Dark spot on my nose - any guess what I have? (Photo)

Question

It started as a line but it continued to widen. I am a little bit concerned as I believe it will continue to get wider. Any guess what I have?

Anna Chacon, MD, FAAD · Answer

As a board-certified dermatologist, a dark spot on the nose that started as a thin line and is now widening is something I would take seriously.

There are a few possibilities. The most common would be a solar lentigo (sun spot) or post-inflammatory pigmentation, especially if there has been sun exposure. However, the key detail you mentioned is that it is continuing to expand, which makes me more cautious.

On the face—particularly the nose—we always have to consider lentigo maligna, an early form of melanoma that can present exactly this way: a slowly enlarging, flat, brown patch that starts subtly and gradually widens over time. These lesions can look deceptively benign early on.

That does not mean this is melanoma, but it does mean it should not be treated blindly with lasers or creams without a diagnosis.

The next step should be an in-person evaluation with dermoscopy, and if there is any uncertainty, a small biopsy. This is quick and helps definitively rule out anything concerning.

If it turns out to be benign, treatment is straightforward (topicals, lasers, or light-based devices). But first, the priority is making the correct diagnosis.

When a spot is changing or growing, it always deserves a closer look rather than watchful waiting.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Dark spot on my nose - any guess what I have? (Photo)

Answers (2)

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