Subtle Yet Serious: Nail Changes That Could Signal Cancer

Medical professionals are raising awareness about often-overlooked symptoms of cancer that may appear in an unexpected place—your toenails or fingernails. These subtle changes can be easy to dismiss, but experts stress that they might be early indicators of a serious health condition like melanoma.

It’s natural to shrug off small physical changes, especially if they don’t cause pain or discomfort. Most people assume these signs will simply resolve on their own. However, even seemingly minor changes in the appearance of your nails could be your body’s way of alerting you to a deeper issue.

When we think of visible symptoms of skin cancer, unusual moles or discolorations on the skin typically come to mind. But nails—while not skin in the conventional sense—can also reflect significant internal health problems. Nail abnormalities may be among the earliest signs of subungual melanoma, a rare but serious type of skin cancer that occurs under the nails.

Because of this, dermatologists emphasize that nail changes should not be ignored. Monitoring the color, shape, and texture of your nails could be a crucial step in early detection and treatment.

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Melanoma Can Develop Beneath the Nails

While melanoma most commonly develops on sun-exposed areas like the face, arms, or legs, it’s important to recognize that it can also form in places where the sun doesn’t shine. According to the American Academy of Dermatology Association (AADA), melanoma can also appear under or around your nails—a form known as subungual melanoma or nail melanoma.

Unlike other types of melanoma, subungual melanoma is not caused by sun exposure. It typically affects the big toe, thumb, or index finger, and has been categorized as a particularly serious condition due to its potential to be misdiagnosed or go unnoticed for extended periods.

The Cleveland Clinic highlights that while this type of melanoma is rare, it can affect anyone. That said, the risk is higher among individuals aged 50 to 70, and it appears to be more prevalent in people with darker skin tones, such as those of African-American, Asian, or Hispanic descent.

Early detection is key. Unfortunately, many people confuse the signs of subungual melanoma with bruising, fungal infections, or other benign nail conditions, which may delay diagnosis and treatment.

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What Are the Warning Signs of Nail Melanoma?

Dermatologists working with the AADA have identified several warning signs that may indicate the presence of nail melanoma. Here are five important symptoms to look out for:

1. A dark, black, or brown streak running along the nail – This is often seen on the thumb or big toe but can develop on any nail. It may gradually widen over time.

2. Darkening of the skin surrounding the nail – The pigment may extend beyond the nail itself, affecting the nearby skin (a condition known as Hutchinson’s sign).

3. Separation of the nail from the nail bed – If the nail starts to lift off or detach from your finger or toe without a clear injury, it could signal an issue.

4. Splitting or cracking down the center of the nail – This can happen even in the absence of trauma or other external factors.

5. A visible bump or growth under or near the nail – This might be accompanied by a discolored band. The band may be irregular, wide, or narrow and very dark in color.

In some cases, the nail may also become brittle or distorted. People might initially mistake the symptoms for fungal infections, which highlights the importance of seeking professional evaluation.

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When to See a Dermatologist

If you notice any unexplained changes to your nails—especially the development of new dark streaks, discoloration, or distortion—it’s important to consult with a dermatologist as soon as possible. Early intervention can make a significant difference in treatment outcomes.

Experts recommend taking photos to document changes over time, particularly if the discoloration or streak seems to grow or spread. This record can help your healthcare provider assess how quickly the condition is progressing and guide next steps.

While not every nail change is a sign of something serious, staying informed and vigilant can help you spot potential issues early—when treatment is most effective.