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Melanoma in Indian skin: the places it hides | CION Cancer Clinics
In Indian skin, melanoma rarely looks the way it does in textbooks from abroad. It most often appears on the soles of the feet, the palms, under the nails, or inside the mouth and nose. These are places people seldom look, which is why it is so often found late. This page explains where to look, what gets mistaken for what, and what it means for families. At CION Cancer Clinics, our oncologists plan screening and care for families with an inherited cancer syndrome, explained in plain words.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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On this page
- Where does melanoma usually appear in Indian skin?
- Which parts of the body need a deliberate look?
- How does a spot on the foot usually get missed?
- The words you will meet, in plain language
- How melanoma in Indian skin differs from the pattern abroad
- What this page cannot tell you
- Four things families tell us, and what is actually true
- Common questions about melanoma in Indian skin
The short answer
Where does melanoma usually appear in Indian skin?
In Indian skin, melanoma most often appears on the soles of the feet, the palms, under the nails, and on the moist linings of the mouth, nose and genital area. These are places the sun rarely reaches and people rarely look. That is the main reason melanoma in India is so often found late.
Why it differs from fair skin
Darker skin carries more natural pigment, which protects against sun damage. The sun-driven melanomas that are common on the backs and legs of fair-skinned people are therefore much less common here. What remains are types that are not mainly caused by the sun, and these tend to hide.
What this means for families
Most melanoma of the sole, nail or mouth is not inherited. The genes linked to familial melanoma were mostly described in fair-skinned families abroad. Studies in Indian families are few and small, so a counsellor has to weigh your family tree carefully rather than apply foreign rules directly.
Knowing where to look matters more here than knowing which sunscreen to buy.The places to look
Which parts of the body need a deliberate look?
Each of these places has an ordinary explanation that people reach for first. That is exactly how melanoma gets missed.
Soles of the feet and palms
A flat brown or black patch that slowly grows, often on the heel or a pressure point. It is commonly mistaken for a corn, a bruise, a wart or a wound that will not heal.
Under the nails
Usually the big toe or the thumb. It starts as a dark line running along the nail and is often blamed on an injury or a fungus.
Signs that need a doctor
- A single new stripe in one nail
- A stripe that widens or darkens
- Colour spreading onto the skin beside the nail
- A nail that splits or lifts over the stripe
Inside the mouth, nose and genital area
A dark patch on the gums or palate, repeated nosebleeds or a nose blocked on one side, or unexplained bleeding from the vagina or anus. These are rare, but they are found late because nobody looks there.
Ordinary skin still counts
Fairer members of a family, and people with many moles, can still develop melanoma on sun-exposed skin. A full check covers everywhere, not only the hidden places.
Not sure whether this applies to you?
Ask an oncologistA familiar story
How does a spot on the foot usually get missed?
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A dark patch appears on the sole
It does not hurt or itch. Because it is on the foot, nobody sees it except when washing, and it is easy to ignore.
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It is treated as something ordinary
A corn plaster, an ointment from the pharmacy, or a visit to a local practitioner who treats it as a fungal patch. Months can pass this way.
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Someone cuts or burns it
Home remedies, paring with a blade, or caustic applications. These damage the surface and can make the diagnosis harder later.
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It becomes a wound that will not heal
In someone with diabetes, it is often assumed to be a diabetic foot ulcer. Dressings continue and nobody takes a sample.
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A biopsy finally gives the answer
A small piece of tissue is examined under a microscope. The earlier this step happens, the simpler the treatment usually is.
On your report
The words you will meet, in plain language
- Acral melanoma
- Melanoma on the palms, the soles or under the nails. Also called acral lentiginous melanoma.
- Mucosal melanoma
- Melanoma that starts in a moist lining, such as the mouth, nose, throat, vagina or anus.
- Melanonychia
- A brown or black line in a nail. Most are harmless, especially when several nails have had them for years.
- Hutchinson sign
- Dark colour spreading from a nail onto the skin around it. This is a warning sign that needs prompt review.
- Biopsy
- Removing a small piece of tissue to look at it under a microscope. This is the only way to confirm melanoma.
- Uveal melanoma
- Melanoma inside the eye. It behaves differently from skin melanoma and is linked to a different gene.
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Side by side
How melanoma in Indian skin differs from the pattern abroad
Common in fair skin
Common in Indian skin
On the back, legs, arms and face
On the soles, palms, nails and inner linings
Strongly linked to sun exposure
Not mainly caused by the sun
Often seen and noticed early
Often hidden and noticed late
Family genes are well described
Family patterns are far less studied
Being straight with you
What this page cannot tell you
It cannot tell you whether the spot on your foot or nail is melanoma. Only a doctor who examines it, and usually a biopsy, can answer that. A photo sent over WhatsApp is a start, not a diagnosis.
It cannot tell you whether your family is affected
If melanoma has appeared in more than one relative, a genetic counsellor needs to see the whole family tree. What any gene result means for your family is a question for the counsellor who ordered the test.
Who this does not apply to
Most dark spots on Indian feet are harmless moles or pigment. Many people with darker skin have brown lines in several nails from childhood, and this is normal. If a mark has looked the same for years, and nothing has changed, it is very unlikely to be melanoma. A genetic test would not help you either.
What matters is change: a new mark, or an old one that is growing, darkening or bleeding.Commonly believed
Four things families tell us, and what is actually true
"Indians do not get melanoma."
It is less common than in fair-skinned countries, but it does occur. Because people believe they are safe, the signs are often ignored until the disease has advanced.
"A black spot on the foot is just from walking barefoot."
Bruises from walking fade within weeks and move as the skin grows. A patch that stays, grows or changes shape needs a doctor to look at it.
"It is safe to cut or burn off a spot at home."
This damages the tissue a doctor needs to examine and can delay the right diagnosis. Leave it alone and have it looked at properly.
"Sunscreen will protect me from melanoma."
Sun protection helps on exposed skin. It does nothing for the soles, the nails or the mouth. In Indian skin, regular looking matters as much as sunscreen.
Questions we are asked
Common questions about melanoma in Indian skin
Is melanoma common in India?
No, it is uncommon compared with fair-skinned countries. But it is not rare enough to ignore, and it is often diagnosed late here. That is why knowing where it hides, and acting on change, matters more than how common it is.
Why does melanoma appear on the feet in Indian people?
The exact reasons are not fully understood. Darker skin protects against sun-driven melanoma, so the types that are not caused mainly by the sun make up a larger share. Some studies suggest pressure or repeated injury on the sole may play a part, but the evidence is not settled.
Is melanoma on the foot inherited?
Usually not. Most acral melanoma arises from faults that build up in one person's cells. If two or more close relatives have had melanoma anywhere on the body, though, a referral to a genetic counsellor is worth discussing.
I have dark lines in several of my nails. Should I worry?
Probably not. Lines in several nails that have been there for years are common in darker skin and are normally harmless. A single new line in one nail, or one that is widening or spreading onto the skin, is different and needs a doctor.
I have diabetes and a foot wound that will not heal. Could it be melanoma?
Most non-healing foot wounds in diabetes are ulcers, not cancer. But if the wound is dark, sits on a patch that was dark before, or does not respond to proper care, ask your doctor whether a biopsy is needed.
Can melanoma appear inside the mouth?
Yes, though it is rare. It usually looks like a flat dark patch on the gums or the roof of the mouth. Dentists sometimes spot it first. Any new dark patch inside the mouth that grows should be examined.
Who should I see about a spot on my sole or nail?
A dermatologist is the right first step. They can examine the spot with a magnifier and arrange a biopsy if needed. If melanoma is confirmed, you will be referred to an oncologist for treatment planning.
Should my relatives be checked if I have melanoma?
Your doctor will ask about your family history. If you are the only one affected, relatives usually only need to know the signs. If others in the family have had melanoma, their skin checks and a genetic referral are worth discussing.
Your Specialists
Meet CION's oncologists. Bring your family history or genetic report to them.
Our medical oncologists see people with a strong family history of cancer, arrange genetic counselling and testing where it fits, and plan the checks that follow.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
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Sources
- National Cancer Institute — Genetics of Skin Cancer (PDQ) - Health Professional Version
- National Cancer Institute — Melanoma Treatment (PDQ) - Patient Version
- MedlinePlus Genetics — Melanoma
- NHS — Melanoma skin cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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