Unless you had your finger accidentally slammed in a door, you probably haven’t even had to think about a nail coming off one of your digits. However, it may be surprising to know that nail removal—specifically, removal of a toenail—is a fairly common procedure.
Sometimes removing the nail is the only way to fix, or attempt to fix, a recurring problem. But why would someone need a toenail removed? How is it done, how do you recover, and what are the most important things to know before having it done? Here are some of the most vital things to keep in mind before you go under the knife.
Table of Contents
- 1 Know What It Is
- 2 Know What It Treats
- 3 Know How It’s Done
- 4 Know It May Have to Be Permanent
- 5 Know Not to be Afraid
- 6 Know It Need Not Be Your Only Option
- 7 Know What to Ask
- 8 Know How to Recover
- 9 Conclusion
Toenail removal means the surgical excision of all or part of a toenail when it is diseased, painful, or infected. It is an extremely minor surgical procedure and can be completed very efficiently in a normal doctor’s office or a clinic.
Most frequently, toenail removal is a treatment for advanced cases of toenail fungus. (Fungus is a surprisingly common problem; over half of the nail infections treated by doctors are caused by fungi!)
It is also very commonly used to treat ingrown toenails (this way, the nail has a chance to regrow in the proper way and other less radical treatments can work more effectively on the nail bed) or “ram’s horn” nails.
Many times, a doctor may choose to excise a portion of the toenail to examine the nail bed, nail folds, or matrix more minutely, apply other treatments, or determine whether a biopsy is necessary in cases of potential cancers or fungal infections.
In addition, toenails can be removed in cases of toenail warts or tumors.
As already alluded to, the entire toenail is not always removed. Sometimes, only a portion is taken off, especially if it is the only diseased, ingrown, or otherwise adversely-affected part.
A toenail removal procedure can be done in less than twenty minutes. It can safely and easily be performed at your podiatrist’s office or at a clinic.
Your doctor will inject a local anesthetic into your toe so you will not feel any pain (or likely any sensation at all). The doctor will then loosen the folds of skin around the nail, aptly called nail folds, and separate the nail from the toe by easing a tool beneath the nail.
This process is called avulsion. While some patients report feeling pain during the procedure, most do not, and generally report the pain comes afterwards.
At this point, if he or she has not discussed this with you earlier, the doctor may recommend that you have the nail permanently prevented from growing back. This is only done in severe cases of fungus or other disorders where the problem would simply keep occurring if the nail grew back.
(It can also be done if the nail matrix has been so badly affected by prolonged lack of treatment, or especially severe infection, that scar tissue would prevent the nail from growing normally ever again.) To do this, the doctor must destroy the nail matrix, which is the part of the toe that produces keratin, the element that toenails are made of.
The matrix can be dissolved chemically, which is the most common. This is called chemical cauterization, and involves the application of a chemical called phenol. Occasionally, some patients report their nails growing back, but generally this method is effective.
If this does not work, your doctor will perform a surgical matrixectomy. A flap of skin is surgically created at the base of the nail, where the matrix is located. After retracting the flap, the matrix is surgically removed.
Surgery can be nerve-wracking and scary. Nobody likes pain, hospitals, scalpels, cuts, and anesthesia. The whole idea can be very unpleasant—even reading about it can turn the stomach!
But, it is very important to remember that thousands of people have experienced nail removal and have lived to tell (even laugh!) about it! While there may be some discomfort and pain following the procedure, if a qualified doctor or other medical professional has concluded this is the best treatment for your specific problem, let that give all the comfort it should. We are very blessed to live in a world where so many health problems can be easily corrected!
As already mentioned, nail removal is usually a last resort, after other methods have failed to be effective. As such, your doctor is not likely to recommend or even mention nail removal before trying oral and topical medications, ointments, and various other treatments.
Depending on the precise issue, many people have found great (even permanent) success and healing using all kinds of other treatments. Because nail fungus (see the symptoms here) is a very common reason for toenail removal, look at these different options for how to safely and effectively treat toenail fungus.
(You can and should also ask your doctor about any preferred or ideal treatments, and be sure to involve him or her whenever undertaking self-treatment options.) However, the more severe the case and the longer it has gone without treatment, the more likely your doctor will insist on nail removal as the only possible option.
As with any medical procedure, but especially anything surgical, it’s wise to know what to ask your doctor so you have the most understanding of what is going to happen to you. Some important questions include:
- Is this my only option?
- What exactly does the procedure involve?
- How effective will this be at treating my condition?
- Can I combine it with other treatment options safely? If so, which ones and at what point before and after surgery? (Multiple factors, including the specific stage of your condition and whether the nail has been partially or totally removed, will affect this answer. Whether or not the matrix has been destroyed, permanently preventing nail growth, will as well.)
- Can I drive a car?
- What other ways will my life be inconvenienced by this surgery?
- How painful will the recovery be?
- What are safe ways to deal with the pain?
- How can I properly care for myself afterwards and ensure a safe, speedy recovery?
- What do I have to do going forward to prevent the fungus or other issue from returning? (Don’t waste your surgery and have to do it all over again!)
Ideally, your doctor or other medical professional will have provided you with clear and understandable instructions for proper self-care following the removal. If so, be sure to follow these instructions precisely and with no deviation, and be sure to notify your doctor if there is unusual pain, heavy bleeding, or other complications so they can be dealt with immediately.
If your doctor has not given you specific instructions, the following basic ones will be a start:
- Be sure to wash the wound in warm, clean water twice a day, and change the dressing. This should be done in the first 24 to 48 hours. Do not use anything like rubbing alcohol because that will dry out the skin and impede healing.
- Cover the wound with a thin layer of Vaseline or other petroleum jelly and apply a nonstick bandage. Do this regularly.
- In the case of full nail avulsion, antibiotics may not be necessary. It is important to dress the wound in nonstick gauze (your doctor will do this for you) and to keep the foot elevated for the first 24 hours. Be sure to wash your hands with soap and hot water first to prevent infecting the wound. After that, you may soak the toe in warm water and redress it.
- Your toenail will take approximately 12 to 18 months to grow back completely. It will look different than your other toes given the injury to the nail bed.
Surgery of any kind tends to not be enjoyable, and it isn’t hard to see why. Besides the general inconvenience of recuperation, the fear of having sharp implements cutting into and removing any part of one’s body is rather disturbing, even if the removing is done by a trained, sane medical professional.
Doubtless if your doctor is recommending, or even insisting upon, toenail removal, you are at the end of a long road of pain, embarrassment, discomfort, frustration, and any number of other emotions that come with recurrent, recalcitrant medical issues.
While surgery isn’t supposed to be fun, knowing what to expect, what will be done, how to recover, and where to go from here will give you the mental framework to approach even minor surgery with resilience and security. Listen to your doctor, approach recovery with diligence and determination, and look at the removal as one step (pun definitely intended) towards the healthy, happy feet you want and deserve.
If part of your nail has been removed it will usually take six to eight weeks to heal. If all of your nail has been removed it will usually take eight to ten weeks to heal. It is normal for the wound to weep.What to expect after toenail removal surgery? ›
Recovery lasts 1-2 weeks.
You can shower with your bandage on and change it afterwards. Pain during ingrown toenail surgery removal should be less than the pain experienced while having the ingrown toenail. Over-the-counter pain relievers and anti-inflammatories can be taken to help minimize any superficial pain.
Most patients can return to work after 48 hours of rest, especially if they take all the advised post-surgery steps. Full healing of the surgical site can take between two to six weeks, and in some cases longer.Is toenail removal surgery painful? ›
It's normal to worry about how painful nail surgery might be. Reassuringly, the only slightly painful part is the injection used to administer anaesthetic - very similar to the one you may have in your gums at the Dentist. Once the toe is numb, you will not experience any pain while the nail is removed.When can I shower after toenail removal? ›
Care of Wound Site
Keep wound dry for 24 hours, then remove bandage and shower normally. Cleanse wound gently, allowing soap and water to run over wound, but do not scrub. Keep wound moist with Polysporin ointment or Vaseline, and cover daily with a clean non-stick bandage.
To help with your recovery: Wear cotton socks and loose fitting shoes for about 2 weeks. Do not run or engage in strenuous activities until the toe is healed. You may need to wait 2 weeks.What shoes to wear after toenail removal? ›
You may want to wear open-toed shoes. If wearing closed shoes, make sure they are not too tight. Wear cotton socks. You may need to do this for about 2 weeks.How painful is recovery from toenail removal? ›
However, the minor surgery to remove an ingrown toenail is mostly painless, and if you follow the doctor's aftercare instructions, your toe should heal with little discomfort. Most patients resume normal activity without restrictions within a few days.How long should I dress my toe after nail removal? ›
Once you start to redress your toe you must change the dressing every 2-3 days following the instructions given. Change the dressing more frequently if there is a lot of weeping from your toe and the dressing is getting soggy, stained or smelly.How do you make a toenail removal heal faster? ›
Use a warm saltwater solution containing 2 teaspoons of table salt per quart of water or an Epsom salt soak following the container directions. Soak the foot for 5-10 minutes, dry the foot and replace the bandage.
Plan on doing nothing more than resting and elevating your limb for the first two weeks after your surgery. Keep your cast or bandage dry and do not change it.Does it hurt to walk after toenail removal? ›
Although you'll be able to walk, your toe will remain numb for a few hours due to the local anaesthetic we use to block the pain. Once this anaesthetic wears off you may feel some slight discomfort in the toe. This is completely normal and we recommend taking some painkillers if you need to.What are the complications of toenail removal? ›
Complications from ingrown toenail removal do not occur very often. Potential complications include recurrence, visible narrowing of the nail, thickening or discoloration and infection. Recurrence of an ingrown toenail is probably the number one complication of following surgery.How do you dress a big toe after nail removal? ›
3 Dry gently and thoroughly around the toe without touching the wound. Pat gently rather than rubbing the toe. 4 Cover your toe with the sterile dressing and strap it to your toe with a thin strip of adhesive tape. Don't wrap the tape around the whole toe.Are you put to sleep for toenail removal? ›
Ingrown toenail surgery is usually an outpatient procedure that involves the use of local anesthesia. Local anesthesia means that the person remains awake, but the doctor numbs the area so that the person cannot feel their toe. Some doctors offer a sedative or twilight anesthesia during the surgery.Will I need time off work after toenail removal? ›
You should keep your foot elevated for a few hours and rest on the day of the surgery; the next day, you can return to work or school. You should refrain from running or vigorous exercise for 2 weeks after the surgery.Should you use Neosporin after toenail removal? ›
Ingrown Toenail Removal
Tonight remove your dressing gently and start with a warm, soapy water or epsom salt soak for about 10 minutes. Afterwards, dry your foot and toe well. Use triple antibiotic ointment or neosporin and a bandaid to cover the area.
You may cover the wound with a thin layer of petroleum jelly, such as Vaseline, and a non-stick bandage. Apply more petroleum jelly and replace the bandage as needed.How do you prepare for toenail surgery? ›
To prepare you for surgery, your doctor will first clean and numb your toe with an anesthetic injection. This can be quite uncomfortable. A snug elastic band may be applied to the area near where your toe joins your foot. They may put a wedge under your nail to hold up the ingrown section.Does a scab form after toenail removal? ›
THE HEALING PROCESS
The toe may appear slightly red and puffy for about 10 days, this is normal. It may weep slightly but will begin to dry out after 2 to 4 weeks, and a scab will form.
Ingrown toenail treatment typically is covered by health insurance. For patients without health insurance, ingrown toenail treatment typically costs less than $50 for at-home treatment, but can reach $200-$1,000 or more if a doctor visit and a procedure to remove all or part of the toenail is required.Can you drive after toenail removal? ›
No, you should not drive until the anaesthetic has worn off. It is also not recommended that you drive any significant distance for the first couple of days after surgery.Can I shower after nail surgery? ›
When removing a dressing be sure to inspect if there is any discharge on it. If there is no discharge on a dressing two days in a row and a black scab has formed over the wound then normal showering and bathing can be resumed. You no longer need to salt water bathe the toe(s) and dressings no longer need to be applied.How do I care for my nail bed after nail removal? ›
The nail bed (the tissue under the nail) is moist, soft, and sensitive. Protect the nail bed for the first 7 to 10 days until it dries out and becomes hard. Keep it covered with a nonstick dressing or adhesive bandage until that time. Bandages tend to stick to a newly exposed nail bed.What are the tips for foot surgery recovery? ›
Elevation is crucial to a fast recovery as it helps with pain and swelling. Elevate above the hip level. This is the most beneficial position as it helps bring blood away to reduce pressure and lessen pain. Also, use ice or ice packs soon after surgery by applying for 20 minutes on and then 20 minutes off.Should I wiggle my toes after foot surgery? ›
After 72 hours
Unless you have had toe surgery we suggest that you wiggle your toes for 15 seconds and rest for 15 seconds. Do this for four minutes. This should be done approximately 4 times per day, separated by at least four-hour intervals.
After your nail has been removed, it will take a few weeks for the nail to start to grow back. It will take about 3 to 6 months for a fingernail to fully grow back. A toenail will take about 6 to 12 months. Your nail will often, but not always, grow back normally.How do you take care of your toe after a toenail is removed? ›
Your provider may recommend soaking your foot in warm water before removing the dressing. This helps the bandage to not stick to the wound. In the following days, change the dressing once or twice a day or as suggested by your provider. Keep your wound covered both day and night in the first week.What are the risks of permanent toenail removal? ›
Permanent removal carries risks. Sometimes a bulbous shape will form on the toe tip, Dr. Langer said, making nerves more sensitive and leaving the toe vulnerable to sores or calluses. And, in some rare cases, toenails grow back even after surgery to do away with them.Can you walk after toenail surgery? ›
We do not advise walking home after your surgery. There is a limit to how much local anaesthetic you can have in a 24-hour period. Avoid any procedures which may involve a local anaesthetic, for example at the dentist, 24 hours before and after your appointment with us. We recommend that you eat and drink normally.