Nail Biopsy and Surgery

Nail Biopsy and Surgery in Pasadena, CA

Comprehensive Dermatology Center of Pasadena provides this information to help you prepare for a nail avulsion or biopsy.

A nail avulsion removes the hard part of your nail (nail plate) from your finger or toe. Your dermatologist may recommend this procedure if you have nail problems that refuse to improve after other treatments.

A nail avulsion may:

  • Treat nail infection
  • Remove growth from your nail
  • Treat a severe nail injury
  • Treat ingrown toenails

A nail avulsion may also treat nail issues like redness, oozing, swelling, discomfort, infection, or odor caused by cancer treatment. Taxane-based chemotherapies and other targeted therapies can cause nail complications.

A nail biopsy takes a sample of skin tissue beneath your nail to check for abnormal cells.

What Does Nail Surgery Treat?

We perform nail aversion to treat nail fungus, tumors, or skin cancer beneath the nail.

Nail Fungus

Many men and women visit their dermatologists because of nail fungus. For some, we can diagnose the issue based on an assessment and begin their treatment immediately. For others, we scrape a sample of the debris beneath the nail for a culture or a KOH prep test to diagnose the fungus accurately.

Once diagnosed, we begin treating the fungus. We usually start fungal treatment with an oral or topical anti-fungal medication. If these medications prove ineffective or the patient no longer wants to deal with the appearance of the nail, they may opt to have the nail removed entirely. With a complete nail plate removal, we keep the patient on anti-fungal medications while the nail grows back. Toenails can take eight to eighteen months to develop. Fingernails take six to eight months to replace.

Irregular Nail Pigmentation or Grooves

Nail plate irregularities may indicate an issue occurring beneath the fingernail or toenail. If we suspect a malignant area or benign tumor underneath the nail, we employ nail surgery to biopsy the area.

Nails have different parts. The nail plate is what we see. The nail cuticle surrounds the nail. The nail matrix is underneath the skin below the nail towards the joint. This is where the nail grows. We examine the nail matrix when we conduct a nail biopsy.

The nail plate shows signs of growth if there’s a cyst or tumor in the nail matrix area. When we see a groove or pigmentation in the nail plate, we surmise the issue comes from the nail matrix. Then, we perform a nail biopsy to check for melanoma, or benign or malignant tumors.

Squamous cell carcinoma is the most common skin cancer in the nail matrix. It’s associated with a virus. A long-lasting virus (wart) can develop into squamous cell carcinoma for some patients. This is treated with Mohs surgery.

If you have melanoma underneath the nail, it’s a difficult situation that requires Mohs surgery, an excision, or amputation in extreme cases.

Before Your Procedure

Buy bandages that are customized for fingers or toes. You will need these after your nail removal or biopsy. They can be purchased at your local drugstore.

If your procedure is performed on your toe, you may want to wear open-toed shoes after your procedure.

Bring someone with you to the appointment to drive you home. Shower the night before or the morning of your nail procedure. Then, you can eat and take all of your medications as usual.

After Your Procedure

We’ve exposed the nail bed during these surgeries, particularly nail aversion. Consequently, oozing is expected after the procedure. To help diminish this effect, we apply a tight bandage that should remain over the area for two to three days. Once the dressing is removed, the oozing should have subsided, and you can continue with standard wound care until your sutures are removed.

Also, be mindful when the entire nail plate is removed, this area will be sensitive and tender for up to a week. We may offer oral pain medication with specific wound care instructions for the exposed nail bed.

Learn More

Call the Comprehensive Dermatology Center of Pasadena today for an examination of your skin or to consult with us if you have been diagnosed with skin cancer.

Contact Us or call us at (626) 793-7790.

Nail Surgery FAQs

Will my nail surgery hurt?

Once we’ve administered lidocaine, you’ll mostly feel pressure, not pain if you’re having the entire nail plate removed. Otherwise, you won’t feel anything and will not experience any discomfort.

Will my nail grow back normally?

Hopefully, your nail surgery will produce a healthier and more attractive nail. However, the exact aesthetic results depend on the type of nail surgery necessary.

If there’s an enlarged lesion in the nail matrix to be removed, there may be a minor nail deformity when it grows back. Likely, this deformity already existed before your procedure.

We strive that your nail will regrow with attractive aesthetics. If we remove the nail plate to treat nail fungus, a healthier-looking nail will be present once it grows out.

How do I know if I need nail surgery?

Nail surgeries are performed based on the specific cause of the nail deformity or fungus. Never hesitate to ask your dermatologist about nail surgery to treat your nail condition.

More importantly, if you suspect a tumor or form of skin cancer around the nail, see a dermatologist. You can have both benign and malignant growths underneath the nail. It’s essential to see a board-certified dermatologist who can identify these nail issues or perform a nail biopsy if necessary.


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