Page last updated: December 2025
The information on this webpage was adapted from Understanding Melanoma - A guide for people with cancer, their families and friends (2025 edition). This webpage was last updated in December 2025.
Expert content reviewers:
This information is based on Australian clinical practice guidelines, and was developed with the help of a range of health professionals and people affected by melanoma:
- A/Prof Rachel Roberts-Thomson, Medical Oncologist, The Queen Elizabeth Hospital, SA
- A/Prof Robyn Saw, Surgical Oncologist, Melanoma Institute Australia, Royal Prince Alfred Hospital and The University of Sydney, NSW
- Alison Button-Sloan, Consumer
- Dr Marcus Cheng, Radiation Oncologist Registrar, Alfred Health, VIC
- Prof Anne Cust, Deputy Director, The Daffodil Centre, The University of Sydney and Cancer Council NSW, Chair, National Skin Cancer Committee, Cancer Council, and faculty member, Melanoma Institute Australia
- Prof David Gyorki, Surgical Oncologist, Peter MacCallum Cancer Centre, VIC
- Dr Rhonda Harvey, Mohs Surgeon, Dermatologist, Green Square Dermatology, The Skin Hospital, Darlinghurst and Sydney Melanoma Diagnostic Centre, RPA, NSW
- David Hoffman, Consumer
- A/Prof Jeremy Hudson, Southern Cross University, James Cook University, Chair of Dermatology RACGP, Clinical Director, North Queensland Skin Cancer, QLD
- Dr Damien Kee, Medical Oncologist, Austin Health and Peter MacCallum Cancer Centre and Clinical Research Fellow, Walter & Eliza Hall Institute, VIC
- Angelica Miller, Melanoma Community Support Nurse, Melanoma Institute Australia, WA
- Romy Pham, 13 11 20 Consultant, QLD
- A/Prof Sasha Senthi, Radiation Oncologist, Alfred Health, and Clinical Research Fellow, Victorian Cancer Agency, VIC
- Dr Chistoph Sinz, Dermatologist, Melanoma Institute Australia, NSW
- Dr Amelia Smit, Research Fellow, Melanoma and Skin Cancer, The Daffodil Centre, The University of Sydney and Cancer Council NSW
- Nicole Taylor, Clinical Nurse Consultant, Crown Princess Mary Cancer Centre, Westmead Hospital, NSW
Surgery is the most common treatment for melanoma that is found early (stages 0–2 or localised melanoma). If found early, 90% of melanomas can be cured with surgery alone.
If the risk of the melanoma spreading is high or it has spread to nearby lymph nodes or tissues (stage 3 or regional melanoma), treatment may also include removing lymph nodes and additional (adjuvant) treatments.
Your doctor may suggest you have drug treatment before surgery (neoadjuvant treatment). For support and information, call Cancer Council 13 11 20.
Your guide to best cancer care
A lot can happen in a hurry when you’re diagnosed with cancer.
The guide to best cancer care for melanoma can help you make sense of what should happen. It will help you with what questions to ask your health professionals to make sure you receive the best care at every step.
Read the guide
Surgery (wide local excision)
After an excision biopsy, most people diagnosed with melanoma will require a second surgery to remove more skin from around the melanoma. This is known as a wide local excision and is the main treatment for early melanoma.
Removing more skin around the melanoma reduces the risk of it coming back (recurring) at that site. The width of the margin is usually 5–10 mm, depending on the type, thickness and location of the melanoma.
For thicker tumours, or tumours with certain characteristics, a wider margin of up to 20 mm may be advised. A wide local excision is often performed as a day procedure, so you can go home soon after the surgery if there are no complications.
If the melanoma is thicker than 1 mm or is considered to have a high risk of spreading to the lymph nodes, the doctor will discuss the risks and benefits of having a sentinel lymph node biopsy.
If you need a sentinel node biopsy, it is done at the same time as the wide local excision.
Repairing the wound
The wound is often closed with stitches. You will have a scar but this will usually become less noticeable with time. If a large area of skin is removed, the surgeon may repair the wound using skin from another part of your body. This can be done in 2 ways:
- Skin flap – Nearby skin and fatty tissue are lifted and moved over the wound from the edges and stitched.
- Skin graft – A layer of skin is taken from another part of your body (most often the thigh or neck) and placed over the area where the melanoma was removed. The skin grows back quickly, usually over a few weeks.
Whether the surgeon does a skin flap or graft will depend on a number of factors, including where the melanoma was and how much tissue has been removed. In either case, the wound will be covered with a dressing.
After several days, the doctor will check to see if the wound is healing properly. If you had a skin graft, you will also have a dressing on any area that had skin removed for the graft.
What to expect after surgery
Most people recover quickly after a wide local excision to remove a melanoma, but you will need to keep the wound clean.
- Pain relief – The area around the wide local excision may feel tight and tender for a few days. Your doctor will prescribe pain medicine if necessary.
- Skin change – If you have a skin graft, the area that had skin removed may look red and raw immediately after the operation. Over a few weeks to months, this area will heal, and the redness will fade.
- When to seek advice – Talk to your doctor if you have any unexpected bleeding, bruising, infection, scarring or numbness after surgery
- Wound care – Your treatment team will tell you how to keep the wound clean to prevent it from becoming infected. Occasionally, the original skin flap or graft doesn’t heal. In this case, you will need to either have a dressing on the wound for longer or have another procedure to create a new flap or graft.
- Recovery time – The time it takes to recover will vary depending on the thickness of the melanoma and how much surgery was required. Most people recover in 1–2 weeks. Ask your doctor how long to wait before returning to your usual exercise and activities.
Managing scars
Surgery for melanoma often leaves a scar, but this usually fades with time. If you’re worried about how the scar looks, you can use cosmetics, hairstyles and clothing to help cover the scar.
Look Good Feel Better is a national program that helps people manage appearance-related effects of cancer treatment.
Learn more about Look Good Feel Better
Removing lymph nodes
Many people with early melanoma will not need to have any lymph nodes removed. But if lymph nodes do need to be removed, these are a few ways it can be done:
Sentinel lymph node biopsy
If the melanoma is thicker than 1 mm or has high-risk features, you may have a sentinel lymph node biopsy at the same time as the wide local excision.
Further scans and treatment
If a sentinel lymph node biopsy shows melanoma in the removed node, you will need to have regular imaging scans to check that the melanoma has not come back or spread.
You may also be offered drug therapy to reduce the risk of the melanoma returning.
Lymph node dissection
If your lymph nodes feel or look swollen, and a fine needle biopsy confirms that a lymph node contains melanoma, you may need to have all the lymph nodes in that area removed under a general anaesthetic.
This operation is called a lymph node dissection or lymphadenectomy, and may mean a longer stay in hospital.
Side effects of lymph node removal
Having your lymph nodes removed can cause side effects. These can be milder if you have a sentinel lymph node biopsy compared with having all of the lymph nodes from an area removed (lymph node dissection).
- Wound pain – Most people will have some pain after the operation, which usually improves as the wound heals. Sometimes, the pain may last longer or be ongoing. Talk to your treatment team about how to manage any pain.
- Neck/shoulder/hip stiffness and pain – These are the most common problems if lymph nodes in your neck, armpit or groin were removed. You may find that you cannot move the affected area as freely as you could before the surgery. It may help to do gentle exercises or ask your GP or treatment team to refer you to a physiotherapist.
- Seroma/lymphocele – This is a collection of fluid in the area where the lymph nodes have been removed. It is a common side effect and usually appears 7–10 days after surgery. It usually gets better after a few weeks, but sometimes fluid may need draining with a needle.
- Lymphoedema – This is a swelling of the neck, arm or leg that may appear after the lymph nodes are removed. Lymphoedema happens when lymph fluid builds up in the affected part of the body because the treatment has damaged or blocked the lymphatic system.
Managing lymphoedema
Your risk of developing lymphoedema depends on the extent of the surgery and whether you’ve had radiation therapy. Lymphoedema can start a few weeks after treatment.
Sometimes it develops several years later. Although it may be permanent, it can usually be managed, especially if treated at the earliest sign of swelling or heaviness.
A lymphoedema practitioner can help you manage lymphoedema. To find a trained practitioner, visit Australasian Lymphology Association or ask your doctor for a referral.
You may need to wear a professionally fitted compression garment. Massage and regular exercise, such as swimming, cycling or yoga, can help the lymph fluid flow.
Keeping the skin healthy can help reduce the risk of infection.
Learn more about lymphoedema
Further treatment
If there’s a risk that the melanoma could come back (recur) after surgery, other treatments are sometimes used to reduce the risk.
These are known as neoadjuvant treatments if used before surgery and adjuvant (or additional) treatments if used after.
They may be used alone or together. Treatments that enter the bloodstream are used if there is a risk a tumour will come back in other parts of the body (further from the regional sites). These are known as drug therapies or systemic treatment.
The main drug therapies for melanoma are:
- immunotherapy – drugs that use the body’s own immune system to recognise and fight some types of cancer cells; can be used before or after surgery
- targeted therapy – drugs that attack specific features within cancer cells, known as molecular targets, to stop the cancer growing and spreading; usually given after surgery.
Rarely, radiation therapy will be used after surgery if there’s a risk the tumour could come back at the original site or to the nearby lymph nodes.
Radiation therapy is the use of targeted radiation to damage or kill cancer cells in a particular area of the body.
Early stage melanoma cancer clinical trials
Cancer clinical trials are research studies that test whether a new approach to prevention, screening, diagnosis, or treatment works better than current methods and is safe.
There are clinical trials for early stage melanoma cancer open to recruitment in Victoria. This list shows the most recently updated early stage melanoma cancer studies on the Victorian Cancer Trials Link (VCTL).
Visit the VCTL to find more early stage melanoma cancer clinical trials.