A scar that starts changing can be unsettling, particularly in Australia, where melanoma is one of the most commonly diagnosed cancers. So, do scars get melanoma? A scar does not usually ‘turn into’ melanoma. However, melanoma can develop in skin close to a scar, be mistaken for a scar-related change, or very occasionally appear within scarred skin. Any new, growing, bleeding or changing spot in or around a scar deserves timely medical assessment.

Knowing what is normal healing and what needs a closer look can prevent both unnecessary worry and dangerous delay. Every minute counts when a suspicious skin lesion is involved.

Do scars get melanoma?

Most scars are not at risk of becoming melanoma simply because they are scars. A scar is fibrous tissue formed as the skin repairs after an injury, surgery, burn, acne lesion or other wound. It may remain paler, darker, firmer, itchy or slightly raised for months, and sometimes much longer. These features can be normal.

Melanoma begins in melanocytes, the cells that produce pigment in the skin. It is not generally understood as a cancer caused by an ordinary scar. Research has described rare melanomas occurring in scar tissue, but this does not mean scars commonly become cancerous. In many cases, it is difficult to know whether the cancer arose because of the scar, was present before the scar formed, or developed nearby by chance.

The practical message is straightforward: do not ignore a new or changing mark because you assume it is only scar tissue. A clinician should examine a concerning area, especially if it looks different from the rest of the scar or continues to change after healing should be complete.

Why a changing scar needs attention

Scars change as part of normal healing. In the first weeks and months, they can look red or pink, feel tender or itchy, and become raised before gradually settling. A surgical scar can also have small bumps from dissolving stitches. These changes should generally improve over time rather than keep progressing.

A spot needs assessment when it is new, enlarging, becoming darker or more irregular, or behaving unlike the surrounding scar. Melanoma does not always look like a dark brown or black mole. Some melanomas are pink, red, skin-coloured or almost colourless. This is known as amelanotic melanoma, and it can be mistaken for a pimple, irritated scar, eczema or a slow-healing wound.

Arrange a skin check promptly if you notice a lump, sore, pigmented patch or mole in or near a scar that is changing. Seek urgent medical advice if it bleeds without a clear reason, becomes ulcerated, develops persistent pain, or will not heal.

Signs that should not wait

Use the familiar ABCDE warning signs as a guide for pigmented marks: asymmetry, an irregular border, varied colour, a diameter that is increasing or a lesion that differs from others, and evolution over time. But do not rely on these signs alone. A small lesion can still be melanoma, and an amelanotic melanoma may not show obvious pigment.

Pay attention to the ‘ugly duckling’ sign too. If one area in or beside a scar looks noticeably different from your other spots, it is worth checking. Your own observation matters. You are most likely to notice when something has changed.

For scars from burns, chronic wounds or old injuries, a long-standing sore that breaks down, thickens, oozes or fails to heal also needs medical review. Chronic scars and wounds are more classically associated with certain forms of squamous cell carcinoma than melanoma, but no persistent change should be diagnosed at home.

A previous melanoma scar requires particular care

If the scar is from a melanoma excision, report changes to your treating doctor or skin cancer clinician without delay. A new pigmented area, nodule, persistent redness or altered texture near the surgical site may be harmless healing or irritation, but it may also need investigation for local recurrence or a new skin cancer.

This does not mean every itch or lump signals that melanoma has returned. Stitches, nerve healing, sun exposure and scar maturation can all cause symptoms. The safest approach is not to guess. Your clinician can compare the area with previous records, examine it with dermoscopy and decide whether monitoring, imaging or biopsy is needed.

People who have had melanoma also have a higher risk of developing another melanoma elsewhere on the skin. Continue regular full-skin checks as advised, rather than focusing only on the original scar.

Can an injury or scar cause melanoma?

An injury does not cause melanoma in the usual sense. People sometimes link a melanoma to a knock, cut or abrasion because they first notice the spot after the injury. More often, the trauma has drawn attention to a lesion that was already there.

Similarly, a mole that is rubbed by clothing or nicked while shaving is not automatically dangerous. What matters is whether it keeps changing, bleeding or failing to settle. Repeated irritation can make assessment harder, so it is sensible to have it checked rather than repeatedly treating it as a minor injury.

Sun exposure remains a major preventable risk factor for melanoma in Australia. Ultraviolet radiation can damage skin cells over time, including skin around scars. A scar does not remove the need for sun protection. Cover healing scars where practical, use broad-spectrum SPF50+ sunscreen on exposed skin, seek shade and wear protective clothing, a broad-brimmed hat and sunglasses.

Who should be especially alert to scar changes?

Anyone can develop melanoma, including people with darker skin. In people with skin of colour, melanoma may be diagnosed later because suspicious changes are less expected or harder to identify. Check scars and the rest of the skin, including palms, soles, nails and less sun-exposed areas.

Be particularly proactive about skin checks if you have had melanoma or other skin cancers, a strong family history of melanoma, many moles, fair skin that burns easily, frequent sunburns, substantial outdoor work or recreation, or immunosuppression. Living in a high-UV part of Australia increases the value of regular sun protection and professional assessment of suspicious changes.

A changing scar in a child or young adult should also be assessed rather than dismissed because of age. Melanoma is less common in younger people, but it can occur.

What happens at a skin check?

A GP, dermatologist or experienced skin cancer clinician will ask when the scar changed, how quickly it has progressed, whether it is painful or bleeding, and whether you have a history of skin cancer. They may examine the scar and surrounding skin with a dermatoscope, a specialised lighted magnifier that helps identify patterns not visible to the naked eye.

If the area looks suspicious, the clinician may recommend a biopsy or excision. This is the only way to confirm whether a lesion is melanoma or another condition. A biopsy can sound daunting, but early diagnosis provides the best chance of simple, effective treatment.

Take a clear photo of the area before your appointment if you can, particularly if the appearance comes and goes. Note the date and any symptoms. Do not use home freezing products, acids or other treatments on a changing lesion before it is assessed, as this can delay diagnosis and alter the appearance of the skin.

Do not wait for certainty

You do not need to decide whether a changing scar is melanoma before booking an appointment. That is the clinician’s job. You only need to recognise that a new, unusual or evolving area deserves a professional look.

Most changing scars will not be melanoma. But reassurance is most valuable when it follows a proper examination, and early action can be lifesaving when a skin cancer is found. If a scar or the skin around it is changing, arrange a skin check soon. Knowledge can save your life.