When individuals undergo melanoma removal, the expectation is often a complete recovery. While the surgical site typically heals, experiencing pain years later can be concerning. This unexpected sensation prompts questions about its origin and implications. Understanding the potential reasons for such discomfort, and knowing when to seek medical advice, is important for appropriate care.
Distinguishing Normal Healing from Concerning Symptoms
Immediately following melanoma removal, a range of sensations is common as the body recovers. These include mild discomfort, tenderness, numbness, or itching around the incision site, typically subsiding within weeks to a few months. Some individuals might notice persistent mild numbness or altered sensation due to nerve regeneration or minor nerve irritation, usually diminishing over the first year. These sensations are generally considered part of normal healing and rarely indicate a serious underlying issue.
However, pain emerging or intensifying years after melanoma removal differs from typical post-operative recovery. This delayed discomfort is not standard healing. The body should have fully healed from surgical trauma within the first year, making any new or worsening pain a signal that warrants medical attention. Such symptoms suggest a new development, not a lingering effect of the initial surgery.
Common Non-Melanoma Related Causes of Pain
One frequent non-cancerous reason for pain at an old melanoma removal site is nerve damage, also known as neuropathy. During surgical excision, small nerves in the skin and underlying tissues can be cut or irritated. While some nerve fibers regenerate, others may not, leading to chronic sensations like burning, tingling, shooting pain, or persistent numbness. This neuropathic pain can manifest years later as nerve endings become hypersensitive or entrapped within scar tissue.
Scar tissue formation can also contribute to discomfort. After surgery, the body produces fibrous tissue to repair the wound, sometimes leading to excessive scar formation like hypertrophic scars or keloids. These raised, thickened scars can exert tension on surrounding skin and structures, causing pulling, tightness, or constant aching pain. The rigidity of scar tissue can also restrict movement, particularly if excision was near a joint, leading to discomfort during activity.
Localized inflammation or a minor infection can occasionally develop years after surgery. These benign conditions, while less common, can mimic more serious issues and and are often easily treatable.
- An ingrown hair, small cyst, or foreign body reaction to suture material near the scar can trigger an inflammatory response, causing redness, swelling, and pain.
- Pain at the site might also originate from referred pain, stemming from an unrelated musculoskeletal issue or nerve impingement elsewhere in the body.
Melanoma Recurrence and Pain
While less frequent than benign causes, pain at a previous melanoma removal site can signal cancer recurrence. Local recurrence occurs when melanoma reappears at or near the original excision site, often presenting as a new pigmented or non-pigmented lump, nodule, or a change in the scar’s texture or color. Pain in this context often accompanies these visible changes, arising from the growing tumor pressing on surrounding nerves or tissues. The discomfort might feel like a persistent ache, tenderness, or sharp, localized pain.
Melanoma can also recur regionally, spreading to nearby lymph nodes that drain the original tumor area. If these lymph nodes enlarge due to cancer cells, they can cause pain or tenderness in the affected area, such as the armpit or groin, depending on the initial tumor location. This pain might be a dull ache or acute discomfort, usually accompanied by a palpable lump or swelling in the lymph node basin. Regular self-skin checks and consistent dermatologist follow-ups are important for early detection of suspicious changes.
Investigation and Treatment Options
Anyone experiencing new or worsening pain at a previous melanoma removal site, especially with visible skin changes, lumps, or swollen lymph nodes, should promptly seek medical attention. A dermatologist or oncologist is typically the best specialist to evaluate such symptoms. The diagnostic process usually begins with a thorough physical examination of the area and a detailed review of the patient’s medical history, including original melanoma specifics and its treatment.
Further investigation might involve imaging studies to visualize underlying tissues and structures. An ultrasound can help assess superficial lumps or lymph nodes, while an MRI provides more detailed images of soft tissues and nerves. If suspicious lesions or enlarged lymph nodes are identified, a biopsy—removal of a small tissue sample for microscopic examination—is usually performed to determine the exact cause of the pain. This definitively differentiates between benign conditions and melanoma recurrence.
Treatment strategies depend entirely on the underlying cause of the pain. For nerve pain, options include neuropathic medications, nerve blocks, or physical therapy. Pain from scar tissue can often be alleviated with massage, steroid injections, laser therapy, or in rare cases, surgical revision.
If the pain is due to melanoma recurrence, treatment is tailored to the cancer’s stage and location. This may involve surgical removal, radiation therapy, targeted therapies, or immunotherapy, determined in consultation with an oncologist. Ongoing surveillance remains a core component of care for melanoma patients.