What should you know about melanoma under nail?

A dark nail mark may follow an injury, represent a harmless pigment band, or come from infection or medication. Melanoma can produce a brown or black band that widens, develops uneven shades, extends onto the surrounding skin, or causes nail splitting and lifting. A single affected nail or a new change in an existing band deserves attention.

A clinician examines the nail plate, nail bed, and surrounding skin. They may use magnification and decide whether tissue sampling is needed. A laboratory diagnosis is required because colour alone cannot separate melanoma from other nail conditions.

Book a prompt dermatology appointment and note which nail is affected, whether there was recent trauma, and how the band has changed. Remove nail polish and avoid acrylic nails until the area has been assessed. Do not drill, scrape, or repeatedly trim the nail to remove the mark.

If melanoma is confirmed, treatment may involve removing the affected tissue or nail area with appropriate surgery. Depending on the findings, clinicians may discuss sentinel lymph node biopsy, imaging, or immunotherapy.

Seek prompt review for a new dark band, a band that becomes wider or more irregular, pigment spreading onto the cuticle or nearby skin, nail lifting, splitting, bleeding, or a persistent sore. Get urgent care for severe pain, pus, rapidly spreading redness, or fever, which can indicate infection or significant injury.

Ask whether the band could follow trauma or infection, whether dermoscopy or biopsy is needed, how the nail will heal after sampling, and when the pathology result will be ready. If melanoma is diagnosed, ask about surgery, lymph-node assessment, nail reconstruction, and follow-up checks.