How effective is nail surgery for melanonychia?

Melanonychia is a dark or brown nail band with several possible explanations, including pigment activity, injury, medicines, infection, or a growth beneath the nail. A clinician considers the band’s pattern, width, colour, change over time, and whether pigment extends onto nearby skin. Nail surgery may lift or remove part of the nail and sample the nail bed or matrix for pathology. The result can guide treatment, but the nail may grow slowly and temporary tenderness, altered nail texture, or a scar can occur.

Do not cover a changing band with polish before an examination. Photograph the nail in natural light if your clinician asks you to track it, and mention trauma, new medicines, family history, or pigment on other nails. After sampling, keep the dressing as directed, protect the fingertip or toe, and attend the pathology review. Do not interpret a darker healing nail as a final result without advice.

Arrange prompt assessment for a new or widening band, several colours, an irregular edge, pigment spreading onto the surrounding skin, nail splitting, bleeding, or a band affecting one nail without an obvious cause. After surgery, report increasing pain, redness, warmth, discharge, fever, persistent bleeding, or wound separation. Rapid change warrants timely review.

Ask what features make sampling appropriate, which nail structure will be examined, how the nail may regrow, when pathology will be available, and what changes should prompt an earlier appointment.