I’m a 64-year-old woman. Four months ago, I noticed a dark triangular shaped spot on my cheek. What could it be?
Dark spots on the face can mean several things, depending on the race, complexion, genetic or familial history, age, history of sun exposure or sunburns, history of taking certain medications, particularly oral contraceptive pills, history of physical or chemical injury to skin, or history of any aggressive/ablative skin treatments etc. or pregnancy-related facial skin darkening conditions such as melasma or cholasma in women. However, in your case, the sudden appearance of the spot and your mention of its increase in size is of some concern.
At your age, appearance of pigmented seborrhoeic keratosis (SK) is commonly seen in fair complexioned individuals, particularly those with a positive family history of similar skin eruptions. These lesions are of a benign nature and nothing to worry about. At the same time very similar-looking brownish-black lesions called lentigens – or commonly known as liver spots – can cause confusion in its clinical diagnosis. These lesions also mostly appear under a genetic influence, but carry the rare risk of transforming into a skin cancer called lentigo maligna melanoma. In a vast majority of sufferers, doctors remain deceived and end up diagnosing them as freckles, which are totally benign.
My best advice is that you consult an experienced dermatologist as soon as possible. In addition to a close clinical examination, your pigmented lesion needs to be assessed through mole mapping as well, which is the most modern diagnostic tool that can help in the early detection of malignant melanoma. A skin biopsy might also be required to confirm or rule out any of the suspected diagnoses.
After ruling out all serious concerns, if the lesion is determined to be a simple pigmentation alteration, then we can effectively take care of it with one of the many available treatment modalities.