What to expect from nail surgery for melanonychia

Melanonychia describes brown or black pigment forming a line or band in the nail. It can have several causes, so a clinician considers the number of nails involved, the band’s pattern, nearby skin changes, and how it has evolved. If the appearance needs clarification, surgery may allow examination of the nail bed or matrix, where nail growth begins. A pigment band is a finding, not a diagnosis of cancer; tissue assessment is used when clinically appropriate.

The digit is numbed before the procedure. Follow instructions about keeping the dressing clean and dry, changing it, and using any prescribed treatment. Protect the area from knocks and avoid trimming, pressing, or scraping the nail while it is healing. Choose footwear that does not press on a treated toenail. Nail appearance can change as the nail grows, and the clinic may arrange review to discuss healing and any tissue result.

Report increasing pain, spreading redness, warmth, swelling, or drainage. Prompt advice is also needed for fever, bleeding that continues with pressure, wound separation, or a dressing soaked through. Once healed, arrange assessment for a pigment band that widens, becomes irregular, reaches the surrounding skin, or changes after the procedure.

Ask which part of the nail unit will be examined, whether a sample will be sent for analysis, how the nail may regrow, and how long dressings are needed. Ask when the result will be explained and which changes require an earlier appointment.