What Does Melanoma Look Like in Albinism?
At a Glance
In people with albinism, melanoma typically lacks pigment and appears as a pink, red, or skin-colored bump, or a bleeding sore. Because visual checks are difficult, patients should use the EFG criteria to feel for spots that are Elevated, Firm, and continually Growing.
In this answer
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In individuals with oculocutaneous albinism type 2 (OCA2), melanomas typically do not look like the dark, brown, or black irregular moles that most people are taught to watch out for [1][2]. Because your body produces very little or no melanin (pigment), if you do develop a melanoma, it is highly likely to be an amelanotic melanoma—a melanoma that lacks typical pigment [1][3]. Rather than appearing as a dark spot, an amelanotic melanoma usually shows up as a pink, red, or skin-colored bump, a scaly patch, or a sore that bleeds and fails to heal [2][4][5].
Because these spots lack pigment, they are notoriously difficult to identify. They are frequently mistaken for harmless skin conditions, bug bites, or other types of skin cancers that are very common in people with albinism, such as squamous cell carcinoma or basal cell carcinoma [6][7][8]. For this reason, relying on the traditional “ABCDE” rule (looking for Asymmetry, irregular Borders, varied Color, large Diameter, and Evolution) is often unhelpful for people with OCA2 [9][10].
How to Spot Amelanotic Melanoma: The EFG Criteria
Because OCA2 also causes severe visual impairment, visually scanning for faint pink patches on pale skin can be incredibly difficult or impossible. Dermatologists recommend using the EFG criteria [9][11]. This tool is specifically designed to catch nodular and amelanotic melanomas [10], and it relies heavily on how a spot feels, making it much more practical if you have low vision. You (or a trusted sighted partner) should check for any spot that has these three features:
- Elevated: The spot is raised above the surface of your skin [9]. You can feel that it is not flat like a freckle.
- Firm: The bump feels firm or hard to the touch [9], rather than soft or squishy.
- Growing: The spot is continually getting larger over time [9][11].
What Else to Watch For and How to Check
In addition to using the EFG criteria, you should be on alert for lesions with the following characteristics:
- Red or pink patches: They may be ill-defined and look like a patch of irritated skin or a minor rash that won’t go away [2][4].
- Scaly textures: The surface of the spot might be rough, dry, or peeling [2][12].
- Unhealing sores: Any sore, ulcer, or scab that bleeds, oozes, or does not completely heal within a few weeks should be evaluated [5][13].
Tips for Self-Exams with Low Vision
- Rely on touch: When you are in the shower and your skin is wet and soapy, run your hands over your skin to feel for any rough, elevated, or firm spots.
- Enlist a trusted helper: Have a sighted partner, family member, or caregiver routinely check areas you cannot see or clearly focus on, like your back or scalp.
- Track changes: If you or a helper spot a suspicious lesion, consider using a smartphone magnifier app or taking reference photos with a coin or ruler next to the spot to accurately track if it is growing before your dermatologist appointment.
Because your visual impairment makes finding these faint spots challenging, and because amelanotic melanomas can mimic harmless spots and tend to be diagnosed at a later stage [14][4], routine professional skin exams are absolutely critical [15][16]. When your dermatologist spots a suspicious pink or red bump, they will likely perform a biopsy (removing a small sample of the tissue) because it is the only definitive way to diagnose an amelanotic melanoma [17][3][18].
Common questions in this guide
What does melanoma look like if you have albinism?
Why is the ABCDE rule unhelpful for people with albinism?
What are the EFG criteria for checking skin?
How can I perform a skin self-exam if I have low vision?
Questions to Ask Your Doctor
Curated prompts to bring to your next appointment.
- 1.Given my visual impairment, how frequently should I be coming in for full-body professional skin exams?
- 2.Do you use dermoscopy (a special lighted magnifying tool) to examine my pink or skin-colored spots during my exams?
- 3.What is the best way for me to contact your office if I or my caregiver feel a new, firm bump on my skin between scheduled appointments?
- 4.Are you experienced in distinguishing between amelanotic melanomas, squamous cell carcinomas, and benign skin lesions in people with albinism?
Questions For You
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References
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This page provides educational information on spotting melanoma in individuals with albinism. It is not a substitute for professional medical advice or routine professional skin exams.
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