Ava Monroe
Toenails can be removed either partially or completely, and the procedure is usually carried out by a doctor or a podiatrist. Toenail removal is often done to treat fungal infections, ingrown toenails, or other foot problems. The procedure typically involves administering a local anesthetic, cleaning the affected area, and then using tools to separate and remove the nail plate. A chemical solution may also be applied to prevent regrowth. While toenails can sometimes fall off on their own, it is not recommended to remove them without professional help due to the risk of infection and other complications.
| Characteristics | Values |
|---|---|
| Toenail removal procedure time | 15-20 minutes |
| Toenail regrowth time | 6-18 months |
| Toenail removal complications | Thickened, misshapen, or ingrown nail |
| Toenail removal side effects | Tenderness, redness, and swelling |
| Toenail removal recovery time | A few weeks |
| Toenail removal aftercare | Keep the wound clean and dry, redress every 2-3 days, elevate the affected toe |
| Toenail removal success rate | Less than 10 out of 100 patients experience regrowth |
| Toenail removal risks | Infection, phenol flare (rare), bleeding, post-operative pain |
| Toenail removal methods | Partial Nail Avulsion, Total Nail Avulsion, Matrixectomy, Nail-bed ablation, Zadek's procedure |
| Toenail removal anesthesia | Local anesthesia |
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What You'll Learn
Toenail removal procedures
There are two primary types of toenail removal procedures: Partial Nail Avulsion and Total Nail Avulsion, both of which can be performed with or without a matrixectomy. A matrixectomy involves introducing a chemical substance to the nail matrix to prevent the removed section of the nail from regrowing permanently. This procedure is often considered for severe or recurring fungal nail infections or when a large portion of the nail is diseased and damaged.
During the procedure, the toe is typically numbed with a local anesthetic to prevent pain. For ingrown toenails, a lateral nail avulsion technique is employed, where the lateral one-fourth or one-fifth of the nail plate, where the nail curves down into the toe, is identified as the site for partial lateral nail removal. A nail elevator or the closed tips of iris scissors are used to separate the nail plate from the overlying proximal nail fold. Subsequently, a nail splitter or bandage scissors are used to cut from the distal (free) end of the nail straight back (proximally) beneath the proximal nail fold.
In some cases, only the diseased or infected portion of the nail is removed, rather than the entire nail. Additionally, post-operative care is crucial to prevent infection and promote healing. Antibiotics may be prescribed to prevent infectious complications, and patients are advised to keep the area clean. The wound typically heals within a few weeks, but toenails may take 12 to 18 months to regrow completely.
It is important to note that toenail removal procedures are generally straightforward and cause minimal post-operative discomfort. Patients do not usually need to take additional time off work or school, and special footwear is not required during the healing process. However, it is recommended to refrain from playing sports or engaging in strenuous exercise for at least two weeks after the procedure.
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Risks and complications
While toenail removal is considered a safe, simple, and effective procedure, it does carry some risks and potential complications. Firstly, there is a small risk of infection due to the open wound left post-surgery. Signs of infection include heat, swelling, pain, and a significant increase in discharge. If left untreated, an infection can lead to more serious health issues. Therefore, it is crucial to follow your doctor's advice on post-operative care to minimize the risk of infection.
Another complication that may arise is related to the use of anaesthesia. Although rare, some individuals may experience a prolonged duration of anaesthesia effects, with potential numbness lasting longer than usual or, in extremely rare cases, permanent numbness in the toe. Additionally, there is a risk of nerve damage during the procedure, which can be temporary or, in some cases, permanent.
Toenail removal surgery may also result in regrowth complications. In some instances, the toenail may grow back misshapen or deformed, leading to aesthetic concerns and potential functional issues. Moreover, there is a small chance of the toenail regrowing entirely, which may require a repeat of the procedure. Phenol, the chemical applied to prevent regrowth, can also cause a reaction called a phenol flare, characterized by redness, heat, and blistering at the base of the toe.
It is important to note that attempting to remove a toenail at home can significantly increase the risks and complications mentioned above. Self-removal can introduce bacteria, damage the surrounding skin, and increase the likelihood of infection. Therefore, it is strongly advised to seek professional medical assistance for toenail removal to ensure proper sanitation, minimize complications, and promote safe healing.
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Post-procedure care
After toenail removal surgery, it is important to follow the necessary post-procedure care for a smooth and speedy recovery. Here are some detailed instructions for post-procedure care:
Dressing Changes and Wound Care
Keep the dressing on your toe clean and dry. If there is excessive bleeding that soaks through the dressing, carefully remove the dressing and apply a new one. Ensure that your wound remains clean and open to facilitate healing. You may need to change the dressing periodically to keep it fresh and secure.
Foot Soaks and Hygiene
To promote healing and reduce discomfort, soak your foot in warm salt water, twice to thrice daily for about 10 minutes. Epsom salt soaks are particularly beneficial for pain relief and reducing inflammation. After each soak, thoroughly dry your foot, apply a thin layer of antibiotic ointment to prevent infection, and redress the wound.
Elevate Your Foot
In the initial hours after the procedure, it is advisable to keep your foot elevated. Propping your foot up can help reduce swelling and promote proper circulation. Aim to keep your foot elevated for at least the first 4 hours post-surgery.
Monitor for Signs of Infection
Be vigilant for any signs of infection at the surgical site. Contact your healthcare provider immediately if you notice increased redness, swelling, or pain around the wound after a few days. Other signs of infection include pus or discharge from the wound, as well as fever or chills.
Appropriate Footwear
Wear appropriate footwear during your recovery. Choose comfortable, open-toed shoes or sandals that will not put pressure on your toe and accommodate the dressing. Avoid tight-fitting shoes that may cause irritation or put you at risk of developing ingrown toenails again.
Activity Modifications
Modify your activities to allow for proper healing. Avoid strenuous activities or excessive walking that may cause discomfort or put pressure on your toe. Take it easy and give your body time to recover.
Prevent Future Toenail Problems
To avoid future toenail issues, practice good nail care. When cutting your nails, trim them straight across, avoiding cutting them too short or curving the edges. This helps prevent ingrown toenails, which can be painful and lead to infections.
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Preventing regrowth
Permanent toenail removal is an elective procedure that involves the surgical removal of the toenail. The procedure is typically carried out under local anaesthesia, with the entire operation taking about 45 minutes.
To prevent regrowth of the toenail, a chemical substance is introduced to the nail matrix or nail bed to destroy it. The matrix is the part of the nail bed that produces keratin for nail growth. This chemical substance, often phenol, burns the nail root, ensuring that the nail cannot grow back.
While regrowth is rare, it is a possible complication of the procedure. To minimise the risk of regrowth, it is important to follow the aftercare instructions provided by your doctor. This includes keeping the dressing clean and dry until your redressing appointment, which is usually scheduled for 3 to 7 days after the surgery. During this time, it is crucial to avoid swimming in pools, lakes, rivers, streams, or the ocean, as these water sources can harbour bacteria and cause infection.
In some cases, nerve damage can occur during the procedure, and while it is usually temporary, it may be permanent. Additionally, there is a small risk of infection, as the wound remains open for several weeks. Therefore, it is essential to follow your doctor's advice and keep the wound clean and dressed to prevent any complications that may affect the regrowth of the toenail.
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When to seek professional help
While it is possible to remove a toenail, it is always best to seek professional help. Removing a toenail yourself could lead to serious complications. While a severely damaged toenail may look "dead", it is actually just damaged. There could be more damage to your toe than is visible to the naked eye.
If you have a damaged toenail, you should consult a doctor to examine or remove it in order to prevent infection or other problems. A doctor can perform the procedure much more quickly and safely than you can at home. The removal procedure usually takes 15 to 20 minutes, but it can take up to 18 months for a toenail to fully regrow.
If you have concerns about the appearance or pain associated with a toenail, you should consider discussing the possibility of removing the nail with a podiatrist. If you don't have a podiatrist, start with a visit to a doctor. Be sure to let the doctor know if you have diabetes or another condition that can affect the feet. After a physical examination of your toes, your doctor may find it necessary to order an X-ray. This will help assess the structure of the toe to see if there is more damage below the surface.
Surgical nail removal is usually performed only when a large portion of the nail is diseased and damaged or if your nails are very painful. In some cases, only the diseased portion is removed, not the entire nail. Toenail removal surgery can be done for severe or returning fungal nail infections.
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Frequently asked questions
The procedure involves injecting local anaesthesia to numb the toe and toenail area. Then, the doctor separates the nail from the skin and uses a tool to lift and remove the nail plate. The area is cleaned, and antibiotic ointment is applied to prevent infection. Finally, the wound is dressed, and aftercare instructions are provided.
Toenails typically take 6 to 18 months to grow back to a normal length.
No, it is not recommended to remove a toenail at home. While there is advice available online, it is a risky procedure that can lead to serious complications. It is best to consult a doctor or podiatrist to determine the best course of treatment.
Toenail removal surgery is typically performed to treat severe or recurring fungal nail infections, ingrown toenails, or other foot problems such as infections, pain, or trauma. It is usually done when a large portion of the nail is diseased, damaged, or causing pain.
