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Changes in a fingernail or toenail can come from infection, inflammation, injury, benign growths, or less commonly skin cancer. When examination alone cannot establish the diagnosis, a nail biopsy or selected nail procedure may be recommended.
The nail unit is anatomically complex, so we explain which part of the nail needs to be sampled, what the procedure may do to the nail as it grows back, and what recovery is likely to involve before proceeding.
Nail Biopsy and Nail Procedures
Why might a nail biopsy be recommended?
A biopsy may be considered for an unexplained dark streak or pigment change, a persistent abnormal nail, a suspected inflammatory nail disorder, a growth beneath or around the nail, or another finding in which microscopic diagnosis would change treatment.
What part of the nail is biopsied?
The biopsy site depends on the suspected condition. A sample may involve the nail plate, nail bed, nail matrix, or tissue around the nail. Matrix procedures require particular care because the matrix produces the nail plate and injury can affect future nail growth.
What happens during the procedure?
The digit is numbed with local anesthetic. Depending on the problem, part of the nail plate may be lifted or removed temporarily so the appropriate tissue can be sampled. The specimen may be sent to pathology, and selected material may also be sent for fungal or other testing when clinically indicated.
Will the nail grow back normally?
That depends on the procedure and the underlying condition. Temporary nail-plate removal does not necessarily prevent regrowth, but procedures involving the nail matrix can lead to a permanent ridge, split, contour change, or other nail dystrophy. Those risks are reviewed before a matrix biopsy or other matrix surgery.
What are the risks?
Potential risks include bleeding, infection, pain, swelling, delayed healing, scarring, altered sensation, temporary or permanent nail deformity, and recurrence of the underlying problem. Toenails generally grow more slowly than fingernails, so visible recovery can take months.
After Nail Biopsy or Surgery
Keep the dressing and activity restrictions exactly as directed. Because nail procedures vary considerably, your procedure-specific instructions take priority over general wound-care advice. Call us for persistent bleeding, worsening pain, spreading redness, pus, fever, or another concerning change.
Schedule a Nail Evaluation
Evaluation is appropriate for a new or widening dark streak, a persistent nail growth, unexplained nail destruction, pain, recurrent drainage, or a nail change that is not improving as expected. Book Appointment.