Painful Black Spots Under the Skin: What Could It Be?

There is a hard black object under the skin?

Hello Dr.
Wu, I would like to ask you about a spot on my face that has been painful to the touch for the past few days.
I initially thought it was a pimple, but I just looked in the mirror and noticed it seems to have darkened a bit, and it hurts when I touch it.
I tried to treat it like a pimple and squeezed it, but nothing came out except for some bleeding.
What could this be? It feels a bit scary.
Could it be skin cancer...?

Juzi, 20~29 year old female. Ask Date: 2016/06/12

Dr. Wu Yuxin reply Dermatology

Without actually seeing the lesion, it is impossible to make a definitive diagnosis.
If it is causing significant distress, please seek medical attention as soon as possible.

Reply Date: 2016/06/12

More Info

It sounds like you're experiencing a concerning skin issue, and I understand how distressing it can be to notice a painful black spot on your face. Based on your description, there are several possibilities for what this could be, but it's crucial to remember that only a qualified dermatologist can provide an accurate diagnosis after a thorough examination.

One potential explanation for a painful black spot under the skin could be a type of acne lesion, such as a cyst or a nodule. These can sometimes become inflamed and painful, and if they are manipulated or squeezed, they may bleed without releasing any pus, which can be alarming. Another possibility is a benign skin growth, such as a seborrheic keratosis or a dermatofibroma, which can appear dark and may be tender to the touch.

However, the concern for skin cancer is valid, especially if the spot has changed in color, size, or shape, or if it has become painful. Melanoma, the most serious type of skin cancer, can sometimes present as a dark spot that is asymmetrical, has irregular borders, and varies in color. If you notice any of these characteristics, it is imperative to seek medical attention promptly.

In terms of what you should do next, here are some recommendations:
1. Avoid Picking or Squeezing: It's important not to pick at or squeeze the spot, as this can lead to infection or scarring.

2. Monitor Changes: Keep an eye on the spot for any changes in size, color, or pain level. Documenting these changes can be helpful for your dermatologist.

3. Consult a Dermatologist: Given your symptoms, I strongly recommend scheduling an appointment with a dermatologist. They can perform a physical examination and may suggest a biopsy if they suspect it could be something serious.

4. Sun Protection: Regardless of the nature of the spot, it's essential to protect your skin from sun exposure. Use a broad-spectrum sunscreen with an SPF of at least 30, wear protective clothing, and seek shade when the sun is at its strongest.

5. Healthy Skin Practices: Maintain a good skincare routine that includes gentle cleansing and moisturizing. Avoid harsh products that could irritate the skin further.

6. Be Aware of Other Symptoms: If you experience additional symptoms such as fever, increased pain, or spreading redness, seek medical attention immediately.

In summary, while there are many benign explanations for a painful black spot under the skin, it is crucial to take any changes seriously, especially if they involve pain or color changes. Early intervention can lead to better outcomes, so don't hesitate to reach out to a healthcare professional for advice. Your health and peace of mind are paramount, and a dermatologist will be able to provide the best guidance tailored to your specific situation.

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