Skin Cancer Can Grow Under Your Nails Too: Know the Warning Signs

Your nails may be the last place you’d imagine skin cancer to unfold. For about 3% of people who develop melanoma, though, that’s exactly what happens. 

Known as subungual melanoma, skin cancer that forms under your nail can be very serious. Thankfully, it’s also quite treatable, particularly when detected early.

Our skin cancer specialists at Ali Hendi, MD, serving the Washington, DC, Maryland, and Northern Virginia areas, specialize in advanced techniques to diagnose and treat skin cancer of all types and stages.

If you’re concerned about skin cancer that grows under your nails, read on to learn common warning signs and what to do when they appear.

Basics of skin cancer under your nail

Melanoma can affect the skin anywhere on your body. When the cancerous cells form in the skin beneath your nail, it’s considered subungual melanoma. Skin cancer can also develop under your nail plate (the hard, pinkish keratin layer at the nail bottom). This is known as ungual melanoma. Skin cancer that forms beside the plate is called periungual melanoma.

Like all skin cancers, nail melanomas happen when malignant cells form and reproduce, potentially spreading to other body areas over time. It can affect one or more fingernails or toenails. 

While the biggest risk factor for subungual melanoma is excessive sun or tanning bed exposure, it’s sometimes unrelated to ultraviolet (UV) rays. Other risk factors include having abnormal or plentiful moles, having light hair, fair skin, or freckles, and being older or male. A family history of skin cancer or a weak immune function also raises your odds.

Warning signs of skin cancer under your nail

Subungual melanoma can be difficult to detect early on because the symptoms may be hidden or subtle. Warning signs to take seriously include:

• A bruise on your nail that doesn’t diminish or move as your nail grows
• A nail that separates from your nail bed
• Black or brown streaks in your nail, unrelated to an injury
• Cracking or thinning of your nail plate
• Darkening skin next to your nail
• Nail streaks that increase in size
• A bleeding nail or a nail nodule

Another common subungual melanoma sign involves nail pigment that extends to the surrounding skin — a symptom known as Hutchinson’s sign. 

What to do about nail skin cancer warning signs

If you notice potential signs of skin cancer under your fingernail or toenail, our team can confirm or rule out a cancer diagnosis through a comprehensive exam. Your provider may recommend a biopsy, which tests a tissue sample from the area, or dermoscopy, which analyzes your nail using a microscope. 

If it turns out that you have subungual melanoma, treatment often involves surgery. During the early stages of the disease, Mohs surgery often works well. This precise procedure meticulously removes cancerous cells layer by layer, without damaging surrounding skin. If the cancer has spread, we may recommend immunotherapy or radiation.

To learn more about nail skin cancer signs or to get the diagnosis or treatment you need, call 301-812-4591 or book an appointment online with Dr. Hendi and Dr. Dong today.