Black Spots on Toenails: Signs of Melanoma? - Dermatology

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The appearance of black spots on toenails can indeed be concerning, especially when there are accompanying symptoms such as changes in nail color, texture, and growth rate. Based on your description, it sounds like you are experiencing a combination of symptoms that could potentially indicate a few different conditions, including onychomycosis (fungal nail infection), trauma to the nail, or even more serious conditions such as melanoma.

Firstly, the small black spots you mentioned, which are about the size of a pinhead, could be a result of a few factors. One common cause of black spots under the nails is a condition known as subungual hematoma, which occurs when blood collects under the nail due to trauma. This can happen from stubbing your toe or from repetitive pressure, especially if you wear tight shoes. However, if the black spots have been present for a month and are not associated with a known injury, it is essential to consider other possibilities.

Another potential cause could be a fungal infection, which can lead to discoloration and changes in the nail's texture. Fungal infections often cause nails to become thickened, discolored, and brittle. The yellowing you mentioned could be indicative of such an infection, especially if the nail is also cracking and growing slowly.

However, the most concerning possibility is melanoma, particularly subungual melanoma, which is a type of skin cancer that occurs under the nail. This condition can present as dark streaks or spots under the nail and may be accompanied by other changes in the nail, such as lifting or changes in texture. The fact that your toenail has been raised and has a grayish color, along with the presence of black spots, warrants further investigation.

Given these possibilities, it is crucial to seek a thorough evaluation from a dermatologist or a healthcare professional specializing in nail disorders. They may perform a physical examination and possibly a biopsy of the nail or surrounding tissue to determine the exact cause of your symptoms. Early diagnosis is key, especially if melanoma is a concern, as it can be more effectively treated when caught early.

In terms of prevention and care, maintaining good foot hygiene is essential. This includes keeping your feet clean and dry, trimming your nails straight across to avoid ingrown nails, and wearing well-fitting shoes to prevent trauma. If you have a history of nail problems or if you notice any changes in your nails, it is advisable to consult a healthcare professional promptly.

In summary, while the black spots on your toenail could be due to various benign conditions, the combination of symptoms you described, particularly the changes in color and texture, necessitates a professional evaluation to rule out serious conditions such as melanoma. Please make an appointment with a dermatologist as soon as possible to get a proper diagnosis and treatment plan.