous cells) he/she will evaluate your medical history and create the appropriate plan moving forward, most likely suggesting your next skin exam in 6 months opposed to 12 (especially for those who have a personal or family history with melanoma). 

If the margins in the sample were not clear  and the degree of atypical was moderate to server the doctor may have you return for a further biopsy to make sure all atypical cells are removed, this is also likely if  have a history of skin cancer.

Most melanomas arise in normal, not atypical, skin so unless you have a higher risk factor your result of atypical/precancerous is just a friendly nudge to perform self skin exams, be diligent about your sun safety and regularly see your dermatologist. 

Over due for your appointment? Have a spot you’re suspicious of? Call today and make an appointment with our new medical dermatologist- Dr. Ashton Rountree


REMINDER: Skin Cancer is REAL. Get Checked.

Some of you may have seen a recent article from the Post and Courier regarding the rise in Melanoma cases. The patient interviewed for this article is one of our own Germain Dermatology patients, Natalie Grantham, and she has offered to shed some extra light on her brush with cancer and her experience with Melanoma with each of you.

We hope you all take a moment to read and realize that this can happen to anyone, and with regular skin checks you too can save your life. 

“I don’t remember when I started seeing a dermatologist but I know I was in high school. It was something both my parents took seriously and something they just led me to do. I always seemed to have a mole or freckle removed at my annual skin checks, but nothing was ever out of the ordinary. 

I moved to Charleston in 2009 and began to see Dr. Germain and her staff for my yearly checkups. In early 2014 I went in for my annual screening and they removed a tiny, literally pin sized, dark spot from my lower stomach/pubic area. A few weeks later they called to let me know that the spot was atypical (showed pre cancerous cells), luckily they had gotten all the margins and told me, as a precaution, I should begin doing skin checks every 6 months, instead of annually. 
The first A-Typical Spot found in 2014.

This past November (2016) I went in for my skin check with Germain Dermatology and saw Physician Assistant Holly Carter. Due to day-to-day life this skin check was about 8 months past when I should have been back in for a screening. At my appointment Holly removed 4 spots (two on my back, one on my upper arm and one on the top of my thigh) that didn’t look quite right to her.

To my surprise less than two weeks later Dr. Germain called me personally to let me know that the spot on my thigh came back as Melanoma, and that I needed to schedule an appointment for a MOHs procedure as soon as possible. Luckily Dr. Joseph McGowan III (MOHs Surgeon at Germain Dermatology) had an opening the next day and I made the appointment. 
My Diagnosis was Clark’s Level II-III Malignant Melanoma with .45MM margins. I have since learned that these margins are SMALL for which for the incision and depth they had to go is terrifying. 

Melanoma found in November 2016
In the Photo with purple marker this is the border they cut- removed the affected tissue and some muscle then closed it back together. I had about 17-20 stitches. Pathology has come back and Dr. McGowan got 100% of the margins and this spot is ALL CLEAR!
*Not to mention I am healing beautifully with minimal scarring & no issues with recovery!

I am always very cautious about new spots or things changing and I knew this spot didn’t look right- it was the first thing I pointed out to Holly at my appointment. I also should have been more rigorous about getting in every 6 months. Had I gone in a few months earlier the possibility of me catching it before it was malignant was great— on the flip side had I waited even another 4 weeks the possibility of them sending me to an oncologist was vast as well. I will now be doing checks ever 3 months until I have a clear biopsy then back to every 6 months for the rest of my life… and you can bet I will be in that door every 6 months! 

What do I think caused it? Tanning Beds. As an adult I know so much more about how horrible tanning beds are for you and I  lived in them all through my youth. As far as family history goes my Maternal Uncle had Malignant Melanoma removed a few years back, but nothing else that my family knows of. People also think that if they wear sunscreen now, as they age, they are safe- most melanoma is caused from damage created years ago that arises with age. No matter how safe you are now melanoma can surface. 
Moral of the story- GET CHECKED!
If you see a dermatologist, if you pay attention to your body- you will catch melanoma early enough. Knowledge & prevention is key! Your skin is your largest organ and people don’t understand the danger of where ‘Skin’ Cancer can spread and how fast it does. 

Dr. McGowan checks all my lymph nodes (neck, arm pits, groin) at each appointment just to be safe. The three other A-Typical spots removed have also been further excised and we are anxiously awaiting the all clear on those.” 

Natalie with Dr. Germain at a previous Skin Check.
We thank Natalie for sharing her real life story with us, and hope her personal account and shock of Melanoma encourages you to be a little extra sun safe and to see a dermatologist regulary. To read her feature in the Post and Courier click here

Mark Your Calendars! Melanoma Monday- May 2nd

May is Melanoma Awareness Month and we kick it off with Melanoma Monday
We encourage everyone to wear Orange with us in observance of Melanoma and Skin Cancer Awareness on Monday, May 2nd.  
Join us to encourage sun safety this Summer. 

  • Each year in the U.S. over 5.4 million cases of nonmelanoma skin cancer are treated in more than 3.3 million people.
  • Each year there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon.
  • Over the past three decades, more people have had skin cancer than all other cancers combined.

Up Close with Lauren ~ Melanoma Awareness Edition

Just like our patients, our Germain staff suffers from common skin issues, the occasional breakout and even wrinkles! Ever wonder what they do to look so fabulous? Find out on our Staff Blog post. Each month we will feature a different staff member their favorite products, routines, skin care battles and more. May’s feature is in honor of Melanoma Awareness month.

Lauren Whitehead

Laser Specialist and
Head of Cosmetic Department
35 years young

Two years ago Lauren had three moles biopsied, which returned as severely atypical.  Growing up in South Carolina Lauren was out in the sun constantly and admits she didn’t apply sunscreen as often as she should have, sacrificing safety for a nice tan (which many of us can relate to). During her 20’s Lauren joined the Germain team and began to understand the importance of protecting herself from the sun.

Now, Lauren states, “I do not go outside anymore without applying sunscreen with a physical block 30 minutes prior to going out.  With the diagnosis of atypical moles I am seen regularly for my full skin exam.  I am thankful that my kids are sun conscience as well, so hopefully they won’t have to worry in the future.

 Skin Type:  Combination Skin, Melasma
Morning Skin Care Regimen:  
Brightening Polish
Skin Ton Enhancement Pads 6%
Magic Eyes
Advanced Vitamin C Brightening Serum
Matte Perfection SPF 50+
Night Time Skin Care Regimen:
Skin Enhancing Cleanser 10%

Rejuvenation Pads 10x
Magic Eyes
Skin Enhancing Treatment Cream 20%

Favorite Germain Rx Product(s):
Magic Eyes
Matte Perfection SPF
Favorite Cosmetic Procedure(s):  

It is so hard to say what my favorite cosmetic procedure is as I have been with Dr. Germain for 8 years and have had everything done.  I absolutely love Fraxel and Coolsculpting.  
I suffer from melasma which is a hormonal pigmentation disorder, Fraxel has helped keep my melasma under control. I have also had Coolsculpting on my abdomen, flanks, and outer thighs!  The results are amazing.   

Lauren has also become a fan of the new Clear + Briliant Permea as it has been successful at treating her melasma without the downtime of Fraxel. 
Favorite Facial Make-Up:
 Jane Iredale Liquid Minerals
Best advice from Dr. Germain:

“It is a journey not a race.  You don’t have to do everything at once.” 
Lauren’s Best Advice:

“If you do a little bit of a lot you will have better results.”

Beating Melanoma~ Real Story of a Survivor

Meet Hayley
Melanoma Survivor

Hayley is a vibrant, fun-loving 35 year old mother of two. She has been a patient with us at Germain Dermatology for several years. Hayley recently visited us for a cosmetic appointment when Dr. Germain noticed a mole on her left calf. When asked about the area Hayley mentioned that it had been bothering her a bit as it had become mildly sensitive to the touch and more raised then usual. Although the mole had been there her whole life-the usually inconspicuous spot had developed many characteristics of an abnormal mole.

Upon closer examination Dr. Germain immediately decided the mole needed to be evaluated.  She performed a biopsy and sent it to the lab for pathological evaluation. Pathology results returned and the diagnosis was Invasive Malignant Melanoma, Stage 1. Hayley returned the next day and had the entire Melanoma removed by Dr. McGowan, one of our on staff Mohs Surgeons. 

Luckily in Hayley’s case the cancer was caught early enough that removal wasn’t too intrusive, nor did the cancer spread. Melanoma is one of the fastest growing cancers, and any delay in diagnosis can cost you a life. If not caught early the melanoma can form roots that grow through the other skin layers and fatty tissues allowing cells the chance to enter the bloodstream and lymphatic system.

“It is so important to work with your dermatologist to make sure that you are checking your moles for any changes. Besides seeing your dermatologist once a year, doing self-exams at home may save your life. Every month you need to stand in front of a full length, well lit mirror with no clothes on.  Look at the front of you, your sides and underarms.   Then take a hand held mirror and look and your back, private area palms and soles — everywhere! If there is anything that you notice that is growing, changing or different, see your dermatologist. It may save your life,” says Dr. Germain.

Haley admits her Melanoma was probably caused from too much unprotected sun exposure through her younger years, but also notes skin cancer runs in her family —  her mother is also a melanoma survivor.

Since her diagnosis and treatment Hayley is avid about wearing sunscreen at all times, not just on beach days, and takes precautions to avoid sun exposure whenever she can. She has continued skin checks with Dr. Germain as well as doing at home self checks.

For Hayley skin cancer truly hit home. She urges everyone to, “Be aware, know your body and pay attention to anything that may be abnormal. When in doubt, check it out!”