You should consult a doctor to examine or remove a damaged toenail, in order to prevent infection or other problems. The removal procedure only takes 15 to 20 minutes, but it can take up to 18 months to fully regrow a toenail.
If you have a damaged toenail, you might be tempted to remove it yourself. But while damaged toenails sometimes fall off on their own, it’s not a good idea to force that process.
Removing a damaged toenail yourself could lead to serious complications that end up making matters worse.
Fast fact: damaged, not dead
While a severely damaged toenail may look “dead,” it’s actually just damaged. All nails, including toenails, are made of a tough, non-living substance called keratin. So, technically, the nails on your toes are already dead, which is why it doesn’t hurt when you trim your nails.
Toenails can become damaged for a variety of reasons, from trauma to fungal infection to complications from an ingrown toenail.
In many cases, these conditions can be treated without removing the nail. A doctor can determine the cause and full scope of the problem and help you understand all your options.
Let’s go over the reasons you shouldn’t remove a toenail on your own, as well as the method a doctor will use, and what to expect after the procedure.
There are several ways a damaged toenail can be partially or completely removed. A doctor can perform these office-based procedures rather quickly — and much more safely — than you can at home.
There’s no shortage of advice out there on how to remove your own toenail, but it’s a risky undertaking. Crucially, there could be more damage to your toe than is visible to the naked eye.
Any misstep and you may end up adding to your problems, and needing more intervention than if a doctor performed the procedure in the first place.
Infection
A doctor will use properly sanitized instruments in a completely sanitized environment. It’s unlikely that you’ll be able to do the same at home. There’s also a good chance of injuring the skin around the nail.
The introduction of the slightest bacteria can raise the risk of developing a toe infection, with symptoms such as:
- redness
- swelling
- oozing of pus
- foul odor
- throbbing pain
- fever
A toe infection may make it difficult to wear normal shoes and engage in your usual activities.
Long-term or permanent damage
Since you don’t know what’s going on internally, there could be a bigger issue than a damaged toenail. You may only succeed in exacerbating the problem.
You definitely shouldn’t try this if you have diabetes. Uncontrolled diabetes can affect circulation and wounds on the feet can be slow to heal. Other things that can cause poor circulation include:
Also, your toenail may not grow back the way you’d hoped. You could end up with a thickened, misshapen, or ingrown nail, which could put you right back where you started — or worse off.
If you don’t have a podiatrist, start with a visit to a doctor. Be sure to let the doctor know if you have diabetes or another condition that can affect the feet.
After a physical examination of your toes, your doctor may find it necessary to order an X-ray. This will help assess the structure of the toe to see if there’s more damage below the surface.
Your doctor can determine if you may benefit from other treatments or partial removal of the nail.
The procedure
First, the affected toe will be thoroughly cleaned with surgical soap or alcohol. Then, you’ll get an injection of local anesthesia. In some cases, an elastic band or tourniquet will be used at the base of the toe.
You won’t feel any pain, but you’ll be fully awake. If you’re squeamish, you may prefer to look away.
Your doctor will start by separating the nail from the skin. Then a tool will be inserted under the nail to lift and remove the nail plate. The entire area will be thoroughly cleaned out. Antibiotic ointment will be used to lower the chances of infection and the wound will be bandaged.
Depending on the cause of the damaged toenail, you may not want it to grow back. This can be accomplished by applying a chemical solution that helps prevent regrowth. Alternatively, the nail matrix can be surgically removed so regrowth isn’t possible.
The whole procedure takes about 15 to 20 minutes. You may need to sit with your foot elevated for a few minutes before you’re released to go home.
Toenails grow slowly, taking 6 to 18 months to reach a normal length.
Right 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.
Take acetaminophen (Tylenol) for any pain or discomfort. Avoid aspirin or NSAIDS (ibuprofen, Advil), as these may increase the risk of bleeding.
Your doctor will provide instructions on how to change bandages, wash, and care for your toe. If you receive a prescription for oral antibiotics, be sure to continue taking them until they’re all gone.
It can take a few days to several weeks for full recovery. Much depends on the reason for the damaged toenail, whether your toe was also injured, and whether there was infection.
Following toenail removal, seek medical attention if you have:
- lingering or worsening pain
- temperature of 100.4° F (38° C) or higher
- chills
- bleeding or discharge from the toe
- skin that’s warm to the touch
- discoloration of the toe
Risks of surgical toenail removal include infection and abnormal nail growth. Other risks may depend on the cause. For example, if you had a fungal infection, it may come back. You can lower your risk of recurrence by:
- keeping feet clean and dry
- wearing breathable socks and changing them when damp from sweat
- disinfecting shoes and changing them when damp
- wearing flip flops near public pools and in public showers
- letting your feet out for air when relaxing at home
- cutting toenails correctly
- seeking medical attention at the first sign of fungus
In the case of repeated fungal infections or painful ingrown toenails, the toenail may have to be removed again. Ask your doctor about the procedure to destroy the nail matrix and permanently prevent the nail from regrowing.
There’s no hope for a severely damaged toenail, but removing one is a job for a doctor. Trying to do it yourself increases the chances of infection and other complications.
Once you get an examination, the actual toenail removal procedure only takes 15 to 20 minutes and can be performed in a doctor’s office. Then it can take up to 18 months to fully regrow a toenail.
If you attempt to remove a toenail yourself or if it falls off, you should still visit with your doctor to check for infection and proper healing.