Liam Carter
Nails are made of a tough, non-living substance called keratin, and they have a good regeneration capacity. However, removing a nail is not without risks. If you remove a nail yourself, you could cause serious complications and damage to the nail bed or overlying nail fold. A doctor will use sanitized instruments in a sanitized environment, and apply a tourniquet at the base of the finger or toe to minimize bleeding. After a nail removal procedure, it is important to keep the wound clean and dry, and to complete any prescribed medication. Nails may take 6 to 18 months to grow back to a normal length.
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What You'll Learn
Removing a nail yourself can lead to serious complications
In many cases, toenail conditions can be treated without removing the nail. A doctor can determine the cause and full scope of the problem and help you explore your options. Toenails can become damaged for a variety of reasons, from trauma to fungal infection to complications from an ingrown toenail. If you have concerns about the appearance or pain associated with a toenail, it is best to consult a podiatrist. Toenails can be discoloured, thickened, curving, and have crumbly debris under the nail. Depending on the severity of the condition, patients could experience pain in the toes, especially when wearing shoes.
If you attempt to remove a nail yourself, you should still visit your doctor to check for infection and proper healing. Toenail removal procedures performed by a doctor take 15 to 20 minutes and can be performed in a doctor's office. The doctor will use properly sanitized instruments in a completely sanitized environment, which is unlikely to be replicated at home. There is also a good chance of injuring the skin around the nail, which can lead to abnormal nail growth.
In the case of repeated fungal infections or painful ingrown toenails, the toenail may have to be removed again. A doctor can perform a procedure to destroy the nail matrix and permanently prevent the nail from regrowing. Removing a nail yourself is especially dangerous for people with diabetes. Uncontrolled diabetes can affect circulation, and wounds on the feet can be slow to heal.
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Toenails can become damaged for a variety of reasons
Ingrown toenails occur when the side corners of a toenail grow into the skin and pierce the soft tissue. This can cause pain and discomfort and may require partial or complete removal of the toenail. Toenail removal procedures can be performed safely under local ring block anaesthesia, although some patients may opt for general anaesthesia. The nail is gently removed by applying firm and steady distal traction using a tool such as a hemostat.
Fungal infections, such as onychomycosis, are another common cause of toenail damage. Nails infected with fungi may become discoloured (yellowish-brown or opaque), thick, and brittle and may separate from the nail bed. Fungal infections can be treated with chemical avulsion, a weekly application of urea and bifonazole, or surgical nail removal.
Other causes of toenail damage include skin conditions such as psoriasis, chemicals such as acrylic-based gel polishes, and repetitive toe stubbing, which is common in athletes wearing tight shoes. Toenails may also become damaged due to underlying medical conditions such as diabetes, peripheral arterial disease, or immune system problems, which can affect blood flow and sensation in the feet.
It is important to note that removing a damaged toenail at home is not recommended as it can lead to serious complications. A doctor will use sanitized instruments in a sterile environment to minimize the risk of infection and further damage to the nail bed and surrounding skin. Proper postoperative care is crucial for a successful recovery, including keeping the wound clean and dry, elevating the affected foot, and completing the prescribed course of medication.
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Ingrown toenails are a common cause of nail removal
There are several treatment options available for ingrown toenails. Home remedies include soaking the affected toe and placing cotton, dental floss, or a splint under the ingrown edge to separate the nail from the skin and promote proper nail growth. This process typically takes 2 to 12 weeks. Corticosteroid cream may also be prescribed by a healthcare provider to aid in the healing process.
If home remedies are ineffective, surgical intervention may be necessary. Ingrown toenail surgery can be performed under local anaesthesia, with the entire procedure lasting about 10 minutes. There are several techniques used for ingrown toenail surgery:
- Nail avulsion: This involves removing the entire toenail.
- Wedge excision: This technique removes the portion of the toenail growing into the skin, along with the underlying tissue in the corner.
- Nail-bed ablation: This procedure combines nail avulsion with the application of a chemical, typically phenol, to the area of tissue from which the nail grows.
- Zadek's procedure: This approach involves removing the entire toenail and then cutting away the underlying tissue.
After the nail removal procedure, proper postoperative care is essential. Patients should keep their feet elevated for the first 24 to 48 hours to reduce pain and swelling. It is crucial to wear appropriately fitted footwear and doctor-recommended cotton socks. Completing the prescribed course of medication, including antibiotics and painkillers, is also necessary for a successful recovery.
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Nails grow back slowly, taking 6 to 18 months
Nails have a good regeneration capacity, but they grow back slowly, taking anywhere from 6 to 18 months to reach a normal length. Fingernails may grow at a rate of one-tenth of a millimeter each day, so completely removed fingernails usually grow back within 6 months. Toenails, on the other hand, may grow at about half or one-third the rate of fingernails, resulting in a longer regrowth period of up to 18 months. Aging and diseases may further slow down nail growth by decreasing blood flow to the hands and feet.
It is important to note that attempting to remove a nail at home can be risky. While there is no shortage of advice on how to remove nails, it is always advisable to seek professional medical help. Doctors use sanitized instruments in a sterile environment, reducing the risk of infection. At home, it can be challenging to ensure the same level of sanitation, and there is a risk of causing further damage to the nail bed or surrounding skin.
Ingrown toenails, for example, are a common issue that may require nail removal. They occur when the side corners of a toenail grow into the skin, piercing the soft tissue. In such cases, a doctor may recommend partial or complete nail removal through a procedure called onychectomy. This procedure can be performed under local anesthesia or general anesthesia, depending on patient preference and the complexity of the case.
After a nail removal procedure, proper postoperative care is crucial. Patients should elevate the affected foot while resting for the first 24 to 48 hours to reduce pain and swelling. Keeping the wound clean and dry is essential, and patients should follow their doctor's instructions for medication and follow-up care.
While nail removal can be necessary in certain situations, it is always best to consult a medical professional to explore all treatment options and ensure safe and effective care.
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Anaesthetic procedures for nail removal
Nail removal is typically performed under local anaesthesia, although some patients may opt for general anaesthesia. Here are the steps for local anaesthesia:
- Position the patient supine, with the arm abducted and the hand placed on an arm extension, palm facing down.
- Scrub and drape the finger in a sterile fashion.
- Administer local anaesthetic to ring-block the finger. Wait 5-10 minutes to confirm anaesthesia is achieved.
- Secure a finger tourniquet at the base of the finger to minimise bleeding.
- Insert curved Iris scissors or a small periosteal elevator beneath the free edge of the nail (hyponychium).
- Gently open and close the scissors or press the nail bed with the elevator, advancing proximally between the nail plate and the nail bed until reaching the nail fold.
- Once the nail is sufficiently separated from the nail bed, apply firm and steady distal traction using a hemostat to gently remove the nail.
For toenail removal, the procedure is similar, and local anaesthesia is typically used. The affected toe is first cleaned with surgical soap or alcohol, after which the patient receives an injection of local anaesthesia. An elastic band or tourniquet may be used at the base of the toe to minimise bleeding. The doctor then separates the nail from the skin and inserts a tool to lift and remove the nail plate.
It is important to note that nail removal, especially toenail removal, should be performed by a medical professional to prevent serious complications and reduce the risk of infection. Removing a nail at home can lead to more problems and increase the risk of infection, especially if proper sanitation is not maintained.
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Frequently asked questions
Nail removal is a procedure to partially or completely remove a toenail or fingernail. It is often done to treat ingrown toenails or severe damage to the nail.
The doctor will separate the nail from the skin and lift it using a tool. The area is cleaned, and antibiotic ointment is applied to prevent infection. Local anesthesia is usually administered to numb the area.
While there is advice available on how to remove your nail at home, it is not recommended due to the risk of infection and further damage to the toe or finger. It is best to seek medical advice and treatment.
Nails have a good regeneration capacity, but they grow slowly. Fingernails may take up to 6 months to grow back, while toenails can take up to 18 months. In some cases, regrowth can be prevented by applying a chemical solution or surgically removing the nail matrix.
Removing a nail may result in thickened, misshapen, or ingrown nails. There is also a risk of infection, especially if proper post-operative care is not followed. It is important to keep the wound clean and dry and complete the prescribed course of medication.
