Follow-up after melanoma: visits, scans, and self-exams

How often doctors see you after melanoma treatment by stage, when scans are used, how to check your own skin and lymph nodes, and what recurrence looks like.

Follow-up after melanoma has 2 purposes. The first is to catch a recurrence of the original melanoma early. The second is to find any new skin cancer, since having had 1 melanoma raises the risk of another.

How often doctors see you, by stage

The schedule depends on the stage at diagnosis. The NCCN Guidelines for Patients (2025 edition) lay out the following pattern, and your own doctor may adjust it.

• Stage 0 (melanoma in situ): a skin exam at least once a year. Scans and blood tests are not recommended.
• Stage IA to IIA: a history and physical exam, with attention to the skin and lymph nodes, every 6 to 12 months for 5 years, then yearly. Scans are done only to investigate a specific sign or symptom.
• Stage IIB to IIC: an exam every 3 to 6 months for 2 years, then every 3 to 12 months for 3 years, then yearly. Scans every 3 to 12 months for the first 2 years and every 6 to 12 months for another 1 to 3 years may be used to look for recurrence.
• Stage III and stage IV with no sign of disease: a similar or tighter schedule of exams, with imaging as the oncologist advises.

Yearly skin exams continue for life at every stage. At each visit the doctor examines the scar, the nearby lymph node areas, and all of the skin.

When scans are used

For stage 0 through IIA melanoma, guidelines reserve imaging for symptoms, because routine scans find very few recurrences and cause many false alarms.

From stage IIB upward, the chance of spread to internal organs is high enough that many oncologists order CT or PET/CT scans, and often brain MRI, at intervals for the first several years. Schedules differ between centers within the NCCN ranges above.

A special case applies after a positive sentinel lymph node biopsy when the remaining nodes were left in place. NCCN recommends monitoring that lymph node area with ultrasound or other imaging at regular visits, so any growth is found while it can still be removed.

Checking your own skin and lymph nodes

The American Cancer Society recommends a skin and lymph node self-exam once a month.

1. Use a bright room, a full-length mirror and a hand mirror. Look at every surface, including the scalp, behind the ears, between the toes, the soles, and the genital area.
2. Look at the scar and the skin around it. Feel for any new bump in or under the skin, colored or skin-toned, between the scar and the nearest lymph nodes.
3. Check your moles for change in size, shape or color, and look for the ugly duckling: a spot that looks unlike your others.
4. Feel the lymph node areas with flat fingertips: the neck and above the collarbones, both armpits, and both groins. Compare left with right.

Report a new lump under the skin, a firm or growing lymph node, a spot that is changing, bleeding or itching, or any new spot that persists.

How and when melanoma comes back

Recurrence takes several forms. A local recurrence grows in or next to the scar. Satellite and in-transit metastases are small deposits in or under the skin, within 2 cm of the scar (satellites) or farther along the path to the lymph nodes (in-transit). A nodal recurrence shows up as a lump in the nearby lymph nodes. Distant recurrence involves organs such as the lungs, liver, brain or bone, or skin far from the original site.

According to AIM at Melanoma, most recurrences appear in the first 2 to 3 years after treatment, which is why visits are most frequent then. Melanoma can also return 10 or more years later.

The risk of a second, unrelated melanoma

A new primary melanoma differs from a recurrence. It starts fresh in a different patch of skin, driven by the same sun history, skin type and genes that produced the first. Doctors stage it separately, and regular skin exams tend to catch it while thin.

Other skin cancers are more frequent still. In the KEYNOTE-716 trial of patients with stage IIB and IIC melanoma, about 1 in 9 people in the placebo group were diagnosed with a new skin cancer of some kind (melanoma, basal cell carcinoma or squamous cell carcinoma) during a median follow-up of a little over 4 years (Leachman and colleagues, JAMA Network Open, 2026).

Life after treatment: sun, family, paperwork and pregnancy

Sun protection still matters after a melanoma diagnosis. The American Academy of Dermatology advises seeking shade in the middle of the day, wearing protective clothing, a wide-brimmed hat and sunglasses, using a broad-spectrum, water-resistant sunscreen of SPF 30 or higher, and never using tanning beds.

Tell your parents, siblings and children about your diagnosis. The American Cancer Society notes that melanoma risk is higher in people with a first-degree relative who has had melanoma, and that about 1 in 10 people with melanoma has a family history of it. A baseline skin exam makes sense for them. Families with several melanomas, or melanoma at a young age, can ask about genetic counseling.

Keep your own copies of pathology reports, scan reports, and a list of drug treatments with dates. Ask for a survivorship care plan that sets out your visit schedule, warning signs, and who to call. The American Cancer Society also stresses keeping health insurance in place.

Pregnancy after melanoma is a common question with no single answer. Timing depends on the stage, the recurrence risk in the first few years, and any drug treatment, since some cancer drugs require contraception for months after the last dose. Raise the subject with the oncologist early.