Sophia Delgado
Nails can be completely removed through medical nail avulsion, which involves the chemical destruction of the nail plate. This procedure is typically carried out on toenails and can take several weeks. Another method is surgical nail removal, which involves removing the nail matrix to prevent regrowth. This procedure takes 15 to 20 minutes, and the nail bed must be protected from injury afterward. While it is possible to remove a nail at home, it is not recommended due to the risk of infection and other complications.
| Characteristics | Values |
|---|---|
| Time taken for the procedure | 15-20 minutes |
| Time taken for nail regrowth | 6-18 months |
| Pain | Minimal |
| Risks | Infection, thickened nail, misshapen nail, ingrown nail, phenol flare, bleeding |
| Post-procedure care | Keep the wound clean and dry, elevate the toe, take painkillers, change dressings, avoid exercise |
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What You'll Learn
Medical nail avulsion
Chemical nail avulsion involves the destruction of the nail plate using chemicals, mainly 40% urea, which slowly macerates the nail plate. This process is painless, but it takes several weeks to complete. It is often used to treat fungal nail infections (onychomycosis), though it is not always successful as fungi may be growing under the proximal nail fold. Topical and/or oral antifungal treatments can be used before, during, and after chemical nail avulsion.
Surgical nail avulsion is a more aggressive process that is often painful and may lead to permanent nail dystrophy. It can be carried out under local ring block anaesthesia, though some patients may opt for general anaesthesia. The procedure involves separating the nail from the skin and inserting a tool under the nail to lift and remove the nail plate. The area is then cleaned, treated with antibiotic ointment, and bandaged.
After either procedure, it can take 6 to 18 months for a toenail to reach a normal length again. Immediately following surgery, patients may experience tenderness, redness, and swelling. Elevating the affected toe above heart level for 48 hours can help reduce pain and swelling, and patients can take acetaminophen for any discomfort, avoiding aspirin or NSAIDs, which may increase bleeding risk.
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Surgical removal
There are several surgical procedures for removing ingrown toenails. The most common approach is a partial nail avulsion or wedge resection, where a doctor removes a portion of the toenail to prevent it from growing into the skin. This procedure can also involve coating the nail matrix with a chemical or acid, usually phenol, to prevent regrowth. A complete nail avulsion or total nail removal may be performed in more severe cases, where the entire toenail is removed. This procedure carries a higher risk of the nail regrowing misshapen or deformed, which can increase the risk of future ingrown toenails.
Before the surgery, patients are advised to remove any nail varnish, acrylic nails, and toe rings. They should also eat something beforehand to avoid feeling faint during the procedure. The surgery is typically carried out in a doctor's office and takes approximately 20 to 45 minutes. After administering local anaesthesia, the surgeon makes an incision near the base of the nail and extends it towards the side of the toe, ensuring that all the skin at the edge of the nail is removed.
Following the procedure, the patient's wound is dressed with an antibiotic ointment and bandaged. Patients are advised to keep the bandage dry and change it regularly until the wound heals, which usually takes about 5 to 7 days. Soaking the toe in warm water or saltwater can aid in the healing process. It is important to follow the aftercare instructions provided by the healthcare provider to avoid infection and ensure proper healing.
While surgical removal of the nail is generally successful, there are some risks to consider. These include the possibility of regrowth, allergic reactions, and infection. In rare cases, patients may experience a phenol flare, a reaction to the chemical applied to prevent nail regrowth, which can cause redness, heat, and blistering at the base of the toe. However, with proper medical care and diligent home management, the likelihood of a full recovery with a healthy nail regrowth is high.
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Risks and complications
While nail removal can be carried out safely by a doctor, there are several risks and complications to be aware of. Firstly, there is a risk of infection, especially if the procedure is performed at home without proper sanitization. Introducing even a small amount of bacteria can lead to an infection, which may cause symptoms such as heat, swelling, and pain, and may interfere with your daily activities. Removing your nail at home can also cause injury to the skin around the nail and worsen the problem.
If you have diabetes or other conditions that affect circulation, you should avoid removing your nail at home, as wounds on the feet may be slow to heal. Additionally, your nail may not grow back as expected and could become thickened, misshapen, or ingrown.
In the case of toenail removal, the procedure can be performed under local anesthesia, with the application of a tourniquet to minimize bleeding. However, there is a small risk of problems with the anesthesia, including rare reactions and nerve damage. After the procedure, you may experience tenderness, redness, swelling, and pain, and there is a risk of delayed healing due to the use of phenol to destroy the nail bed.
Furthermore, there is a small possibility of the nail growing back, which may require a repeat of the procedure. A rare reaction called phenol flare may also occur, causing redness, heat, and blistering at the base of the toe. Overall, it is crucial to carefully consider these risks and complications before undergoing nail removal surgery.
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Healing and recovery
After a nail has been removed or detached from the nail bed, it will not reattach. The recovery process involves keeping the area clean and dry to prevent infection and waiting for a new nail to grow. This can take around 3-6 months for fingernails and up to 4-18 months for toenails. During this time, it is beneficial to keep nails short to prevent further damage or injury.
If the detached nail has sharp edges, it is recommended to file them down or trim off the detached part to prevent the nail from catching and tearing. The uncovered nail bed can be protected with tape, an adhesive bandage, or petroleum jelly/ointment until the new nail grows out enough to provide protection.
In the case of nail surgery, such as ingrown toenail removal, a tourniquet is applied to stop bleeding, and a chemical called phenol is used to prevent the nail from growing back. The wound is then dressed, and it is advised to keep the foot raised for the first 24 hours to reduce swelling and bleeding. The recovery time for this type of procedure is typically 6 to 12 weeks, during which proper wound care and redressing are crucial to prevent infection.
It is important to monitor the area for any signs of infection, such as heat, swelling, pain, or pus, and seek medical attention if these occur. Additionally, if there is bleeding under the nail, it is recommended to consult a physician to rule out any underlying issues such as bone fractures or tissue tears.
To promote nail health and support the regrowth process, maintaining a well-rounded diet and good general health is advised.
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Prevention and treatment
While it is possible to remove a nail completely, it is not recommended to do so at home. The risk of infection is high, and there is a chance of further damage to the nail bed. A doctor will be able to advise on the best course of treatment and can perform the procedure in a sterile environment with sanitized instruments.
To prevent nail issues, it is important to practice good nail hygiene and care. Nails should be trimmed straight across to prevent ingrown toenails, and any injuries to the nail or nail bed should be treated promptly. If you have a bruise under your nail, a procedure called nail trephination can be performed to drain the trapped blood and provide pain relief. This must be done within 48 hours of the injury.
If a nail is severely damaged, it may need to be removed. This can be done through surgical nail avulsion, which involves separating the nail from the skin and removing the nail plate. The wound is then cleaned, treated with antibiotic ointment, and bandaged. This procedure typically takes 15-20 minutes and can be performed under local anesthesia.
To prevent the nail from growing back, a chemical solution such as phenol can be applied to the nail bed. This is a common method used to prevent the recurrence of ingrown toenails. Alternatively, the nail matrix can be surgically removed, which permanently prevents regrowth.
After any nail removal procedure, it is important to follow your doctor's instructions for postoperative care. This may include keeping the area clean and dry, changing bandages, and taking prescribed medications such as antibiotics and painkillers. Elevating the affected foot or hand can help reduce pain and swelling. It is normal for a nail to take several weeks to several months to grow back, depending on whether it is a fingernail or toenail.
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Frequently asked questions
No, you should not attempt to remove your nail at home. You should consult a doctor to examine or remove a damaged toenail to prevent infection or other problems. The doctor will use sanitized instruments in a sanitized environment, reducing the risk of infection.
First, the affected toe will be thoroughly cleaned with surgical soap or alcohol. Then, you will get an injection of local anesthesia. A tourniquet will be placed at the base of the toe to stop any bleeding. The doctor will then separate the nail from the skin and insert a tool under the nail to lift and remove the nail plate. The area will be cleaned, and an antibiotic ointment will be applied to prevent infection. The wound will then be dressed.
Toenails grow slowly, taking 6 to 18 months to reach a normal length. You may experience tenderness, redness, and swelling right after the surgery. It is important to keep your foot elevated for the first 24 hours to reduce the risk of swelling and bleeding.
Yes, the nail matrix can be surgically removed to prevent regrowth. Alternatively, a chemical solution like phenol can be applied to the nail bed to stop the toenail from growing back.
