What should you know about racial melanonychia?

Melanonychia describes brown, grey or black pigment running along part or all of a nail. In people with naturally deeper skin pigmentation, several nails may show similar bands because pigment-producing cells in the nail unit are more active. This pattern can be longstanding and symmetrical. A single band, a band that widens, several shades within one band, pigment spreading onto nearby skin, nail splitting or bleeding needs a closer look because trauma, medicines, infection and growths can also change nail colour. Discoloured Nails provides related information.

Take a clear photograph and note when the band appeared, whether it is changing and whether one or several nails are involved. Protect nails from repeated injury, avoid picking the cuticle and mention medicines, previous nail trauma and family patterns at the appointment. A clinician may examine the nail with magnification and compare nearby nails. Nail Surgery is not automatically needed; a procedure may be considered when the appearance cannot be safely explained or a sample is required.

Book a dermatology review for a new solitary band, noticeable widening, irregular colour, pigment extending onto the surrounding skin, nail destruction or bleeding. Seek earlier advice if the change is progressing quickly or follows persistent pain. Sudden swelling, severe pain or signs of infection such as pus and fever warrant prompt care.

Does the pattern fit racial melanonychia? Are other nails involved? What changes should I monitor? Could trauma or a medicine explain it? Would magnified examination or Nail Surgery be useful?