Is nodular melanoma always dark or black?

No. About one-third of nodular melanomas are not pigmented, and they are often pink, red, or skin-colored rather than dark. This is a major reason they are missed, so don't dismiss a fast-growing firm lump just because it isn't black or brown.

How fast does nodular melanoma grow?

Nodular melanoma typically enlarges over weeks to months rather than years. It skips the slow surface-spreading phase that other melanomas go through and grows vertically into the skin from the start, which is why it is often thicker at diagnosis.

How is nodular melanoma different from a normal mole?

A normal mole is usually flat or only slightly raised, stable in size, and unchanged over time. Nodular melanoma is a firm, raised lump that grows noticeably over weeks to months and may bleed or ulcerate. Any new bump that is elevated, firm, and growing should be checked.

Can nodular melanoma be cured?

Yes, especially when caught early. Surgical removal of a thin, early nodular melanoma is often curative. Because this subtype grows quickly, the best outcomes come from getting a suspicious lump evaluated and biopsied as soon as possible.

Learning›Skincare Basics

Nodular Melanoma: The Fast-Growing Skin Cancer That Hides in Plain Sight

Q: What is the survival rate for nodular melanoma?

In a US population study using the SEER database, the five-year relative survival was 53.7% for nodular melanoma, compared with 87.3% for superficial spreading melanoma, among patients diagnosed from 2004 to 2009. These numbers reflect that nodular melanoma is often caught late; melanoma found and treated early has a much better outlook.

June 5, 2026

You noticed a new bump on your skin a few weeks ago, and now it looks bigger, firmer, or has started to bleed. It may not even be the dark brown or black color you'd expect from skin cancer. That fast change is exactly what makes nodular melanoma worth taking seriously, and why getting it checked quickly matters so much.

Nodular melanoma is an aggressive form of skin cancer, but caught early it is very treatable. Here's what it is, how to spot it, and when a new or changing lump should send you to a dermatologist right away.

What is nodular melanoma?

Nodular melanoma is a type of cutaneous (skin) melanoma that grows as a raised, firm lump rather than a flat spot. It is the second most common subtype of melanoma after superficial spreading melanoma, accounting for roughly 15% of all melanoma cases. Despite being less common, it is responsible for a disproportionate share of melanoma deaths because of how aggressively it grows.

What sets nodular melanoma apart is its growth pattern. Most melanomas spread outward across the surface of the skin first (a horizontal or radial growth phase) before going deeper. Nodular melanoma skips that step. It grows straight down into the skin from the start, which is why it tends to be thicker, more often ulcerated, and diagnosed at a later stage than other types.

What does nodular melanoma look like?

This is where nodular melanoma can be deceiving. People expect melanoma to be a dark, irregular mole, but nodular melanoma is often not dark at all. According to DermNet, about one-third of nodular melanomas are not pigmented, and their color is most often black, red, or skin-colored. That means a fast-growing firm lump that is pink, red, or flesh-toned can absolutely be a melanoma.

Common features to watch for include:

A firm, dome-shaped lump that protrudes above the skin
Rapid growth over weeks to months, not years
Often larger than a common mole
Color that may be black, blue-black, or brown, but also pink, red, or skin-toned
A surface that may bleed, crust, or develop an open sore (ulceration)

The EFG rule: why ABCDE often misses nodular melanoma

The familiar ABCDE rule (Asymmetry, Border, Color, Diameter, Evolving) was built around flat, pigmented moles, so it can miss a melanoma that is raised and colorless. That is where the EFG rule helps. A new lesion that is elevated, firm, and growing over days to weeks deserves prompt evaluation, even if it doesn't look like a classic melanoma.

Elevated: the lesion is raised above the skin
Firm: it feels hard or firm to the touch
Growing: it has been getting bigger over the past few weeks to a month

Nodular melanoma vs. superficial spreading melanoma

The key difference is speed and depth. Superficial spreading melanoma is the most common type and usually spreads slowly along the skin's surface, giving it more of the classic flat, multi-colored, irregular appearance. Nodular melanoma grows down and outward as a lump, with most of the tumor sitting below the surface.

That difference shows up starkly in survival data. In a large US population study using the SEER database, the five-year relative survival was 53.7% for nodular melanoma versus 87.3% for superficial spreading melanoma among patients diagnosed between 2004 and 2009, a gap of more than 33 percentage points. Survival improved somewhat in the more recent 2010 to 2015 cohort (61.5% for nodular melanoma versus 89.7% for superficial spreading melanoma), but the gap between the two subtypes remained wide. Importantly, these figures reflect tumors that were often caught late. Melanoma found and removed early, before it grows deep, has a much better outlook, which is exactly why fast action on a changing lump matters.

How nodular melanoma is diagnosed and treated

Diagnosis starts with a clinical and dermoscopic exam, but because nodular melanoma can lack the usual visual clues, a skin biopsy is the only way to confirm it. A pathologist examines the tissue and measures the tumor's depth (Breslow thickness), checks for ulceration, and assesses how quickly the cells are dividing (mitotic rate). Nodular melanomas tend to score higher on all three because of their vertical growth.

Treatment depends on stage but typically begins with surgical removal of the tumor along with a margin of healthy skin. Depending on thickness and other findings, a doctor may recommend a sentinel lymph node biopsy and, for more advanced disease, additional therapies such as immunotherapy or targeted drugs. Your dermatologist and care team will tailor the plan to your specific diagnosis.

When to see a doctor

Because nodular melanoma moves fast, timing is everything. Make an appointment promptly, and ask for urgent evaluation, if you notice a skin lesion that is:

Do not wait to see whether a fast-growing, firm bump goes away on its own. A quick skin check is simple, and if it turns out to be nothing, you've lost nothing. If you're unsure whether a spot warrants a visit, a clinician-overseen skin assessment, like the kind Nolla offers, can help you decide whether it's time to be seen in person.

New and growing over just weeks to months
Raised, firm, and dome-shaped
Bleeding, crusting, or forming an open sore
Changing in size, shape, or color, even if it isn't dark
Different from your other moles and spots

Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting any new skincare treatment, especially if you have underlying health conditions, are pregnant, or are taking medications.