Caleb Foster
Toenails are made of a tough, non-living substance called keratin, so they are technically already dead. However, they can become damaged or separated from their nail bed (a condition called onycholysis) due to various reasons, including trauma, fungal infections, and complications from ingrown toenails. While it may be tempting to remove a damaged toenail yourself, it is important to consult a doctor first as attempting removal without medical advice can lead to serious complications and increase the risk of infection. Doctors can determine the underlying cause and scope of the problem and suggest appropriate treatments, which may include trimming away the dead nail, antifungal medications, or, in extreme cases, toenail removal surgery.
| Characteristics | Values |
|---|---|
| Reasons for dead nails | Trauma, fungal infection, complications from an ingrown toenail, iron deficiency, chemotherapy, non-steroidal anti-inflammatory drugs, nail polish, nail gloss, nail hardener, nail polish remover, fake nails, psoriasis, autoimmune diseases |
| Risks of self-removal | Increased chance of infection, risk of damaging the skin of the nail bed, thickened, misshapen, or ingrown nail regrowth |
| Pre-removal steps | Clean the toe with warm, soapy water, dry it, sterilize the clippers with rubbing alcohol |
| Removal steps | Clip away the portion of the nail resting on dead skin, wrap the toe with an adhesive bandage, apply antibiotic ointment or petroleum jelly |
| Post-removal steps | Keep the toe clean and bandaged, trim away new pieces as they begin to loosen naturally |
| Professional removal | A doctor will use sanitized instruments in a sanitized environment, they may use local anesthesia, an elastic band, or a tourniquet |
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What You'll Learn
Consult a doctor
While there is advice available on how to remove a dead nail yourself, it is a risky undertaking. There could be more damage to your toe than is visible, and any misstep may lead to serious complications. A doctor will be able to perform the procedure in a sanitized environment with the correct tools, reducing the risk of infection.
If you have a blood blister under the nail, it is recommended that you consult a doctor. They will be able to pierce the nail with a sterilized pin to drain the blister. If you have diabetes, peripheral arterial disease, or any problems with your feet, do not attempt to drain a blister at home.
Fungal infections are a common cause of nail separation. Your doctor can prescribe suitable oral or topical antifungal medication. If you have onycholysis, your doctor may perform a biopsy to evaluate your symptoms. They may also recommend that you stop using certain nail products that could be causing the issue.
If you have a severely damaged toenail, it is a good idea to consult a doctor. They can determine the cause and full scope of the problem, and help you understand your options. The doctor will start by separating the nail from the skin, then insert a tool under the nail to lift and remove the nail plate. The area will be cleaned, and antibiotic ointment will be applied to prevent infection. Depending on the cause, you may not want the nail to grow back. This can be accomplished by applying a chemical solution, or surgically removing the nail matrix.
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Treat the underlying cause
While it is possible to remove a dead toenail at home, it is recommended that you seek advice from a medical professional first. A doctor will be able to determine the underlying cause of the issue and advise on the best course of treatment.
Toenails can become damaged for a variety of reasons, from trauma to fungal infection, complications from an ingrown toenail, or even autoimmune diseases such as psoriasis. In many cases, these conditions can be treated without removing the nail. For example, fungal infections can be treated with oral antifungal medication, such as terbinafine (Lamisil), itraconazole (Sporanox), or fluconazole (Diflucan). Topical antifungal medications are also available in the form of creams, ointments, or gels, which are rubbed directly onto the nails. It is important to finish the full course of medication to prevent the fungus from returning and being harder to treat.
If you have onycholysis, which is when your nail separates from its nail bed, treatment may involve cutting away the separated nail as it grows out or taking antifungal medication. Onycholysis can be caused by an injury to the nail, fungi, or a reaction to chemicals in nail polish, nail gloss, nail hardener, nail polish remover, and fake nails. It can also be caused by certain medications, such as chemotherapy, tetracycline, nonsteroidal anti-inflammatory drugs (NSAIDs), psoralens, and oral retinoids (vitamin A derivatives).
In some cases, toenail removal surgery may be necessary, especially if you have a difficult-to-treat fungal nail infection, a suppressed immune system, or diabetes.
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Clip away dead nail
Clipping away dead nails is a straightforward process, but it requires careful execution to avoid injuring the skin around the nail. Before you begin, ensure you have the proper tools. Use a nail clipper or nail scissors for your fingernails and a toenail clipper for your toenails. It is recommended to opt for high-quality tools as they are less likely to tear or bend your nails.
Once you have the right tools, start by washing your toe with soapy water. Carefully inspect the nail to identify the portions that are not firmly attached to the nail bed. Use the nail clippers to clip away only the dead parts of the nail, being careful not to clip any healthy portions. If there is a blood blister under the nail, pierce the nail with a sterilized pin to drain it before proceeding with clipping.
After removing the dead nail, use a nail file to smooth down any jagged edges on the remaining part of the nail. Clean your toe again with soapy water, then apply an antibiotic ointment, and cover it with a bandage. Change the bandage regularly while waiting for your toe to heal, which may take around 6 to 12 months.
It is important to note that attempting to remove a toenail at home can increase the risk of infection and other complications. If you are unsure or uncomfortable with the process, it is best to seek advice from a medical professional. They can guide you through the proper removal and aftercare procedures to ensure your nail heals effectively.
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Clean the toe
Before attempting to remove a dead toenail, it is important to clean the affected toe with warm, soapy water. Dry it thoroughly before proceeding. Cleaning your toe and nail area will help prevent infection. You should also clean your hands to reduce the risk of transmitting bacteria.
It is recommended that you seek medical advice before attempting to remove a toenail. A doctor will be able to advise on the best course of action and can perform the procedure in a sterile environment, reducing the risk of infection. They may also recommend an X-ray to assess the structure of the toe and determine if there is any underlying damage.
If you choose to proceed with removing the toenail yourself, it is important to sterilize any tools you will be using, such as nail clippers or scissors, with rubbing alcohol. This will help prevent the introduction of bacteria, which can lead to infection.
After removing the top portion of the nail, it is advisable to apply a bandage to the toe. The exposed skin will likely be sensitive, and a bandage can provide protection and minimize discomfort. You can also apply an antibiotic ointment or petroleum jelly to encourage healing and further reduce the risk of infection.
Keeping the area clean and dressed is crucial during the healing process. Continue to trim away any loose pieces of the nail as it comes away from the nail bed. Do not attempt to pull off any pieces of the nail that are still attached, as this can cause pain and damage to the nail bed.
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Wrap the toe
Wrapping your toe is an important step in the process of removing a dead nail and caring for your toe as it heals. The newly exposed skin will likely be raw and tender, so wrapping your toe will help to minimise any discomfort.
To wrap your toe, start by cleaning your toe with warm water and gentle soap, ensuring that you remove any debris. You can then apply a thin layer of petroleum jelly, such as Vaseline, to the exposed area. Cover the toe with a non-stick bandage, being careful not to apply too much pressure. Change the bandage regularly, especially if it gets wet, and reapply the petroleum jelly each time.
It is important to keep the nail bed dry to prevent infection. Watch out for signs of infection, such as increasing heat, redness, pain, tenderness, swelling, or pus. If you notice any of these symptoms, remove the bandage and seek medical advice.
You may need to wrap your toe for several days or weeks, depending on the severity of the injury and the rate of healing. During this time, it is important to keep your toe elevated and to rest as much as possible. Avoid any activities that may put pressure on the toe or expose it to dirt or bacteria.
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