We present a new technique for melanocytic lesion segmentation, Mimicking Expert Dermatologists' Segmentations (MEDS), and extensive tests of its accuracy, speed, and robustness. MEDS combines a thresholding scheme reproducing the cognitive process of dermatologists with a number of optimizations that may be of independent interest. MEDS is simple, with a single parameter tuning its “tightness”. It is extremely fast, segmenting medium-resolution images in a fraction of a second even with the modest computational resources of a cell phone-an improvement of an order of magnitude or more over state-of-the-art techniques. And it is extremely accurate: very experienced dermatologists disagree with its segmentations less than they disagree with the segmentations of state-of-the-art techniques, and in fact less than they disagree with the segmentations of dermatologists of moderate experience.