Sophia Delgado
Toenail removal is a simple procedure that can be performed in a doctor's office. It is often done to treat recurring toenail fungus, ingrown nails, bunions, and severe or returning fungal nail infections. The surgery can be done on one toe or multiple toes, with the affected area numbed before the procedure. The entire nail or just the infected piece can be removed, depending on the situation. After the surgery, it is important to take care of the area to prevent infection and promote healing. Toenail removal can provide relief from painful and embarrassing nail problems, giving your feet a chance to start over with healthy new nails.
| Characteristics | Values |
|---|---|
| Procedure Time | 15-20 minutes |
| Recovery Time | Up to 18 months |
| Cost | £375 for one toe, £110 for each additional toe |
| Anaesthetic | Local anaesthetic |
| Pain Medication | Yes |
| Permanent Procedure | Matrixectomy |
| Temporary Procedure | Toenail may grow back |
| Risks | Infection, abnormal nail growth |
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What You'll Learn
Toenail fungus
If conservative treatments are unsuccessful, surgical nail removal can be considered for severe or recurring fungal nail infections. This procedure can be performed in a doctor's office or clinic and involves administering a local anaesthetic and surgically removing the entire nail or part of it. It is a safe, straightforward procedure that rarely results in complications. After the surgery, patients are typically prescribed pain medication and instructed to rest, ice, and elevate the surgical limb, commencing lukewarm water soaks the following day.
An alternative approach to treating toenail fungus that has gained traction in recent years is the focus on optimising gut health and strengthening the immune system. The connection between gut health, immune function, and fungal infections has prompted the development of natural treatment methods that address the root cause of onychomycosis. One such example is the Overcoming Onychomycosis program by Scott Davis, which offers a digital guide and meal plans that integrate seamlessly into daily routines to improve overall wellness and eliminate stubborn toenail fungus.
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Ingrown toenails
There are several causes of ingrown toenails, including:
- Incorrect toenail trimming: Cutting toenails too short, especially on the sides of the big toes, can cause the nail to curve and grow into the skin.
- Improperly fitting shoes: Tight or narrow shoes that place too much pressure on the toes can cause the nail to grow into the surrounding tissue.
- Toe trauma: Injuries such as stubbing or banging the toe can lead to ingrown toenails.
- Nail infections: Infections can affect the growth of the nail and increase the risk of ingrowing.
However, if the pain is severe, there is a lot of inflammation or discharge, or the infection persists or worsens, it is recommended to seek medical attention. A healthcare provider may prescribe oral antibiotics or perform a partial or complete nail avulsion to remove part or all of the affected toenail. In some cases, a permanent procedure called a matrixectomy may be performed to prevent the regrowth of the toenail. This procedure involves applying a chemical, typically phenol, to "kill" the toenail.
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Tumours
Toenail removal is often necessary due to issues like painful ingrown toenails, severe infections, or tumours. In the case of tumours, specifically, there are several treatment options available.
Subungual Glomus Tumours
Subungual glomus tumours are a type of tumour that originates in structures within the nail. Treatment options for these tumours include:
- The traditional transungual approach: This method involves removing the nail plate and repairing the nail bed. However, this approach can lead to postoperative pain and an increased risk of infection.
- Modified transungual and periungual approaches: These techniques aim to skillfully remove the tumour without the need for nail plate removal, thereby reducing postoperative pain and infection risks.
- Nail-sparing and sub-nail bed approach: This technique minimizes manipulation of the nail plate, nail bed, and germinal matrix, resulting in reduced postoperative deformities and pain.
Subungual Melanoma
Subungual melanoma is a type of cancer that affects the toenail, and treatment typically involves the removal of the lesion (excision). If the cancer has spread to the lymph nodes, lymph node removal may also be necessary. Wide margins of healthy surrounding tissue are also removed to reduce the risk of recurrence.
Post-Surgery Care
Proper aftercare following toenail removal is crucial for a speedy recovery. Here are some essential post-surgery care guidelines:
- Keep the wound clean and change dressings regularly.
- Monitor the area for signs of infection.
- Soak your foot in Epsom salts for pain relief.
- Wear appropriate footwear to support the healing process.
- Avoid getting your toe wet for extended periods, as this will slow the healing process.
- It is normal for the wound to weep a light yellow discharge and for the area to be inflamed or blistered.
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Trauma to the nail
More severe trauma, such as crushing injuries or deep cuts, may result in long-term or permanent effects if the nail matrix is significantly damaged. Blood collecting beneath the nail can cause a painful, dark blue or black discolouration. A deep cut or tear in the skin beneath the nail is known as a nail bed laceration, which can cause pain, bleeding, and potential damage to the nail matrix. This can happen when the nail separates from the nail bed due to severe trauma or forceful pulling or tearing.
Fractures can occur horizontally or vertically and may involve a partial or complete separation of the nail. If you experience severe pain, excessive bleeding, or signs of infection such as pus, redness, or swelling, it is crucial to consult a podiatrist. Nail trauma can also cause the development of splits or ridges on the nail surface, affecting its smooth appearance. In some cases, the damage to the nail's growth area can result in permanent changes, and the toenail may never grow back to its original shape.
To prevent nail injuries, it is recommended to wear protective gloves during repetitive tasks or heavy lifting and to keep nails trimmed and maintained to minimise the chance of breakage.
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Nail warts
Toenail removal is a simple procedure that can be performed in a doctor's office. It is often carried out to address recurring toenail problems, such as toenail fungus, ingrown nails, and bunions. One of the primary reasons for toenail removal is to treat nail warts.
Periungual warts can be challenging to treat due to their location. They may spread and recur even after treatment. Treatment options include salicylic acid, cryotherapy, and laser therapy. Salicylic acid is one of the most popular treatments, supported by evidence from the American Academy of Family Physicians (AAFP). However, it may take regular applications of up to 3 months for effectiveness. Cryotherapy, or freezing the warts with liquid nitrogen, is often a quicker treatment option.
In some cases of periungual warts, doctors may need to remove parts of the nail or make incisions to access the warts directly. This can cause permanent deformation of the nail. Therefore, it is essential to consult a doctor as soon as possible if you suspect nail warts to increase the chances of successful treatment and reduce the risk of permanent damage.
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Frequently asked questions
A trained podiatrist will conduct an initial examination to determine the best course of treatment. If necessary, they will proceed with toenail removal surgery, which can be done in the office. The procedure can be temporary, allowing the toenail to grow back, or permanent, using a chemical like phenol to "kill" the toenail.
It can take up to 18 months for a toenail to fully regrow after removal.
Risks include infection and abnormal nail growth. Removing a toenail yourself can lead to serious complications, so it is important to consult a doctor for examination and removal.
Toenail removal is often necessary for severe or recurring conditions such as ingrown toenails, fungal infections, bunions, and nail tumours.
