AAD Releases New Melanoma Management Guidelines


The American Academy of Dermatology (AAD) released new guidelines on the care of primary cutaneous melanoma. New recommendations were developed based on the latest evidence and address new areas in the field, such as genetic testing for hereditary risk and pregnancy.1   

“The guidelines development process included patient advocate and community dermatologist input, and the resulting document emphasizes the importance of the doctor-patient dialogue in all aspects of melanoma management,” said Hensin Tsao, MD, PhD, FAAD, co-chair of the guidelines work group.2

Among the new recommendations:

  • Patients with a family history of melanoma are recommended to receive education and counseling on genetic risk. However, physicians should consider formal genetic testing on a case by case basis as it may not be appropriate for everyone.
  • Due to the lack of evidence that pregnancy increases or affects the prognosis of patients with melanoma, the management of melanoma among pregnant patients should be based on the patient’s health and disease stage. Counseling on future pregnancies should be considered based on the patient’s history and melanoma risk.



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Other recommendations include:

  • Surgical excision is strongly recommended for the treatment of melanoma. However, subtypes of melanoma on certain parts of the body may be treated with Mohs surgery or other forms of staged excision.
  • Topical or traditional radiation therapy may be considered as second-line therapy for patients whom surgery is contraindicated.
  • Electronic brachytherapy is not recommended for melanoma due to the lack of evidence on its efficacy.

“Melanoma is the deadliest form of skin cancer, and we hope these guidelines will help dermatologists and other physicians enhance their delivery of life-saving treatment to patients,” said Susan M. Swetter, MD, FAAD, chair of the guidelines work group.

In addition, the AAD recommends the public conduct regular skin self-exams to identified early signs of skin cancer and to see a board-certified dermatologist if they notice any new or suspicious spots or changes on their skin.


1. Swetter SM, Tsao H, Bichakjian CK, et al. Guidelines of care for the management of primary cutaneous melanoma [published online November 1, 2018]. J Am Acad Dermatol. https://doi.org/10.1016/j.jaad.2018.08.055

2. American Academy of Dermatology Releases Guidelines for Melanoma Treatment [press release]. Rosemont, IL: American Academy of Dermatology; October 30, 2018. https://www.newswise.com/articles/american-academy-of-dermatology-releases-guidelines-for-melanoma-treatment. Accessed November 1, 2018.