Black Spots on the Areola: Causes and Treatments

Areola hyperpigmentation

Dear Dr.
Yuan,
Hello, I am a male.
I would like to consult about 2 to 3 dark spots on my left areola, each approximately 0.3 cm or smaller, oval in shape, and generally brownish-black in color.
They are slightly raised above the surface of the areola.
I initially thought these dark spots were moles, but I find it strange that exactly 2 to 3 spots are located on the areola (it feels like they are confined to that area), and they are slightly elevated rather than being flat junctional nevi.
I have not noticed any similar spots on my right areola.
Recently, I researched and found that the dark spots on my left areola could possibly be seborrheic keratosis.
I would like to ask you the following questions:
Q1.
Is the areola a common site for seborrheic keratosis?
Q2.
If the dark spots on my left areola are indeed seborrheic keratosis, will they undergo malignant transformation if left untreated, especially due to frequent friction and irritation from clothing?
Q3.
If the dark spots on my left areola are indeed seborrheic keratosis, what methods do dermatologists typically use to remove these spots (such as electrosurgery, laser treatment, cryotherapy, or surgical excision)?
Thank you for your guidance, Dr.
Yuan.

Kris, 40~49 year old female. Ask Date: 2023/06/06

Dr. Yuan Tianmin reply Breast and Thyroid

I am concerned that it might be melanoma, but it's best to visit a dermatology clinic or outpatient department for confirmation.

Reply Date: 2023/06/06

More Info

Understanding black spots on the areola can be concerning, especially when they appear suddenly or change in appearance. Based on your description, it seems you have a few black spots on your left areola that are small, oval-shaped, and slightly raised. You mentioned considering the possibility of these being seborrheic keratosis, which is a common benign skin condition. Let’s address your questions one by one.

Q1: Is the areola a common site for seborrheic keratosis?
Seborrheic keratosis can occur on various parts of the body, including the chest, back, and face. While it is less common for seborrheic keratosis to appear specifically on the areola, it is not impossible. These growths are generally harmless and can vary in color from light tan to black. They are often mistaken for moles or other skin lesions. If the spots are indeed seborrheic keratosis, they are typically not a cause for concern unless they change in size, shape, or color.

Q2: If the black spots are indeed seborrheic keratosis, will they undergo malignant transformation due to friction from clothing?
Seborrheic keratosis is a benign condition and does not typically transform into cancer. However, any skin lesion that experiences constant friction or irritation can potentially become inflamed or irritated, which might lead to changes in appearance. While it is unlikely for seborrheic keratosis to become malignant, it is always wise to monitor any skin changes and consult a dermatologist if you notice significant changes or if the spots become painful or bleed.

Q3: If the black spots are confirmed to be seborrheic keratosis, what treatment options are available?
If you decide to have the black spots removed, dermatologists have several methods at their disposal. Common treatments for seborrheic keratosis include:
1. Cryotherapy: This involves freezing the growth with liquid nitrogen, causing it to fall off after a few days.

2. Electrosurgery: This method uses an electric current to burn off the growth.

3. Laser Therapy: Laser treatments can effectively remove seborrheic keratosis with minimal scarring.

4. Surgical Excision: In some cases, the dermatologist may opt to surgically cut out the growth, especially if it is large or if there is uncertainty about the diagnosis.

5. Topical Treatments: While not commonly used for removal, some topical treatments may help in managing the appearance of seborrheic keratosis.

It’s essential to have a proper evaluation by a dermatologist to confirm the diagnosis and discuss the best treatment options based on your specific situation. They will also be able to differentiate between seborrheic keratosis and other potential skin conditions, including moles or other types of lesions that may require different management.

In conclusion, while the presence of black spots on the areola can be concerning, they are often benign. Regular monitoring and consultation with a healthcare professional are crucial for peace of mind and to ensure proper skin health. If you have any further concerns or if the spots change, do not hesitate to seek medical advice.

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