Black Spots on Toenails: Is It Melanoma?

Small black spots on the nails?

I'm not a doctor, but if you noticed a red spot on the upper left corner of your big toe that has since turned into a small black dot, it is important to have it evaluated by a healthcare professional.
While it could be a benign condition, changes in the skin, especially in the form of new growths or color changes, can sometimes indicate more serious issues such as melanoma.
Please consult a dermatologist for an accurate diagnosis and appropriate management.

AN, 20~29 year old female. Ask Date: 2017/06/13

Dr. Wu Yuxin reply Dermatology

Medical regulations stipulate that "physicians must personally examine patients before administering treatment or prescribing medications," and therefore, online diagnosis is also not permissible.

Reply Date: 2017/06/13

More Info

When it comes to black spots on toenails, it is essential to approach the situation with caution and seek a professional medical evaluation. The appearance of a black spot, especially if it changes in color or size, can be concerning and may warrant further investigation.
From your description, the initial red area on your toenail that transitioned into a black spot could be indicative of several conditions. One possibility is a subungual hematoma, which is a collection of blood under the nail that can occur due to trauma. This condition typically presents as a dark red or black spot and may not be painful unless there is significant pressure or if the nail is damaged.
Another possibility is a benign condition known as a melanonychia, which is characterized by a brown or black pigmentation of the nail. This can be due to various reasons, including increased melanin production, which can occur from trauma, certain medications, or systemic conditions. However, it is crucial to differentiate between benign melanonychia and malignant conditions such as melanoma.

Melanoma of the nail, known as subungual melanoma, is a rare but serious form of skin cancer that can present as a dark streak or spot under the nail. It is often accompanied by other symptoms such as changes in the nail's texture, shape, or growth pattern, and it may also cause pain or discomfort. The absence of pain does not rule out the possibility of melanoma, making it essential to have any new or changing pigmentation evaluated by a dermatologist.

Given the potential seriousness of nail changes, I strongly recommend that you consult a dermatologist as soon as possible. They will likely perform a thorough examination of the nail and surrounding tissue, and if necessary, a biopsy may be performed to determine the nature of the pigmentation. Early detection is crucial in the case of melanoma, as treatment outcomes are significantly better when the condition is caught early.

In terms of prevention and care for your nails, maintaining good hygiene is essential. Regularly trimming your nails, avoiding trauma to the nail area, and keeping your feet dry can help prevent fungal infections and other nail disorders. If you have a history of skin cancer or any other risk factors, regular skin checks by a healthcare professional are advisable.

In conclusion, while the black spot on your toenail could be due to a benign condition, it is vital to have it evaluated by a healthcare professional to rule out any serious conditions such as melanoma. Early diagnosis and treatment are key to ensuring the best possible outcome. Please do not hesitate to seek medical attention for your concerns.

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