What should you know about melanoma nail treatment?

Nail-unit melanoma can look like a brown or black band, pigment extending onto nearby skin, a changing patch under the nail, splitting, or a sore that does not settle. A dark band is not automatically melanoma: injury, infection, medication effects, and other benign causes can look similar. A clinician examines the nail and surrounding skin, compares both hands or feet, and may take a tissue sample so a pathologist can identify the cause and measure important features.

Do not cover a changing band with polish or repeatedly trim it before assessment. Take a clear photograph for comparison and arrange dermatology review. If testing confirms melanoma, surgical excision removes the affected tissue with a margin selected for the individual case. The operation may involve part or all of the nail unit; reconstruction and healing depend on the site. Further scans, lymph-node assessment, or immunotherapy may be discussed when pathology suggests a wider risk or spread.

Seek a prompt appointment for new pigment in one nail that widens or changes, pigment reaching the cuticle or fingertip skin, unexplained bleeding, a persistent sore, nail destruction, or a mass under the nail. Seek urgent help for uncontrolled bleeding, spreading redness with fever, or severe pain after a procedure. These signs do not identify the diagnosis on their own, but delay can make assessment harder.

Ask where the sample will be taken, how much nail may be removed, what the pathology report means, whether a sentinel lymph node biopsy is relevant, and how the wound will be dressed. Discuss expected nail regrowth, hand or foot function, warning signs after surgery, and the schedule for follow-up.