I am running Windows 11 Pro and PSE 20.0 64 Bit. When using the Spot Healing Brush one of the three things will happen:
I have tried doing a tool reset but that has not made any difference.
I have tried it on several photos and had the same problem on all of them.
What are you trying to heal?
Can you give us an example photo with any unexpected result?
What option(s) have you chosen for the tool?
Do your images have multiple layers?
Based on the size/resolution of the photo you have attached (when I download it), it seems to me that you are using too large a brush. When using the Spot Healing brush, you should size the brush to just cover the spot you are trying to remove. You can use the square bracket keys to quickly resize the brush ([ ]).
I removed the white blemish in the screenshot below, using a brush size of 60 px. When I increased the brush to 200 px (as shown in your settings), nothing happens because too large an area is covered.
Let us know if this fixes the problem for you. (I'm not sure whether the forum changes the resolution of the photo when I download it.)
I admit that does seem to work but I am sure I have had the problem with smaller sized brushes. I will try some more files over th enext couple os days and let you know how it goes. Thanks for your help.