Problems with your toenails can be incredibly painful. When simple treatments like soaking your feet or applying an anti-fungal cream don’t work, you might start to consider having your toenail removed.
Toenail removal can be either temporary or permanent. A temporary removal means your toenail will likely grow back. This article is about permanent toenail removal, which involves procedures that prevent your toenail from growing back.
There are advantages and disadvantages to procedures that permanently remove a toenail, and this article will explore those pros and cons.
Many people consider permanent toenail removal to relieve the pain and trouble caused by ingrown toenails and toenail fungus.
When is toenail removal necessary?
Most of the time, your toenails keep to themselves. But sometimes, they can cause pain and problems.
Here are some of the reasons you might need to have a toenail removed:
- Recurring toenail fungus: If you have a toenail fungus that just won’t go away with other treatments, it may be time for the nail to come off.
- Ingrown toenails: When a toenail grows into the skin around it over and over, it’s called an ingrown toenail. If this happens frequently, you might need to have the nail removed.
- Trauma to the nail: If you badly damage a toenail, it may not be able to grow back normally.
- Onychogryphosis: That’s the medical term for a toenail that’s gotten super thick or deformed.
- Nail tumors or warts: If something abnormal is growing on or around your nail, you may need to have it removed.
Permanent removal may be the answer when:
- Other treatments haven’t worked for you.
- You have severe pain or infections that keep coming back.
- Scar tissue keeps your nail from growing normally.
What happens during permanent toenail removal?
If you’re considering permanent toenail removal, it’s important to understand the procedure itself.
Preparation
First, you’ll have a consultation with a podiatrist to make sure you’re a good candidate for the procedure. The podiatrist will walk you through the process, including any risks and benefits.
You’ll also get instructions to follow before the procedure. For example, you may need to stop taking certain medications.
The surgical process
Here’s a brief overview of what to expect during permanent toenail removal:
- The podiatrist will numb your toe with local anesthesia to minimize pain.
- Next, the toenail will be detached from the nail bed.
- Then, the nail matrix will be destroyed using a chemical (usually phenol) or surgical methods. This step is crucial to prevent the nail from growing back.
- Finally, a tourniquet may be applied to control bleeding.
After the procedure
After the procedure, you’ll receive instructions on how to care for your toe as it heals. This typically involves:
- Bandaging and wound care
- Keeping your foot elevated and avoiding pressure on the toe
- Redressing the toe with sterile, non-adherent dressings
- Soaking the affected toe in warm water and Epsom salts daily (as directed by your podiatrist)
Pros of permanent toenail removal
So, what are the good things about getting a permanent toenail removal?
- No more pain. The procedure provides long-term relief if you’ve been dealing with chronic pain due to ingrown toenails, fungal infections, or other issues.
- No more recurrence. Permanent toenail removal prevents the toenail from ever growing back, which solves the problem permanently.
- Better quality of life. You’ll be able to participate in activities without having to worry about pain and discomfort.
- Lower risk of infection. Problematic toenails can cause recurring infections, but removing the nail eliminates that risk.
- Simple procedure. The procedure itself is quick (about 20 minutes) and is performed with local anesthesia.
- Convenience. You won’t have to spend time and money on ongoing treatments and maintenance.
Essentially, if you’re tired of dealing with a painful toenail problem, permanent removal can be a very effective and convenient solution.
What are the cons of permanent toenail removal?
Like any procedure, permanent toenail removal has some potential drawbacks.
Permanence
Once a toenail is removed permanently, it’s gone for good. For some people, this may not be a big deal. For others, it’s a cosmetic concern.
Potential complications
- Infection. There’s always a risk of infection at a surgical site.
- Delayed healing. Some people heal more slowly than others.
- Nerve damage. It’s possible to experience nerve damage, which can cause numbness or tingling in your toe.
- Phenol flare. Phenol is a chemical used in some procedures. Some people experience an inflammatory reaction to it.
- Regrowth. The goal is to prevent the nail from growing back, but there’s a small chance of partial regrowth. According to the Australasian College of Podiatric Surgeons, this happens in fewer than 10 out of every 100 patients.
Cosmetic concerns
Without a toenail, your toe will look different, but solutions like Keryflex can help restore your toenails. The nail bed may also become more sensitive to pressure or temperature.
Recovery time
You’ll need to allow time for the area to heal, usually one to two weeks. During that time, you may need to limit your activities.
Alternative Treatments and Considerations
If permanent toenail removal seems too drastic, there are other options to explore. Keep in mind that most of these won’t solve the underlying problem, though.
- Temporary Toenail Removal: This is an option if you want relief but aren’t ready to commit to permanent removal.
- Routine Nail Care: Regular trimming, including expert tips for safe trimming of fungus toenails, and proper maintenance can help prevent ingrown toenails.
- Topical or Oral Medications: If you have a fungal infection, antifungal treatments may help.
- Orthotics: Shoe inserts can correct foot problems and reduce pressure on your toes.
Talk with your doctor about what’s best for you.
Frequently Asked Questions
Can you get nerve damage after toenail removal?
While rare, nerve damage is a potential risk following toenail removal, whether temporary or permanent. The nerves surrounding the nail bed are delicate, and surgery can sometimes lead to temporary or, in very rare cases, permanent nerve damage. That’s why it’s so important to choose an experienced podiatrist.
What is the downside of toenail removal?
The main downsides include the risk of infection, pain during and after the procedure, potential for nerve damage (as mentioned above), and the possibility of the nail growing back abnormally if the nail matrix isn’t completely removed during a permanent procedure. Plus, without a toenail, the toe is more vulnerable to injury.
What happens if you pick your whole toenail off?
Picking off your entire toenail is a big no-no. It can cause significant pain, bleeding, and a high risk of infection. It also increases the chances of the nail growing back deformed or not at all. If your toenail is loose or damaged, see a podiatrist for proper evaluation and care, instead of taking matters into your own hands.
Can I live without toenails?
Yes, you can definitely live without toenails! Many people have had permanent toenail removal and lead perfectly normal lives. However, keep in mind that your toes will be more susceptible to injury and you’ll need to take extra care to protect them from trauma and infection.
How do podiatrists remove toenails?
Podiatrists typically remove toenails using a procedure called a nail avulsion. After numbing the toe with a local anesthetic, the podiatrist carefully separates the nail from the nail bed. For permanent removal, a chemical (usually phenol) is applied to the nail matrix to prevent regrowth. The whole procedure is usually quick and performed in-office.
To Conclude
Permanent toenail removal can be a great solution for long-term nail problems like recurring ingrown toenails. The upside is that you’ll no longer have the pain and discomfort associated with the problem nail. The downside is that you’ll have to consider the risks of surgery and be sure that you’re okay with the way your toe will look afterward.
If you’re considering permanent toenail removal, a podiatrist can help you decide whether it’s the right choice for you. It’s important to weigh the pros and cons carefully, think about your preferences, and get a professional opinion before making a final decision.