Black Spots on Ankles: When to See a Dermatologist - Dermatology

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When it comes to the appearance of black spots on the skin, particularly around the ankles and wrists, it is essential to approach the situation with caution and seek professional medical advice. Based on your description, the black spots are approximately the size of a ten-cent coin, non-painful, and some are peeling. These characteristics can suggest a variety of dermatological conditions, and while your doctor previously assessed them as "okay," the progression and new developments warrant further evaluation.


Possible Causes of Black Spots
1. Post-Inflammatory Hyperpigmentation: This occurs after an inflammatory skin condition, such as eczema or psoriasis, where the skin darkens in response to injury or irritation. If you have had any previous skin issues, this could be a contributing factor.

2. Fungal Infections: Conditions like tinea (ringworm) can cause dark patches on the skin, often accompanied by peeling or flaking. These infections can spread and may require antifungal treatment.

3. Dermatological Conditions: Other skin conditions, such as lichen planus or seborrheic keratosis, can present as dark spots. These are generally benign but can sometimes require treatment if they become bothersome.

4. Melanoma: Although less common, changes in the skin, especially new spots that appear suddenly or change in appearance, can be concerning for melanoma, a type of skin cancer. Characteristics to watch for include asymmetry, irregular borders, multiple colors, and a diameter larger than a pencil eraser.

5. Other Causes: Conditions such as acanthosis nigricans, which is associated with insulin resistance, can also cause dark patches, typically in skin folds.


When to See a Dermatologist
Given the recent development of spots on your wrists and the existing spots on your ankles, it is advisable to consult a dermatologist. Here are some reasons to seek further evaluation:
- Change in Appearance: If the spots are changing in size, shape, or color, this is a significant reason to see a dermatologist.

- New Symptoms: The emergence of new spots, especially in different areas of the body, should be assessed to rule out any systemic issues.

- Persistent Symptoms: If the spots do not resolve or continue to spread, a professional evaluation is warranted.

- Concern for Skin Cancer: If you have any concerns about the possibility of skin cancer, it is crucial to get a thorough examination. Early detection is key in managing skin cancers effectively.


What to Expect During a Dermatology Visit
During your visit, the dermatologist will likely perform a thorough examination of your skin. They may ask about your medical history, any previous skin conditions, and any other symptoms you may be experiencing. If necessary, they might conduct a skin biopsy to analyze the tissue and determine the exact nature of the spots. This procedure is typically quick and involves minimal discomfort.


Conclusion
In summary, while your initial visit to the doctor provided some reassurance, the emergence of new spots and changes in your skin's appearance necessitate a follow-up with a dermatologist. They can provide a comprehensive evaluation, accurate diagnosis, and appropriate treatment options. Remember, it is always better to err on the side of caution when it comes to skin changes, especially those that are new or evolving. Taking proactive steps can lead to better outcomes and peace of mind regarding your skin health.