Does nail surgery treat melanonychia?

Melanonychia means brown or black pigment appearing in the nail, often as a longitudinal band. It can have harmless explanations, but pigment can also arise from the nail matrix, the tissue that produces the nail, or from a changing lesion that needs closer assessment. Surgery is therefore not chosen simply to make a dark line disappear. A clinician may examine the band, surrounding skin, and other nails before deciding whether observation, a sample, or removal is appropriate. The procedure and its effect on future nail growth depend on the location and depth of the problem.

Arrange a dermatology assessment for a new, changing, or unexplained pigmented band. Bring photographs showing when it appeared and whether its width, colour, or borders have changed. Do not scrape, file, or cover the band with products that make assessment harder. If a sample is advised, ask what area will be sampled, how the result will guide treatment, and how the nail may look while it grows out.

Seek prompt assessment if pigment becomes wider or more uneven, extends onto the skin beside the nail, involves bleeding or a persistent sore, or appears in a single nail without an obvious injury. A band that changes alongside nail lifting, splitting, or a new lump also deserves review. These signs do not identify the cause by themselves; they indicate that an in-person examination should not be delayed.

Ask whether the pigment appears to come from the nail matrix, whether a biopsy is needed, and what alternatives to surgery are reasonable. Clarify the expected nail change, wound care, and how results will be communicated.