QQ: Can You Get Skin Cancer on Your Nails?

You slather on your SPF, get your yearly skin check, stay in the shade and take all other sun protection measures. You’re deserving of a gold star in sun protection. But even though you’re doing your best to help safeguard your skin, there may be one sneaky spot that skin cancer can creep up on — your nails. As it turns out, there is evidence that shows skin cancer can  present around and even under your nail bed. Granted, it’s a rare occurrence. But we still wanted to know how we can help to protect our nails and how to spot the signs of skin cancer on the nail. With our trusty sunscreen on stand-by, we turned to board-certified dermatologist, Dr. Hadley King for guidance. 

Can You Get Skin Cancer on Your Nail? 

Skin cancer on or under your nail is a rare occurrence, but it does happen. According to Dr. King, the most common form of skin cancer on the nail is called subungual squamous cell carcinoma. “It has a wart-like appearance on the nail bed and periungual skin (meaning around the nail or toenail),” she says. “Clinical presentation can also include chronic pain, swelling, onycholysis (detachment of the nail from the nail bed), nail plate discoloration, nodularity and ulceration.” She explains that while these signs are aligned with skin cancer, a malignancy in this area is commonly misdiagnosed as a benign condition. The cancer can mimic anything from a wart or nail fungus to something like inflammation or psoriasis. That said, if you notice any of these signs, consult with your dermatologist. “If it is a short-lived redness or puffiness that quickly resolves after a trauma, then this is not worrisome, but if it's a chronic finding that seems to be getting worse instead of better, then this should be evaluated.”

While subungual squamous cell carcinoma is the most common type of skin cancer on the nail, melanoma can also develop beneath the surface of the nail in rare cases. “It appears as a brown or black streak,” says Dr. King. “Most of the time, it occurs in the thumbnail or big toenail, though it can develop in any nail.” She explains that the risk of developing this type of cancer increases after the age of 50 and is more common in darker skin tones. 

Protecting Your Hands and Nails 

Anything from chronic inflammation to UV exposure can cause these kinds of cancers, but there are a few measures you can take to help protect your nail area. First and foremost? Limit your sun exposure and apply sunscreen to the skin around your nail bed — and don’t wash it off. If you do wash your hands or go for a swim, make sure to reapply SPF directly after. Look for a broad-spectrum sunscreen, like the La Roche-Posay Anthelios Melt-In Milk SPF 100. This is especially important before getting a gel manicure or using a UV lamp to dry your nails at home. Dr. King explains that UV radiation can increase the risk of subungual squamous cell carcinoma.

In addition to body sunscreen, your nail polish may help protect your actual nail. “Opaque nail polish provides some protection from UV radiation, both because of the coloring and also because many nail polishes have protection built into their formulas to help keep the color from being ruined by the sun,” says Dr. King. She also recommends using a UV-protecting top coat such as the IBD Intense Seal LED & UV Top Coat. 

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