Changes in Moles: What to Do About Painful Black Spots

Black mole on the right back?

Doctor, on June 30th, while reaching for my car keys, I felt a sharp pain from behind, which I initially thought was a bee sting and didn’t pay much attention to it.
After two days, I noticed that raising my right hand caused a localized tight, sharp pain.
When I looked in the mirror, I found a black mole in the area where I felt the tight pain.
Could this mole be indicative of any pathological changes?

A-Liang, 20~29 year old female. Ask Date: 2017/07/03

Dr. Wu Yuxin reply Dermatology

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

Reply Date: 2017/07/03

More Info

When it comes to changes in moles, especially when accompanied by pain or discomfort, it is essential to approach the situation with caution. The symptoms you describe—a painful black spot that appeared after an incident—could indicate a few different things, and it is crucial to consider the potential implications for your health.

Firstly, it is important to understand that moles, or nevi, are common skin growths that can vary in color, shape, and size. While many moles are benign, changes in their appearance or the development of new symptoms can sometimes indicate underlying issues, including skin cancer. The fact that you experienced pain in the area of the mole, especially following a physical incident, warrants further investigation.

Pain in a mole can arise from several factors. It could be due to irritation or trauma, especially if the mole was affected during the incident you described. However, persistent pain, especially if it is accompanied by changes in the mole's color, size, or shape, should not be ignored. The appearance of a black spot, particularly if it is new or has changed, can be a cause for concern.

The ABCDE rule is a helpful guideline for assessing moles:
- Asymmetry: One half of the mole does not match the other.

- Border: The edges are irregular, ragged, or blurred.

- Color: The color is not uniform and may include shades of brown, black, or even red, white, or blue.

- Diameter: The mole is larger than 6mm (about the size of a pencil eraser).

- Evolving: The mole is changing in size, shape, or color.

If your mole exhibits any of these characteristics, it is advisable to seek medical attention promptly. A dermatologist can perform a thorough examination and may recommend a biopsy to determine whether the mole is benign or malignant.

In addition to the visual assessment, the history of pain associated with the mole is significant. Pain can sometimes indicate inflammation or irritation, but it can also be a symptom of more serious conditions, including melanoma, especially if the mole has changed in appearance.
Given your situation, I recommend the following steps:
1. Schedule an Appointment with a Dermatologist: It is crucial to have a professional evaluation of the mole. A dermatologist can provide a thorough examination and determine if further testing is necessary.

2. Document Changes: Keep a record of any changes in the mole, including size, shape, color, and any associated symptoms like pain or itching. This information will be helpful for your healthcare provider.

3. Avoid Irritation: Until you can see a doctor, try to avoid further irritation to the area. This includes avoiding tight clothing or any activities that may cause friction against the mole.

4. Follow Up: If the mole changes or if you experience increased pain, swelling, or other symptoms, seek medical attention sooner rather than later.

In summary, while not all changes in moles indicate a serious problem, the combination of pain and a new or changing mole should be evaluated by a healthcare professional. Early detection and treatment are key in managing any potential skin cancer effectively. Your health and peace of mind are paramount, so do not hesitate to seek the care you need.

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