Dark Spots Under Thick Skin: When to Seek Medical Advice - Dermatology

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Hello, thank you for reaching out with your concerns regarding your mother's skin condition. Given her medical history of melanoma, it's essential to approach any new skin changes with caution and seek professional evaluation. Let's address your questions one by one.

1. If it's dirt, will the body naturally eliminate it? How can it be removed?
If the dark spots under the thick skin are indeed dirt or debris, the body may not always eliminate it naturally, especially if it's trapped beneath a layer of thickened skin. Thickened skin can occur due to various reasons, including friction, pressure, or skin conditions like psoriasis or eczema. If the dark spots are superficial and are indeed dirt, they can often be removed through gentle cleansing. Using a mild exfoliating scrub or a soft brush during bathing can help dislodge any surface debris. However, if the dark spots persist despite cleaning, it is crucial to consult a dermatologist for further evaluation.

2. Could the dark spots be more than just dirt, such as a mole or potentially diseased tissue?
Yes, the dark spots could potentially be more than just dirt. Given your mother's history of skin cancer, any new or changing pigmentation should be taken seriously. The presence of black spots under thick skin could indicate a variety of conditions, including benign moles (nevi), seborrheic keratosis, or even precancerous lesions or skin cancer. Melanoma can sometimes recur or manifest in different areas of the skin, so vigilance is crucial.

It is important to note that changes in the skin, such as new growths, changes in color, size, or shape of existing moles, or any unusual pigmentation, warrant a professional evaluation. A dermatologist can perform a thorough examination and may recommend a biopsy if there is any suspicion of malignancy.
In summary, while it is possible that the dark spots are simply dirt, given your mother's medical history, it is advisable to err on the side of caution. I recommend scheduling an appointment with a dermatologist as soon as possible for a comprehensive evaluation. They can provide a definitive diagnosis and appropriate treatment options if necessary.

Additionally, it’s important to educate your mother on the ABCDEs of melanoma: Asymmetry, Border irregularity, Color variation, Diameter greater than 6mm, and Evolving changes. If she notices any of these characteristics in her skin lesions, she should seek medical attention promptly.

In conclusion, while some skin changes may be benign, your mother's history necessitates a careful and proactive approach. Regular skin checks and consultations with a dermatologist can help ensure any potential issues are addressed early on. Thank you for your inquiry, and I wish you and your mother the best in navigating this health concern.