Toenail Removal , The Patient Education Institute, Inc. po Last reviewed: 10/27/2014 1

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1 Toenail Removal Introduction Toenail removal is often done for severe fungal nail infections or for ingrown toenails. Part or all of the toenail may be removed. The procedure can be done in your health care provider s office. If your health care provider recommends a toenail removal, the decision whether or not to have the procedure is yours. This reference summary explains toenail removal. It covers why the procedure is needed, alternative treatments and how toenail removal is done. It also talks about what to expect before and after the procedure. Toenails Toenails protect the tissue of the toe. They are made of layers of a hardened protein called keratin. Healthy nails are usually smooth with a consistent color. The toenail rests on the nail bed. This is a soft layer of cells under the hard nail. The toenail is surrounded by supportive skin on all sides. These areas of skin are called the nail folds. Healthy toenails are a sign of good peripheral circulation. Peripheral circulation is when fluids and nutrients are passed through the outer parts of the body, such as the toes. Reasons for Toenail Removal Toenail removal is typically done when a large part of the toenail is damaged or diseased. It is also done if a nail is causing a lot of pain. Part or all of the toenail may be removed, depending on the problem. 1

2 Reasons for full or partial toenail removal include: Repeated inflammation of the nail fold. Injury or deformation of the nail bed. Infection or tumor. Other reasons for toenail removal include: Ingrown nail. Deformed or curved toenail. Fungal infection. Trauma to the nail. A deformed or curved toenail can be caused by injury to the nail area of the toe. It can also be hereditary or result from long-term neglect. It can curve outward or into the skin. Alternative Treatments Not all toenail infections or deformities will need surgery. There are other methods to prevent and heal toenail problems. These may be tried before surgery. A deformed toenail that catches on things may be trimmed with nail clippers if there is little or no pain or other serious problems. This may be done at home or at a health care facility. An ingrown toenail may be treated by soaking it in warm water or applying an antibiotic cream. A fungal infection may require an anti-fungal medicine. There are many types of anti-fungal medicines available, including creams and pills. Sometimes a toenail problem can be a sign of an underlying health condition. Contact your health care provider if: A toenail problem becomes severely painful. A toenail is discolored. A toenail is deformed. 2

3 Before the Procedure A health care provider will want to know the details about a toenail condition before going forward with surgery. Talk to your health care provider about: Home treatments used. If the problem is ongoing. If you have constant or occasional symptoms. Also talk to your health care provider about: If you have diabetes or a circulation problem. When the problem started. Sharing this information with a health care provider can help him or her determine if surgery is the best option to correct your toenail problem. You should also talk to your health care provider about any health issues you have or medications you take before surgery. Toenail Removal Surgical nail removal can be done in a clinic or your health care provider s office. It is an outpatient surgery. You will not need to stay overnight. The procedure will probably take less than a half hour. Anesthesia may be used to numb the toe. Once the anesthesia is working, the toe is cleansed and made sterile. This helps prevent infections. The skin around the toenail is then loosened with a small, sticklike tool. The nail will be lifted off the nail bed. If only part of the nail is diseased, only the diseased part is removed. The toenail is then gently pulled from the base of the nail bed. Clean, dry bandages are wrapped around the exposed tissue on the toe. 3

4 Risks and Complications Toenail removal is safe. But there are possible risks and complications. These are not likely. But they are possible. You need to know about them just in case they happen. By being informed, you may be able to help your health care provider detect complications early. Risks of toenail removal include those related to any type of surgery, such as: Bleeding. Infection. Pain. Other possible complications are related to this type of surgery. Rarely, a toenail removal may result in injury to the: Nail bed. Tissues at the base of the nail. Soft tissue around the border of the toenail. Injury to this can lead to pain and bruising. Blood may also pool. It can be drained through a small hole in the nail made with a needle. Injury to this area can cause pain, swelling and redness around the toenail. Injury may also cause a bacterial infection with pus-filled blisters. Contact your health care provider right away if you experience severe pain. After the Procedure The toe will need to be kept clean and dry for several weeks. Antibiotic ointment will need to be applied to the nail bed area during this time. Antibiotic ointment kills or prevents the growth of bacteria that could lead to infection. The wound from the toe removal procedure typically heals within a few weeks. The toenail may take 12 to 18 months to fully grow back. It may not grow back in some cases. During a follow-up appointment, your health care provider will monitor your healing progress and check for signs of complications. 4

5 Summary Toenails protect the tissue of the toe. Toenail removal is typically done when a large part of the toenail is damaged or diseased. It is also done if a nail is causing a lot of pain. Part or all of the toenail may be removed, depending on the problem. Reasons for full or partial toenail removal include: Repeated inflammation of the nail fold. Infection or tumor. Ingrown nail. Deformed or curved toenail. Fungal infection. Surgical nail removal can be done in a clinic or your health care provider s office. It is an outpatient surgery. You will not need to stay overnight. The procedure will probably take less than a half hour. Regional anesthesia may be used to numb the toe. If only part of the nail is diseased, only the diseased part is removed. The toe will need to be kept clean and dry for several weeks. Antibiotic ointment will need to be applied to the nail bed area during this time. The wound from the toe removal procedure typically heals within a few weeks. The toenail may take 12 to 18 months to fully grow back. It may not grow back in some cases. Toenail removal is safe. But there are possible risks and complications. These are not likely. But they are possible. You need to know about them just in case they happen. By being informed, you may be able to help your health care provider detect complications early. 5

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