The fear of melanoma has become deeply ingrained in people's minds. Particularly regarding black spots, such as moles or dark spots that appear on toenails, many people are especially fearful. This is especially true for those with sensitive or suspicious personalities, or individuals who subconsciously project health information they read onto themselves. These people may be even more prone to this kind of fear.

Several months ago, a young man in his twenties returned to Beijing from his hometown. While washing his feet, he noticed a dark spot on the nail plate of his big toe. It wasn't painful or itchy, but it immediately reminded him of melanoma he'd read about online. Could this be melanoma? Instantly, he broke out in a cold sweat all over. He couldn't sleep at all that night, his mind completely consumed by thoughts of melanoma.

Unfortunately, he had very important work the next day and couldn’t take time off to go to the hospital, leaving him unsettled the entire day. Having followed my medical science articles online daily, he took the opportunity during his break to consult with me online, expressing his intense fear and sending me a photo of the dark spot on his big toe.

The photo showed a very typical case of subungual hemorrhage—definitely not what he feared, melanoma. I reassured him, explaining that melanoma never appears suddenly; it develops over many years, and given his young age—only in his 20s—it was highly unlikely. I pointed out that the dark spot was clearly beneath the nail plate with well-defined borders, likely caused by factors like ill-fitting shoes, prolonged standing, or extensive walking, which can lead to subungual bleeding. This type of bleeding often causes no pain or itching, so many people discover it by accident.

It took intermittent communication with him over ten to twenty interactions before his doubts were eased. Still somewhat concerned, he visited my clinic a few days later. I performed a dermatoscopy, a painless examination that clearly distinguishes between subungual hemorrhage and melanoma, providing objective evidence that it was indeed just subungual bleeding, not melanoma. This finally eliminated his worries completely.

The absorption of such subungual hemorrhage can take several months. A few months later, he messaged me privately to say the bleeding under his toenail had completely disappeared and everything was back to normal, making him very happy.

I'm very happy too.