Caleb Foster
Removing a nail from the body is a serious medical procedure that should only be carried out by a trained professional. It is important to note that attempting to remove a nail yourself can lead to serious complications and infections. The procedure involves first administering local anaesthesia to the affected area. Then, the doctor will separate the nail from the skin and insert a tool to lift and remove the nail plate. The area will then be cleaned, treated with antibiotic ointment, and bandaged.
Characteristics of Nail Removal Procedures
| Characteristics | Values |
|---|---|
| Anesthesia | Local ring block, procedural sedation |
| Patient Position | Supine with the affected hand on an arm extension, palm facing down |
| Antiseptic | Sterile scrub and drape |
| Tourniquet | Finger tourniquet, elastic band |
| Nail Removal Tool | Straight hemostat, curved iris scissors, periosteal elevator |
| Post-Removal Care | Antibiotic ointment, bandage, elevation of the affected area |
| Regrowth Prevention | Chemical solution, nail matrix removal |
| Recovery | 6-18 months for nail regrowth, tenderness, redness, and swelling may occur |
| Risks | Infection, thickened nail, misshapen nail, ingrown nail |
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What You'll Learn
Removing fake nails at home
Firstly, you will need to gather your equipment: a coarse nail file, acetone, cotton balls or pads, aluminium foil, a glass or ceramic bowl, a cuticle pusher, and cuticle oil or moisturiser.
Next, use the coarse nail file to buff off the top coat of the nail. This removes the shine and helps the acetone penetrate the nail. You can also cut down the fake nail to speed up the process. It is important to take your time with this step, as removing the top layer too quickly can damage your natural nails.
Once the top layer has been removed, soak your nails in acetone. You can do this by dipping your hands into a bowl of acetone, or by soaking a cotton ball in acetone and placing it on your nail, secured with aluminium foil. You will need to leave the acetone to work for 20-30 minutes. During this time, you will be able to see the product melting.
After the product has melted, gently push it off the nail with a cuticle pusher or orange stick. You may need to rinse and repeat this process a few times to fully remove the product.
Finally, use a fine-grit file or buffing block to buff your nails and smooth out any remaining residue. Finish by applying cuticle oil or moisturiser to rehydrate your nails.
It is recommended that you give your nails a break after removing fake nails, to allow them to recover and strengthen.
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Removing a damaged toenail
If you have a damaged toenail, you should not force it to fall off. Removing a damaged toenail yourself could lead to serious complications. Toenails are made of a tough, non-living substance called keratin, so while they are technically "dead", they are actually just damaged. Toenails can become damaged for a variety of reasons, including trauma, fungal infection, and complications from an ingrown toenail. In many cases, these conditions can be treated without removing the nail.
If you do decide to remove your toenail, it is critical that you make your toe as sterile as possible before attempting to do so. Wash the toe and nail area with soap and water, and consider swabbing the toenail and surrounding area with iodine, which kills bacteria that cause infection. If there is a blister, sterilize and heat the tip of a pin or straightened paper clip with a flame and wipe it with rubbing alcohol.
If you go to a doctor, they will first separate the nail from the skin and then insert a tool under the nail to lift and remove the nail plate. The entire area will be thoroughly cleaned, and antibiotic ointment will be used to lower the chances of infection. The wound will then be bandaged. The procedure takes about 15 to 20 minutes, and it can take up to 18 months for a toenail to fully regrow.
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Using anaesthesia
Nail removal is a common procedure, often carried out to relieve issues caused by fungal infections, ingrown nails, or trauma. Anaesthesia is typically used to numb the affected area before the nail is removed.
Local anaesthesia is commonly used for nail removal, with the patient remaining awake while the area is numbed. Local anaesthesia is administered by exposing the peripheral sensory nerve trunks or branches to a local anaesthetic solution, creating a sensory block in the target territory. The patient should be warned that the injection may be painful, and the anaesthetic should be warmed to body temperature to reduce pain. Small amounts should be injected slowly to minimise pain due to tissue stretching.
Alternatively, patients may opt for general anaesthesia, which is administered intravenously. Procedural sedation is another option, although this is not usually required.
Nail removal procedures typically involve separating the nail from the nail bed, either fully or partially, and then gently removing the nail. In partial nail removal, scissors are used to cut the desired amount of nail away, and the nail matrix may be chemically destroyed to prevent ingrown nails from recurring. In full nail removal, the nail is gently pulled away from the nail bed.
Following nail removal, a bandage should be kept around the wound until it heals.
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Preventing regrowth
Preventing nail regrowth after removal is possible through a chemical application or surgery.
Chemical Application
After a nail has been removed, a chemical called phenol can be applied to the nail bed to stop the nail from growing back. This procedure is known as nail surgery and is performed under local anaesthesia. While it is rare, some people may experience a reaction to the chemical, known as a phenol flare, which causes the skin at the base of the toe to become red, hot, and blistered.
Surgery
Surgical options for preventing nail regrowth include partial and total nail removal. During partial nail removal, a small piece of the nail is removed from the painful side and treated to prevent regrowth, while the rest of the nail remains intact. Bilateral partial nail removal involves removing a small piece from both sides of the nail. Total nail removal, on the other hand, involves removing the entire nail, leaving no toenail after the procedure.
Nail Matrix Damage
In some cases, damage to the nail matrix, the area where nails form, can prevent nail regrowth. While it is rare for the nail matrix to be permanently damaged, severe injuries or certain health conditions can interfere with nail growth. However, with proper care, the nail matrix can heal, allowing for healthy nail growth.
Home Care
While not a guaranteed method to prevent regrowth, proper home care after nail removal can help promote healing and prevent infection. Keeping the area clean, dry, and protected is essential. Trimming any sharp edges or removing the detached nail can also help prevent further tearing. Additionally, taking biotin supplements may promote cell growth and contribute to faster nail regrowth.
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Post-removal care
Dressing the Wound
Keep the wound clean by gently cleansing the toe with warm, soapy water, then pat it dry. It is recommended to use gauze to cover the toe for the first few days, allowing the wound to breathe. Change the dressing once or twice daily, or as advised by your healthcare provider. Maintain a dry dressing for the first week, then you may leave it uncovered at night during the second week to promote airflow and aid healing.
Soaking and Footwear
Soaking your foot in a solution of warm water and Epsom salt can provide pain relief and reduce inflammation. Ensure you wear appropriate footwear to support the healing process and prevent future ingrown toenails. Avoid tight, pointy shoes, and replace your footwear every 8 to 12 months.
Monitor for Infection
Be vigilant for signs of infection, such as increased redness, swelling, or pain, and contact your healthcare provider if these occur. Other signs of infection include pus or discharge from the wound, fever, or chills.
Follow-up Care
Schedule a follow-up appointment with your podiatrist or doctor about a week after the procedure to assess the healing process, check for signs of infection, and provide further treatment recommendations. During the first two weeks, monitor for regrowth of the nail, as partial regrowth can cause pain, and further procedures may be required.
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Frequently asked questions
The first thing to do is remain calm and seek medical attention. Do not try to remove the nail yourself, as this could lead to serious complications and increase the risk of infection.
The doctor will first determine the best course of action by examining the affected area. They may order an X-ray to assess the damage and determine if other treatments are needed. The procedure involves administering local anesthesia, cleaning the area, separating the nail from the skin, and using tools to lift and remove the nail plate. Antibiotic ointment will be applied to prevent infection, and the wound will be bandaged.
Toenails typically take 6 to 18 months to reach a normal length after removal.
Removing a toenail at home can lead to infection and other complications. It may also result in a thickened, misshapen, or ingrown nail.
In many cases, a damaged toenail can be treated without removal. It is recommended to consult a doctor, who can determine the cause and the best course of treatment.
