The warning is real: A hard “pimple” that’s still there after a few months with no sign of going away may be a deadly cancer.
“The most concerning things that can present in this manner are skin cancers: melanoma, SCC and BCC,” says Erum Ilyas, MD, a board certified dermatologist who performs adult and pediatric medical dermatology, cosmetic dermatology and skin cancer treatment with Schweiger Dermatology Group.
• Nodular melanoma — above image (very deadly if not caught early; fast growth). It’s hard.
• Nodular squamous cell carcinoma (growth not as fast as NM; but can still metastasize and kill)
• Basal cell carcinoma (very slow growing, usually never metastasizes; death is exceedingly rare)
“A harmless ‘pimple’ should last about two to three weeks,” says Dr. Erum.
A typical pimple — which contains oil, bacteria and harmless debris — will not stay on your face for two months when left alone.
Common harmless pimple
“It will go through natural stages of first ‘developing,’ then ‘coming to a head’ or to its peak size, then healing,” explains Dr. Erum.
“It may remain pink or discolored after this point for a few more weeks, but in general should be flat and no longer palpable.”
Two Months and You Still Have the Same Hard Pimple?
“Concerning ‘pimples’ are ones that do not naturally proceed through these stages,” says Dr. Erum.
“They develop and appear as though they will come to a head or to their peak size. Then, they do one of a few things.
“They either persist as they are without healing, they continue to enlarge, or they progress through stages where they appear to be attempting to heal only to recur again and not quite go away.
“The most common to present in this manner, the classic ‘blind pimple’ that doesn’t heal, would be a basal cell carcinoma.
Basal cell carcinoma. Shutterstock/Dermatology11
Basal cell carcinoma. Shutterstock/Dermatology11
“In their initial stages they can be difficult to distinguish from benign lesions.
“Many times patients tell me they tried to pop it, but just couldn’t seem to get anything out of it.
“Or, they say they thought it was going to heal but it kept growing back.
“Squamous cell carcinoma can present this way as well.” SCC’s can really look like pimples , as in the one below.
Squamous cell carcinoma
Since when does melanoma look like a pimple?
Few melanoma pamphlets warn of a growth that looks like a zit.
Dr. Ilyas explains, “Nodular melanoma is a very aggressive form of melanoma that can develop rapidly.
“I have had patients tell me they watched what looked like a pencil dot develop into the size of a grape in less than three weeks.
“These do not always have a ‘core’ — they can often be smooth or dome shaped. The key that tells you it should not be there is just how quickly it develops.”
Nodular melanoma. Source: pcds.org.uk
Nodular melanoma
Features that Make a “Pimple” Highly Suspect for Skin Cancer
1 After a few months it hasn’t budged.
2 Especially, after two months it’s bigger.
3 Very firm and hard.
4 Upon close inspection you realize it doesn’t quite look like other pimples you’ve had.
If you’ve seen photos of basal cell carcinoma, they may have been of very invasive forms – in which patients ignored the progressing growth for many years.
When ignored, BCCs can invade neighboring tissues and cause a gruesome situation.
But in their early form, a basal cell cancer can look like a pimple. It can even seem to heal, but it will come back if this happens.
So if you’ve had an untouched pimple for two months that finally “went away,” but then it returned…have a dermatologist inspect it.
No need to panic. BCC is the most common overall cancer in the world but extremely rarely fatal – and in fatal cases the patient ignored it for many years.
A BCC may initially appear as a little pimple with a blackhead that you could squeeze out, but then it doesn’t heal like a pimple should.
Should you panic over a hard pimple that you still have after two months?
Don’t lose sleep tonight, but next day book an appointment with a dermatologist.
As far as incidence rates, it’s far more likely to be a basal cell carcinoma, as this is diagnosed in 750,000 Americans every year according to the Skin Cancer Foundation.o months hard
Dr. Ilyas is the founder of the AmberNoon line of fashionable sun-protective clothing.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
