Sophia Delgado
Toenail injuries are common and can be caused by trauma, fungal infections, or complications from ingrown toenails. While many toenail injuries can be treated without removing the nail, in some cases, the nail may need to be partially or completely removed. Removing a toenail can be risky, and it is recommended to consult a doctor to ensure proper treatment and reduce the risk of infection. After toenail removal, it is important to keep the area clean and treat any underlying issues to promote healing and prevent further complications.
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What You'll Learn
Risks of removing your own toenail
Toenails can become damaged for a variety of reasons, from trauma to fungal infection to complications from an ingrown toenail. While a severely damaged toenail may look "dead," it is actually just damaged. All nails, including toenails, are made of a tough, non-living substance called keratin. Therefore, it is not recommended to remove a damaged toenail yourself as it could lead to serious complications that end up making matters worse.
The risks of removing your own toenail include infection and abnormal nail growth. If you had a fungal infection, it may come back. Removing a toenail yourself can also increase the chances of other complications. Once you get an examination, the actual toenail removal procedure can be performed in a doctor's office and takes 15 to 20 minutes.
Toenail surgery is a minor procedure to remove all or part of a problematic toenail. Local anaesthetic is used to numb the affected toe(s). After the toenail (or section of nail) has been removed, a chemical called phenol is applied to the exposed nail bed to stop the toenail from growing back and prevent further problems.
After the surgery, you may experience tenderness, redness, and swelling. Elevating the affected toe above heart level for about 48 hours after the procedure will help decrease pain and swelling. You will be advised to avoid aspirin or NSAIDs (ibuprofen, Advil) as these may increase the risk of bleeding.
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Toenail regrowth after removal
Post-Removal Care
- Keep the wound clean and change dressings regularly. Use warm, soapy water to gently cleanse the toe, then pat it dry.
- Cover the toe with gauze for the first 3-4 days to allow for drainage and breathing. After this, you can switch to a band-aid.
- Keep your toe covered during the day for the first week. At night, leave it uncovered starting in the second week to aid the healing process and allow it to breathe.
- Keep the foot elevated for the first 4 hours after the procedure.
- Avoid getting the dressing wet, swimming, and strenuous sports activities.
- Soak your foot in a solution of warm water and salt or Epsom salts a few times a day for pain relief.
- Apply a thin layer of petroleum jelly to the nail bed and cover it with a non-stick bandage until the nail bed is firm.
- If you experience bleeding, this is normal. However, if there is excessive bleeding, change the dressing.
- Schedule a follow-up appointment with your doctor or podiatrist one or two weeks after the procedure to ensure proper healing and monitor for any regrowth.
Preventing Future Problems
To prevent future toenail issues, implement the following practices:
- Cut your nails straight across, avoiding cutting them too short.
- Choose comfortable footwear that is not too tight or pointy, and replace your shoes every 8 to 12 months.
- Keep your feet moisturized and avoid cutting the cuticles.
- Avoid biting your nails and be careful when cleaning underneath them.
- Avoid chemicals and products that can irritate your nails, such as nail polish, nail hardeners, and artificial nails.
- Keep your nails short to prevent them from catching on objects.
Regrowth Timeline
It's important to remember that toenails grow back slowly. It can take up to 12 to 18 months for a toenail to fully regrow. During this time, continue to practice good nail care and maintain proper hygiene to support the regrowth process.
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Preventing toenail bed injuries
Toenail bed injuries are quite common, and they can occur when a heavy object crushes or hits the toes, resulting in a cut or bruise. Here are some ways to prevent toenail bed injuries:
Keep Your Nails Trimmed
Keeping your nails short can prevent them from catching on objects and pulling off your nail beds. It is especially important to maintain short nails if you engage in activities that put you at risk of stubbing your toes.
Avoid Wearing Tight Shoes
Wearing shoes that are too tight or not roomy enough can lead to toenail injuries over time. Opt for footwear that provides adequate space for your toes to move freely and avoid shoes that constrict your nails or toes.
Limit Exposure to Water
Prolonged exposure to water can contribute to nail bed injuries. Avoid soaking your nails in water for extended periods, and if your nails tend to get wet frequently, ensure they are thoroughly dried afterward.
Be Mindful of Chemicals and Nail Products
Certain chemicals and nail products can irritate your nails or the skin surrounding them. Avoid using nail polish, nail gloss, nail hardeners, nail polish removers, and fake nails, as these may cause or exacerbate nail bed issues.
Practice Caution with Manicures
Regular manicures, especially those involving forceful trimming, buffing, and polishing, can weaken your nails and make them more susceptible to injuries. If you choose to get manicures, ensure that the tools are sanitized, and consider opting for gentler techniques that minimize force and chemical exposure.
Treat Underlying Conditions
Some medical conditions, such as fungal infections, psoriasis, and skin pigmentation disorders, can increase your risk of nail bed injuries. Consult with a healthcare professional to address any underlying conditions and receive appropriate treatment.
Remember, if you experience a toenail bed injury, it's important to seek prompt medical attention to ensure proper healing and smooth nail regrowth.
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Home remedies for toenail bed injuries
Toenail bed injuries are common and often occur when a heavy object crushes or hits the toes. Many toenail bed injuries can be treated at home, but it's important to know when to seek medical attention. If you are experiencing severe pain, or if your nail is black or purple, it is best to see a doctor.
If you have a mild toenail bed injury, you can follow these steps to treat it at home:
- If any part of your nail is hanging off, gently trim away the part that is not connected to your skin. Use nail clippers or nail scissors to do this.
- Clean the wound gently using soap and water.
- Apply a cool, damp washcloth to the wound to reduce swelling.
- Prop your foot up on pillows so that the injured toe is higher than your heart. This will also help to reduce swelling.
- Take ibuprofen or acetaminophen to relieve pain and reduce swelling.
- Keep a light dressing on the nail, such as an adhesive bandage or a small piece of gauze, to provide padding and protection while it heals.
- Wrap the wound with an elastic bandage, but be careful not to wrap it too tightly.
It's important to keep your nails short to prevent them from catching on objects and causing further injury. Toenails grow slowly, so it may take 12 to 18 months for your toenail to grow back completely after an injury. In the meantime, you can take steps to prevent another nail injury by keeping your nails trimmed and wearing shoes that fit well and have a wide toe box.
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When to seek professional help for toenail bed injuries
Toenail injuries are quite common and can occur from stubbing your toe, dropping a heavy object on your foot, or even from frequent rubbing or friction against a shoe. Most toenail injuries are minor and can be treated at home, but some require prompt medical attention to ensure the nail grows back smoothly.
If you experience any of the following, it is recommended to seek professional help:
- Excessive bleeding: If you are unable to stop the bleeding quickly, it is important to seek medical attention.
- Serious cuts or tears: If your nail is severely cut, torn, or detached from the nail bed, you should seek medical care.
- Infection: Toenail injuries can lead to infections. If you notice any signs of infection, such as redness, swelling, or discharge, it is important to consult a doctor.
- Fractures: If the underlying bone is fractured, you should seek medical attention. An X-ray may be required to determine the presence of any fractures.
- Subungual hematoma: This occurs when there is bleeding underneath the nail, causing a pool of blood to form between the nail and the nail bed. If the blood covers more than half of the nail area, it is important to seek professional help to drain the blood and relieve pressure.
- Fungal infections: Toenail injuries can make you more susceptible to fungal infections. If you notice any signs of a fungal infection, such as thickened, yellow nails with white spots or streaks, you should seek medical attention.
- Nail separation (onycholysis): If your nail separates from the nail bed, it is important to seek professional help to ensure proper treatment and prevent further complications.
It is always better to seek professional advice if you are unsure about the severity of your toenail injury or if you are experiencing any persistent pain or discomfort.
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Frequently asked questions
Removing your toenail yourself is risky as there could be more damage to your toe than is visible. You may end up with a toe infection or a thickened, misshapen, or ingrown nail. It's recommended that you visit a doctor so that you can receive proper treatment and avoid further complications.
Your doctor will first determine the cause and full scope of the problem. They will then perform a physical examination of your toes and may order an X-ray to assess the structure of your toe. After cleaning the affected toe, they will inject local anaesthesia and separate the nail from the skin using sanitized instruments. The procedure takes about 15 to 20 minutes.
Toenails grow slowly, taking 6 to 18 months to reach a normal length. To ensure that your toenail grows back smoothly, elevate your toe above heart level for about 48 hours after the procedure to help decrease pain and swelling. Keep your nails trimmed short to prevent them from catching on objects and pulling further off of your nail bed.
