Does Your Pregnancy Make Melanoma More Dangerous?

You likely know that melanoma is a more serious form of skin cancer, but researchers were recently surprised to discover that the disease is even more of a threat if you are pregnant or recently had a baby.

According to research led by Brian D. Gastman, MD, women under the age of 50 who had a diagnosis of malignant melanoma during or soon after pregnancy were significantly more likely to have tumors spread to other organs and tissues, and were more likely to have the cancer come back after treatment.

However, although melanoma is on the rise (particularly in this age group), Dr. Gastman says that very few pregnant women get melanoma.

Still, if you’re pregnant or thinking of getting pregnant, you need to know the risk factors and watch for signs of melanoma.

What puts you at higher risk?

The most obvious risk is already having melanoma. “In my opinion, if you had an active or recently active melanoma, that is a very high risk,” Dr. Gastman says.

He lists several other factors that put you in the high-risk category:

• Any kind of personal history with melanoma.
• A strong history of melanoma in your family.
• Any moles on your body.
• Excessive sunburns or tanning bed use in your past.

“So what that means then, if you are a patient who is in a higher risk category, you should see your dermatologist anyway,” he says.

What warning signs should you watch for?

If you’re pregnant and in the high-risk category, you should do a self-examination monthly during your pregnancy and throughout the year after you have your baby, Dr. Gastman says.

Look for moles, and if you have them, look for the “ABCDE” signs of melanoma, If you see one or more, call your doctor or dermatologist.

The ABCDE signs of melanoma are:

• Asymmetry – If you draw an imaginary line down the center of your mole, will both halves match? If they do not, it’s asymmetrical which is a warning sign for melanoma.
• Border – The borders of a benign mole typically are smooth and even. Irregular borders could indicate melanoma.
• Color – A variety of colors, even different shades of the same color, within your mole is a warning signal. A dark black mole is a warning sign as well.
• Diameter – Another cause for concern is if the suspected lesion is greater than 6mm in diameter.
• Elevation – The most important warning sign is if your mole changes size or texture, or begins to bleed.

You may see changes in your skin as a normal part of pregnancy, but Dr. Gastman cautions against ignoring the changes he describes. “It’s a ‘see something, say something’ kind of thing,” he says.

“These changes can occur naturally because pregnancy induces hormonal skin changes,” he says. “As a result, many women don’t take these signs seriously because their mother or a friend would tell them the same thing happened to them and it’s normal. But it is not necessarily normal. These warning signs are all concerning.”

Talk to your doctor if you have risk factors

To ensure that you’re receiving the best care possible, take an active role in your own care — especially if you have some risk factors.

In addition to checking for skin and mole changes, tell your doctor about excessive sun or tanning exposure, or a personal/family history of skin cancer.

“Your physician should take you seriously if you’re worried,” says Dr. Gastman. “They should tell you if they are comfortable managing this for you. If they are uncomfortable, they should refer you to a colleague in dermatology.”

Expect a dermatologist to give you a full head-to-toe and “everywhere the sun doesn’t shine” skin examination, he says. If you don’t feel comfortable with a full exam, discuss your concerns with that doctor, or find a new one.

“If you're pregnant and have melanoma risk factors, you should see a dermatologist a minimum of twice during your pregnancy — or at every trimester,” says Dr. Gastman. “Continue doing that at least a year after the pregnancy, because we've found you’re still at high risk during that time.”