Isla Bennett
Removing a toenail can be done for medical or cosmetic reasons. Ingrown toenails, for example, are a common, painful condition that can cause infection and can be corrected with surgery. Toenails can also become damaged due to trauma, fungal infection, or complications from an ingrown toenail. While it may be tempting to remove a damaged toenail yourself, it is not recommended as it could lead to serious complications. A doctor can perform a toenail removal procedure in about 15 to 20 minutes, using sanitized instruments in a sterile environment to prevent infection.
| Characteristics | Values |
|---|---|
| Who can remove a toenail | A doctor or podiatrist |
| When to remove a toenail | When it is causing pain or infection, or when it is discoloured or misshapen |
| Risks of removing a toenail | Introducing bacteria, causing infection, damaging the toe, thickened or misshapen regrowth, or ingrown nail |
| Toenail removal procedure | Cleaning the toe, administering local anaesthesia, inserting a tool under the nail to lift and remove the nail plate, cleaning the area, applying antibiotic ointment, and bandaging the wound |
| Toenail removal techniques | Nail avulsion, wedge excision, nail-bed ablation, surgery or electrocautery, and Zadek's procedure |
| Toenail removal recovery | Elevate the toe, rest, apply a wet compress, take pain relievers, avoid activities that hurt the toe, and avoid swimming or using a hot tub until advised otherwise by a healthcare provider |
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What You'll Learn
Why you shouldn't remove a toenail yourself
Removing a toenail yourself is not recommended and can lead to serious complications. Firstly, there could be more damage to the toe than is visible. Any mistake during the procedure can lead to further problems, requiring more intervention than if a doctor had performed the procedure. Doctors use sanitized instruments in a sanitized environment, which is difficult to replicate at home. Introducing bacteria can lead to a toe infection, which may cause difficulty in wearing shoes and performing daily activities.
There is also a chance of injuring the skin around the nail, which can lead to pain and redness. The toenail may not grow back as expected, resulting in a thickened, misshapen, or ingrown nail. Ingrown toenails can become infected, causing increased redness and pus in the area. Infections can spread and cause systemic complications throughout the body. Furthermore, an attempt to remove a toenail may not be successful, and the nail may not fall off completely.
In many cases, toenail issues can be treated without removal. A doctor can determine the cause and scope of the problem and suggest appropriate options. For example, a doctor may separate the nail from the skin and lift the nail plate, clean the area, and apply an antibiotic ointment to prevent infection. They can also perform a partial removal of the nail if necessary.
If you have a toenail issue, it is best to consult a doctor or a podiatrist, especially if you have diabetes or another condition that affects the feet. They can examine your toes and determine the best course of treatment.
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Soak in Epsom salt or Castile soap
While it is always recommended to consult a doctor or a podiatrist for toenail removal, there are several natural remedies that can be tried at home. One such remedy is soaking the affected foot in a solution of Epsom salt or Castile soap. This method is particularly useful for treating ingrown toenails, which occur when the edge of a toenail cuts into the surrounding tissue or when the skin grows over the toenail bed. Ingrown toenails can cause pain and inflammation and, if left untreated, can lead to serious infections.
To create an effective soak, mix 3 tablespoons of Epsom salt with 2.8 litres of warm water in a bathtub or large bucket. You can also use table salt if Epsom salt is unavailable. Soak your foot for 15 to 30 minutes, massaging the area to reduce inflammation. The warm water softens the nail, while the salt acts as an antibacterial agent, helping to prevent infection. For added benefits, essential oils such as lavender, tea tree oil, or eucalyptus can be added to the soak. These oils promote healing and help deter infections.
Castile soap is another effective option for a soak. It is recommended to use Castile soap once a day if you are unable to soak your foot multiple times daily. To use Castile soap, simply mix it with water and cleanse the nail bed using a soft washcloth. This method will help keep bacteria at bay and soften the toenail, making it easier to treat.
It is important to note that while these soaks can be beneficial, they may not completely resolve the issue. If your ingrown toenail is advanced or causing you significant discomfort, it is advisable to consult a doctor or podiatrist for proper evaluation and treatment. They may recommend surgical treatments such as Matrixectomy, Wedge Resection, or the Vandenbos Procedure to address the problem effectively.
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Surgical toenail removal
The surgery involves removing the entire toenail or just the infected part. In some cases, the nail matrix, responsible for nail growth, may also need to be destroyed to prevent regrowth. A chemical, typically phenol, is applied to the nail bed to stop the nail from growing back. The wound is then dressed with antibiotic cream and a bandage.
After the surgery, it is important to follow the doctor's instructions for wound care to prevent infection. The wound should be kept clean, and it is recommended to wash around it with clean water twice a day, avoiding the use of hydrogen peroxide or alcohol, which can slow healing. A thin layer of petroleum jelly and a non-stick bandage can be applied to keep the area moist and protected. The wound typically heals within a few weeks, but toenail regrowth can take 12 to 18 months, and the new nail may be odd in shape and appearance.
While surgical toenail removal is an effective solution, it is not a common procedure and is often considered when other treatments have failed. It is important to consult with a medical professional to determine if this surgery is the best course of action for your specific condition.
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Natural remedies for ingrown toenails
Ingrown toenails are a common problem that can usually be resolved on their own or with simple home remedies. However, it's important to know when home remedies are not enough, and medical attention is required. If you notice signs of infection, such as increased pain, redness, swelling, or discharge, or if the condition doesn't improve with home treatments, it's time to consult a doctor or podiatrist. With that in mind, here are some natural remedies for treating ingrown toenails:
Soaking your feet in warm water is a simple yet effective way to reduce swelling and ease the pain associated with ingrown toenails. You can use warm water alone or add soap, apple cider vinegar, or Epsom salts. Soak your feet for up to 20 minutes at a time, three to four times a day, until you notice improvement.
After soaking your feet, you can place small pieces of cotton or waxed dental floss under the ingrown edge of the toenail. This helps to separate the nail from the overlying skin and encourages the nail to grow above the skin edge.
Applying a petroleum jelly, such as Vaseline, or an antibiotic ointment to the affected area can provide relief from pain and help prevent infection. Cover the area with a bandage after application.
Additionally, choosing sensible footwear is essential. Wear open-toed shoes or sandals to reduce pressure on the toes and give them room to heal. Ensure your shoes fit well and leave enough space in the toe box to prevent rubbing and reduce the risk of ingrown toenails.
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Aftercare and recovery
Dressing and Cleaning the Wound
It is crucial to keep the wound clean and dry to reduce the risk of infection and promote proper healing. Change the dressing once or twice daily, or as advised by your healthcare provider. Before removing the initial dressing, which should be left in place for a few days, soak your foot in warm water to ease its removal. Clean the area with warm, soapy water, then pat it dry. Keep the wound covered for the first week, and you may leave it uncovered during the second week to promote airflow.
Foot Soaks and Pain Management
Soaking your foot in a solution of warm water and Epsom salt can provide pain relief and reduce inflammation. Additionally, foot elevation for the first few days can help reduce swelling and prevent further damage. Take the recommended pain relievers to manage any discomfort.
Choosing the Right Footwear
Selecting appropriate shoes is vital for protecting the wound site and ensuring your toes have ample room to heal. Wear open-toed, loose shoes, or sandals for at least two weeks, avoiding tight or pointy shoes. Refrain from walking or standing as much as possible during the first week.
Monitoring for Signs of Infection
Be vigilant about potential signs of infection, such as increased redness, swelling, or pain after a few days, pus or discharge from the wound, and fever or chills. Contact your healthcare provider if you notice any of these symptoms.
Nail Care and Follow-up Appointments
To prevent future ingrown toenails, practice proper nail care by cutting your nails straight across, avoiding cutting them too short, and not curving the edges. Schedule a follow-up appointment with a podiatrist within one to two weeks after the surgery to ensure proper healing and monitor for any regrowth of the nail.
Please note that these instructions are for general informational purposes, and you should always consult with your healthcare provider for specific aftercare guidelines and medical advice.
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Frequently asked questions
You can soak your foot in warm, soapy water with Epsom salt or Castile soap for 10 to 30 minutes to soften the toenail. Wash your hands and push the skin back from the nail border. Cut the toenail straight across, starting at the edges, then place cotton or dental floss under the nail to prevent it from growing back into the skin. Apply a medicated ointment to the affected area.
A podiatrist will first examine your toe and may order an X-ray to assess the structure of the toe and determine the best course of treatment. They will then clean the affected toe with surgical soap or alcohol and administer a local anaesthetic. The nail will be separated from the skin, and a tool will be inserted under the nail to lift and remove the nail plate. Antibiotic ointment will be applied, and the wound will be bandaged.
Toenails grow slowly and it can take anywhere from 2 to 18 months for a toenail to reach a normal length after removal.
Yes, regrowth can be prevented by applying a chemical solution or surgically removing the nail matrix.
