Skin cancer on the hand can be caused by sun exposure, but did you know it can affect areas of the skin not exposed to the sun, like the palms of your hands? Whether you’re living with melanoma or worried about developing the condition, it’s important to know the warning signs so you can report symptoms to your doctor right away.

New or changing spots or patches on the palms of the hands may be a sign of a rare type of melanoma called “acral melanoma.” Other types of skin cancer can develop on the backs of the hands, which are often exposed to the sun. Learn the symptoms of melanoma on the hands, who may be more at risk, and when it’s time to see a doctor. Early detection and treatment of skin cancer, including melanoma, is key to successful treatment and a better prognosis.

How Melanoma Can Affect the Hands

Acral melanoma — also called “acral lentiginous melanoma” — develops on the palms of the hands. This form of melanoma is rare, making up only 1 percent to 3 percent of all melanoma cases (about 2,000 to 3,000) each year in the U.S.

Unlike some skin cancers, acral melanoma isn’t thought to be caused by sun exposure and occurs in areas of the body not usually exposed to the sun, like palms of the hands, soles of the feet, and fingernails and toenails, including the nail beds.

Another type of melanoma, amelanotic melanoma, can also develop on the hand. Amelanotic melanoma is rare.

Other Types of Skin Cancer That Affect the Hands

Other types of skin cancer can affect the hand and may be more likely than acral or amelanotic melanomas. For example, squamous cell carcinoma, which makes up 20 percent of all skin cancers, commonly develops on areas on the skin that are frequently exposed to the sun, including the backs of hands. According to the American Society for Surgery of the Hand, squamous cell carcinoma is the most common type of skin cancer of the hand.

Merkel cell carcinoma is another type of cancer affecting the skin that may develop on the back of the hand. Like squamous cell carcinoma, merkel cell carcinoma often develops in parts of the body exposed to the sun, but it’s more rare.

Hand Melanoma: What To Watch For

Melanoma of the hand can look similar to other types of skin melanomas. Usually, melanoma on the hand shows up as an irregular, colored lesion that changes over time. These changes often follow the ABCDE rule, for which the letters stand for:

• Asymmetry — When split in half, one side of the mole doesn’t match the other.
• Border — The edges are no longer rounded and may be irregular, blurred, ragged, or uneven.
• Color — There are several colors within the mole, including shades of brown, tan, black, red, gray, or blue.
• Diameter — The mole is about the size of a pencil eraser or larger, about 6 millimeters across.
• Evolving — The mole has recently changed in shape, size, or color, or it’s spreading onto healthy skin nearby.

For example, melanoma of the hand can show up as something that looks like a mole or birthmark and has the following characteristics:

• Irregular shape and border
• Different colors
• Larger than 1/4 inch
• Looks different over time

Symptoms of Specific Types of Melanoma on the Hand

Symptoms of acral melanoma can look different depending on where the melanoma is located and what stage the cancer is in. Common symptoms of acral melanoma to watch out for include:

• New mole or an existing mole that changes suddenly or gradually and is bigger than other moles
• Tan, brown, gray, or black spot on the palms of the hands or soles of the feet
• Any type of spot on the hands or feet that grows or changes
• Itchy, painful, or bleeding spot on the hands or feet
• Dark, vertical streaks on the toenails or fingernails that may cause the nails to crack or break

Amelanotic melanoma appears as a fleshy, pink lesion, with no pigment, making it look different from the dark, pigmented lesions that are characteristic of melanoma.

Other Skin Conditions on the Hand That Can Look Like Melanoma

Melanoma on the hand can look like other skin conditions and is often misdiagnosed as other less serious conditions, such as a fungal infection. When a doctor suspects melanoma on the hands, they must rule out other skin conditions, such as:

• A benign (noncancerous) mole
• Pigmented basal cell carcinoma (the most common form of skin cancer)
• Dermatofibroma (a benign nodule, usually found on the skin of the lower legs)
• Solar lentigo (age spot)
• Seborrheic keratosis (a noncancerous skin growth)

Risk Factors for Hand Melanoma

Anyone can get melanoma on their hands, but some people may be at higher risk. Risk factors for acral melanoma include older age and darker skin tone. According to research cited in the Journal of Hand Surgery, acral melanoma is more common in people of Asian, African, and Native American heritage, accounting for up to 20 percent of all melanomas in these populations.

Unlike cutaneous melanomas, which usually develop on sun-exposed areas of the skin, acral melanomas aren’t believed to be associated with sun exposure.

Risk factors for melanoma in general include:

• History of ultraviolet (UV) exposure, from the sun or indoor tanning (e.g., tanning beds)
• Fair skin
• Several moles
• History of skin cancer
• Family history of melanoma
• Weakened immune system, such as from medications or a health condition

When It’s Time To See a Doctor

Early detection and treatment is important for a better prognosis (outlook) with melanoma. It’s important to talk to your doctor or dermatologist as soon as you notice any unusual spots on your skin or changes to your skin so that they can assess them for signs of melanoma.

Because melanoma can sometimes look like harmless skin conditions, such as a mole or age spot, it can be difficult to know if and when to be concerned. When in doubt, talk to your doctor to know for sure.

Tests To Diagnose Hand Melanoma

If you have a suspicious spot on your hand, your doctor will do a full skin examination to look for other spots of concern. They will also likely take a biopsy of the spot and surrounding skin to get more details on the lesion, including how thick it is, which can help determine prognosis and treatment. A biopsy entails removing a portion of the spot for examination under a microscope.

You may also need to get a computed tomography (CT) scan or positron emission tomography (PET) scan. Your doctor may also look at the nearby lymph nodes for signs of metastasis, which indicates the spread of cancer cells to other parts of the body.

Prognosis of Hand Melanoma

Melanoma prognosis depends on several different factors, including your age, tumor characteristics, and sex. It also depends on what type of melanoma you have.

Melanoma of the hand is often diagnosed later than melanoma in general, which can lead to worse prognosis. For example, acral melanoma, which forms on the palms, generally has a worse prognosis than cutaneous melanoma, the kind that develops on sun-exposed areas of the skin, as it often goes undetected for longer.

The exact reasons why acral melanoma has a worse prognosis are unknown, but factors that affect prognosis include the stage at diagnosis, tumor size and location, and overall health.

Treatment for Hand Melanoma

Melanoma treatment options vary depending on the stage of the melanoma. For acral melanoma, surgery to remove the tumor is the main treatment option. Other treatments for acral melanoma may be used by themselves or in combination with surgery, including:

• Radiation therapy
• Targeted therapy
• Immunotherapy
• Chemotherapy

These same therapies may be used to treat cutaneous melanoma. However, some therapies that are used to treat cutaneous melanoma don’t work as well for acral melanoma, and research is ongoing to find treatments that better target acral melanoma.

Other types of skin cancer on the hand may have different treatment options. For example, treatment for squamous cell carcinoma, which can develop on the back of the hand, may include:

• Different types of surgery
• Photodynamic therapy
• Topical medication
• Radiation

Treatment options may change with progression of the melanoma based on what is most likely to reduce the risk of the melanoma returning.

Talk With Others Who Understand

MyMelanomaTeam is the social network for people with melanoma and their loved ones. On MyMelanomaTeam, hundreds of members come together to ask questions, give advice, and share their stories with others who understand life with melanoma.

Have you been diagnosed with skin cancer on your palm or the back of your hand? What did it look or feel like? Share your experience in the comments below, or start a conversation by posting on your Activities page.