Permanent Toenail Removal (Update)

Permanent Toenail Removal

Permanent toenail removal is a surgical procedure that involves the complete removal of the toenail and nail bed. In some cases, individuals may opt for permanent toenail removal due to chronic toenail infections, recurring ingrown toenails, or toenail abnormalities that cause pain and discomfort.

This procedure is typically performed by a podiatrist or foot specialist using a local anesthetic to numb the toe area. After the toenail and nail bed are removed, the wound is carefully sutured to promote healing.

While permanent toenail removal may alleviate the issues associated with certain toenail conditions, it is important to consider the potential risks and potential for complications before making a decision.

Consulting with a healthcare professional is recommended to discuss the benefits, risks, and alternatives of permanent toenail removal.

What Is Permanent Toenail Removal?

Definition and explanation of the procedure

Permanent toenail removal, also known as toenail avulsion or onychectomy, is a surgical procedure that involves the complete removal of the toenail and its underlying nail bed. This procedure is typically performed by a qualified podiatrist or foot surgeon.

It is done under local anesthesia to numb the area and minimize discomfort. The main purpose of permanent toenail removal is to treat severe and chronic nail conditions that have not responded to conservative treatments.

The procedure itself involves making a small incision along the side or the base of the toenail to gain access to the nail bed. The podiatrist then carefully lifts the nail off the bed and removes it completely. Depending on the condition of the nail, the podiatrist may also remove a portion of the nail bed to prevent regrowth.

After the removal, the area is cleaned and dressed with a sterile bandage to promote healing. In some cases, the podiatrist may also use a chemical called phenol to cauterize the nail bed and prevent regrowth. This step is known as a chemical mastoidectomy and helps to ensure the nail does not grow back.

When is it necessary?

Permanent toenail removal is typically considered as a last resort when other treatments have failed to alleviate the pain and discomfort associated with chronic nail conditions. Some situations where toenail avulsion may be necessary include:

  1. Recurrent ingrown toenails: Ingrown toenails occur when the nail grows into the surrounding skin, leading to pain, redness, and swelling. For individuals with chronic ingrown toenails that do not respond to conservative treatments, permanent toenail removal may be recommended as a means to provide long-term relief.
  2. Fungal nail infections: Fungal infections, such as toenail fungus, can cause thickening, discoloration, and crumbling of the nails. In severe cases where other treatments have failed to eliminate the infection, permanent toenail removal may be considered as an option.
  3. Severe trauma or damage: In cases where the nail has sustained severe trauma, such as from a crush injury or repetitive trauma, the nail may become deformed, loose, or painful. If the damage is irreversible and causing ongoing discomfort, permanent toenail removal may be recommended.
  4. Chronic nail deformities or abnormalities: Some individuals may be born with nail deformities or have congenital conditions that cause abnormal nail growth. When these conditions are causing pain, persistent infections, or significant discomfort, permanent toenail removal may be considered.

It’s important to note that toenail removal is a serious decision that should be thoroughly discussed with a qualified healthcare professional. They will evaluate your specific situation, consider all possible treatment options, and recommend the most suitable course of action based on your individual needs.

Reasons For Permanent Toenail Removal

Permanent toenail removal, also known as toenail avulsion, may be recommended in certain circumstances to address chronic toenail infections, severe ingrown toenails, or trauma or injury to the toenail.

While this procedure is not typically the first course of action, it can provide long-lasting relief for individuals who have exhausted other treatment options without success. Here, we will explore each of these reasons in detail.

Chronic toenail infections

Chronic toenail infections can be a source of constant pain, discomfort, and embarrassment. If a toenail infection doesn’t respond to initial treatment attempts, such as oral or topical antifungal medications, an ingrown toenail, or even minor nail bed injury.

Permanent toenail removal can effectively eliminate the source of the infection.

Severe ingrown toenails

Ingrown toenails, a common condition where the nail grows into the surrounding skin, can cause severe pain, tenderness, swelling, and infection. While many cases of ingrown toenails can be managed with home care or minor procedures, severe cases may require permanent toenail removal.

This procedure ensures that the ingrown portion of the nail is completely removed, preventing future ingrown toenail episodes.

Trauma or injury to the toenail

Accidents happen, and sometimes our toenails bear the brunt of them. Trauma or injury to the toenail, such as a heavy object falling on the foot or stubbing the toe, can result in significant damage or deformity.

If nonsurgical treatments aren’t effective at repairing the toenail, permanent removal may provide a solution. Although it might seem extreme, this procedure can alleviate pain and discomfort caused by a damaged toenail and restore normal foot function.

In conclusion, permanent toenail removal can be a viable solution to address chronic infections, severe ingrown toenails, and trauma or injury to the toenail that doesn’t respond to conventional treatments. By eliminating the source of the problem, individuals can experience long-lasting relief and improved quality of life.

Alternatives To Permanent Toenail Removal

When considering a treatment for persistent toenail issues, many individuals may immediately think of permanent toenail removal. While this option can be effective in certain cases, it is important to also explore the alternatives that could potentially provide relief without the need for complete removal.

Medications and Topical Treatments

One alternative to permanent toenail removal is the use of medications and topical treatments. This approach focuses on managing the underlying condition that is causing the nail problem. There are several options available:

  • Antifungal medications: These medications are typically prescribed for toenail fungus, a common condition that can cause brittle, discolored nails. Antifungal drugs work by targeting the fungus responsible for the infection, helping to eliminate the problem and promote healthy nail growth.
  • Topical antifungal treatments: In addition to oral medications, topical treatments such as antifungal creams, ointments, or nail lacquers can be applied directly to the affected nail. These products contain antifungal agents that penetrate the nail and fight off the infection.
  • Antibiotics: If the toenail issue is caused by a bacterial infection, antibiotics may be prescribed. These medications work by killing the bacteria responsible for the infection, allowing the nail to heal and grow normally.

Partial Toenail Removal

Another alternative worth considering is partial toenail removal. This procedure involves removing only a portion of the affected nail, rather than the entire nail. It is commonly used in cases where the nail is ingrown or causing recurrent infections. The benefits of partial toenail removal include:

  • Pain relief: By removing the problematic portion of the nail, individuals can experience immediate relief from pain and discomfort caused by ingrown nails or infections.
  • Preservation of the nail bed: Unlike permanent toenail removal, partial nail removal allows the nail bed to remain intact. This means that the remaining nail can continue to grow, ensuring the nail’s appearance is maintained.
  • Reduced risk of complications: Partial toenail removal carries a lower risk of complications compared to complete nail removal. In many cases, this procedure can effectively address the underlying issue while minimizing the potential for persistent problems.

Laser Therapy

Laser therapy is gaining popularity as a non-invasive alternative to permanent toenail removal. This innovative treatment involves using laser technology to target the affected nail tissue and destroy fungal or infected cells. The benefits of laser therapy include:

  • Effective fungal eradication: Laser therapy has been shown to be highly effective in eliminating toenail fungus. By precisely targeting the infected tissue, it can destroy the fungus and promote healthy nail regrowth.
  • Minimal discomfort: Unlike surgical procedures, laser therapy is generally painless and does not require anesthesia. Most individuals report feeling a mild warming sensation during the treatment.
  • No downtime: Following laser therapy, there is no downtime or recovery period. Individuals can resume their regular activities immediately after the treatment.

When exploring alternatives to permanent toenail removal, it is important to consult with a qualified healthcare professional who can assess your specific condition and recommend the most suitable treatment option. While permanent toenail removal may be necessary in certain cases, trying these alternatives can provide relief and improve the health and appearance of your toenails.

Preparing For Permanent Toenail Removal

Before undergoing permanent toenail removal, it is important to prepare yourself physically and mentally. This will help ensure a smooth and successful procedure, as well as a faster recovery.

In this article, we will guide you through the essential steps to take when preparing for permanent toenail removal.

Consultation with a podiatrist

A consultation with a podiatrist is the first step in preparing for permanent toenail removal. During this appointment, the podiatrist will assess your condition, discuss the reasons for the procedure, and answer any questions or concerns you may have.

It is important to find a reputable and experienced podiatrist who specializes in nail procedures to ensure the best possible outcome.

Pre-operative instructions and considerations

Once you have scheduled your permanent toenail removal procedure, your podiatrist will provide you with pre-operative instructions that you should follow closely. These instructions may include avoiding certain medications, such as blood thinners, in the days leading up to the surgery. Additionally, you may be advised to stop smoking, as smoking can interfere with the healing process.

Your podiatrist will also discuss any considerations or precautions you need to take when preparing for the procedure. This may include arranging for transportation to and from the clinic, as you may not be able to drive yourself home afterward. It is important to follow these instructions carefully to ensure your safety and optimize the results of the procedure.

To reduce the risk of infection, your podiatrist may recommend cleaning the affected area with an antiseptic solution prior to the surgery. Keeping the area clean and dry in the days leading up to the procedure can also help prevent complications.

During the consultation, your podiatrist may discuss the expected recovery time and any limitations or restrictions you may have during the healing process. It is important to be aware of these factors and plan accordingly. This may involve taking time off work, arranging for assistance at home, or making arrangements for mobility aids, if necessary.

In conclusion, preparing for permanent toenail removal involves consulting with a podiatrist and following pre-operative instructions and considerations. By taking these steps, you can ensure a successful procedure and a smoother recovery.

Remember to communicate openly with your podiatrist and ask any questions you may have to put your mind at ease.

Surgical Techniques For Permanent Toenail Removal

If you are one of the many individuals who suffer from chronic toenail issues such as painful ingrown nails or persistent fungal infections, you may have considered the option of permanent toenail removal.

While the idea of a surgical procedure may seem daunting, there are several effective techniques available that can offer long-lasting relief and improved foot health.

Total Nail Avulsion

Total nail avulsion is a surgical procedure that involves the complete removal of the toenail. This technique is typically recommended for individuals with severe or recurrent nail issues who have not responded to conservative treatments. During the procedure, a local anesthetic is administered to numb the toe, ensuring a pain-free experience.

The podiatrist will then carefully lift the nail using specialized tools and gently detach it from the nail bed. This process allows for the complete removal of the nail, including the nail plate and underlying nail bed tissue.

Nail Matrix Ablation

Nail matrix ablation is another surgical technique used for permanent toenail removal. The nail matrix, the tissue from which the nail plate grows, is selectively ablated or destroyed to prevent future nail regrowth. This procedure is often utilized for individuals with chronic ingrown toenails or deformities that affect the nail matrix.

Local anesthesia is applied, and the podiatrist carefully removes the portion of the nail matrix responsible for nail growth. By targeting the source of the problem, nail matrix ablation eliminates the risk of further nail issues.

Chemical Cauterization

Chemical cauterization is a non-surgical technique that can be used for permanent toenail removal. This method involves the application of a chemical agent to destroy the nail matrix and prevent nail regrowth.

First, the toe is numbed with a local anesthetic to ensure comfort during the procedure. Then, the podiatrist will apply the caustic chemical to the area of the nail matrix.

Over time, the chemical agent works to break down the nail matrix tissue, preventing the growth of a new nail. This technique is ideal for individuals seeking a less invasive option or those who may have contraindications for surgery.

When considering permanent toenail removal, it is crucial to consult with a qualified podiatrist who can assess your specific needs and determine the most appropriate technique for you. Surgical techniques such as total nail avulsion, nail matrix ablation, and chemical cauterization offer effective solutions for chronic toenail issues, providing long-lasting relief and improved foot health.

Recovery And Aftercare

Recovery and Aftercare

After undergoing permanent toenail removal, proper recovery and aftercare are crucial for a smooth healing process. Taking care of the wound and managing any pain or discomfort are essential steps to ensure optimal recovery.

This article will walk you through pain management techniques, dressing changes, wound care, and activities to avoid during the recovery period.

Pain Management

Pain management is an important aspect of the recovery process after permanent toenail removal. While every individual’s pain tolerance may vary, there are several effective techniques that can help alleviate discomfort. Here are some pain management strategies:

  • Take over-the-counter pain relievers such as acetaminophen or ibuprofen as directed by your healthcare provider.
  • Apply ice packs or cold compresses to the affected area for 15-20 minutes every few hours to reduce pain and swelling.
  • Elevate your foot to reduce blood flow and minimize inflammation.

Dressing Changes and Wound Care

Proper dressing changes and wound care are vital for preventing infection and promoting healing. Follow these steps to ensure the wound remains clean and protected:

  1. Clean the wound gently with mild soap and water, and pat it dry with a clean towel.
  2. Apply a sterile dressing or bandage to the area, making sure it covers the entire wound and is snug but not too tight.
  3. Change the dressing regularly, according to your healthcare provider’s instructions. This may involve cleaning the wound and applying a new dressing daily or as advised.
  4. Keep an eye out for signs of infection, such as increased pain, redness, swelling, or discharge from the wound. If you notice any of these symptoms, contact your healthcare provider immediately.

Activities to Avoid During Recovery

To facilitate the healing process and prevent complications, certain activities should be avoided during the recovery period:

  • Avoid wearing tight shoes or footwear that puts pressure on the toe area.
  • Avoid engaging in high-impact activities, such as running or jumping, that may strain the healing wound.
  • Avoid soaking the foot in water, such as in bathtubs, swimming pools, or hot tubs, as it may increase the risk of infection.
  • Avoid excessive walking or standing for prolonged periods to minimize pressure on the healing toe.

By following these pain management techniques, dressing changes, and avoiding certain activities, you can ensure a smooth recovery post-permanent toenail removal. Remember to consult your healthcare provider for personalized guidance and support throughout the healing process.

Common Risks Associated With Permanent Toenail Removal

In some cases, individuals may opt for permanent toenail removal as a solution for chronic toenail problems. However, it’s crucial to be aware of the potential risks that come with this procedure. By understanding these risks, you can make an informed decision and take necessary precautions.


One of the common risks associated with permanent toenail removal is the possibility of infection. When the toenail is removed, it exposes the underlying tissue to potential bacteria or fungi. If proper care is not taken during the recovery period, these microorganisms can enter the wound site and cause infection.

Symptoms of infection may include redness, swelling, pus, and increased pain. It is important to follow the post-operative instructions provided by your healthcare professional to minimize the risk of infection.


Bleeding is another risk that may occur during or after permanent toenail removal. As the toenail is removed, there is a chance of damage to the blood vessels in the surrounding tissue, leading to bleeding. To control bleeding, pressure may be applied to the affected area or a dressing may be used.

If the bleeding persists or is excessive, medical attention should be sought to ensure proper treatment and prevent complications.

Nail Regrowth Abnormalities

Nail regrowth abnormalities can also be a potential risk following permanent toenail removal. Without the presence of the toenail, the nail bed may undergo changes that can affect the regrowth process. Abnormalities such as ingrown nails, thickened nails, or misshapen nails may occur.

It is important to note that these abnormalities can vary from person to person. Regular follow-up appointments with a healthcare professional specializing in foot care can help address any concerns and ensure proper nail regrowth.

Overall, it is important to weigh the potential risks and benefits of permanent toenail removal before undergoing the procedure. Being aware of the risks mentioned above can help you make an informed decision and take the necessary precautions for a successful recovery.

Less Common Risks And Complications

While permanent toenail removal is generally considered a safe procedure with minimal risks, it’s important to be aware of the less common risks and complications that can arise. These include nerve damage, allergic reactions to anesthesia, and excessive scarring or keloid formation.

Understanding these potential risks can help you make an informed decision about whether or not permanent toenail removal is the right choice for you.

Nerve Damage

Nerve damage is a rare but possible complication of permanent toenail removal. The nerves in your toes are delicate and can sometimes be inadvertently damaged during the procedure. This can result in numbness, tingling, or loss of sensation in the affected toe.

While nerve damage is uncommon, it’s essential to discuss this risk with your doctor and ensure they have the necessary expertise and experience to minimize the potential for complications.

Allergic Reactions to Anesthesia

Allergic reactions to anesthesia are another less common risk associated with permanent toenail removal. Anesthesia is typically used to numb the area and prevent pain during the procedure. However, some individuals may have an allergic reaction to the specific type of anesthesia used.

Symptoms of an allergic reaction can range from mild itching and rash to more severe reactions such as difficulty breathing or swelling. If you have a known allergy to certain types of anesthesia or if you have a history of allergic reactions, make sure to inform your doctor beforehand to prevent any complications.

Excessive Scarring or Keloid Formation

Excessive scarring or keloid formation can occur after permanent toenail removal, although it is relatively uncommon. Some individuals may have a predisposition to developing abnormal scars or keloids, which are thick, raised, and sometimes itchy scars that extend beyond the original wound.

While the risk of excessive scarring or keloid formation can vary from person to person, it’s important to discuss this potential complication with your doctor. They can provide guidance on scar prevention techniques and recommend appropriate wound care to minimize the risk of noticeable scarring.

Qualities To Look For In A Podiatrist

When it comes to permanent toenail removal, finding a skilled and reliable podiatrist is crucial. Not all podiatrists are created equal, and it’s important to choose one who possesses the right qualities. Here are two key qualities to look for in a podiatrist:

Experience and Expertise

When considering permanent toenail removal, it’s essential to find a podiatrist with extensive experience and expertise in the field. Look for a podiatrist who has a proven track record of successfully performing this procedure.

An experienced podiatrist will be well-versed in the latest techniques and technologies used for permanent toenail removal, ensuring that you receive the highest quality of care.

Positive Patient Reviews and Testimonials

Another important factor to consider when choosing a podiatrist for permanent toenail removal is the feedback and experiences of previous patients. By reading positive patient reviews and testimonials, you can gain valuable insights into the podiatrist’s expertise and patient satisfaction level.

Look for podiatrists who consistently receive high ratings and positive feedback from their patients, as this is a strong indication of their professionalism and commitment to delivering excellent results.

In conclusion, when searching for a podiatrist to perform permanent toenail removal, it’s crucial to prioritize experience, expertise, and positive patient reviews. By choosing a podiatrist who possesses these qualities, you can have peace of mind knowing that you are in capable hands and can achieve the desired outcome.

Questions To Ask During The Consultation

When considering permanent toenail removal, it is essential to have a thorough consultation with a qualified professional. This allows you to understand the procedure, potential risks, and expected outcomes.

Asking the right questions during the consultation ensures that you make an informed decision. Here are two crucial questions to help you gather important information:

Success rates and expected outcomes

One of the primary concerns when undergoing any medical procedure is the success rate. During the consultation, don’t hesitate to ask your doctor about the success rates of permanent toenail removal. This will give you a realistic understanding of the likelihood of achieving the desired outcome.

Additionally, inquire about the expected outcomes of the procedure. Will your toenails be completely removed, or is there a chance of regrowth? Understanding these details will help you make an informed decision about whether permanent toenail removal is the right choice for you.

Insurance coverage and costs

Another crucial aspect to discuss during the consultation is insurance coverage and costs. Permanent toenail removal may or may not be covered by your insurance provider. Therefore, it is important to inquire about the coverage and any potential out-of-pocket expenses.

During the consultation, ask your doctor about the potential costs associated with the procedure. This includes pre-operative evaluations, the surgery itself, as well as any post-operative care. Understanding the financial aspect of permanent toenail removal will help you plan accordingly and avoid any unexpected financial burdens.

Taking the time to ask these questions during your consultation will ensure that you have a comprehensive understanding of the procedure, success rates, expected outcomes, insurance coverage, and costs. Armed with this information, you can confidently make a decision about permanent toenail removal.

Permanent Toenail Removal


Frequently Asked Questions For Permanent Toenail Removal

What Happens If You Permanently Remove A Toenail?

Removing a toenail permanently can result in pain, infection, slow healing, and altered nail growth.

How Painful Is Permanent Toenail Removal?

The pain experienced during permanent toenail removal can vary from person to person.

Is A Matrixectomy Permanent?

Yes, a matrixectomy is a permanent procedure that effectively removes the entire nail matrix.

Can You Permanently Remove the Ingrown Toenail?

Yes, a permanent solution to remove an ingrown toenail is possible through professional medical procedures.


Permanent toenail removal is a procedure that offers relief for those suffering from persistent toenail problems. By eliminating the affected toenail, individuals can significantly improve their quality of life and reduce pain and discomfort. Whether caused by fungal infections, ingrown nails, or trauma, permanent toenail removal can be a viable solution for individuals who have exhausted other treatment options.

While the decision to opt for permanent toenail removal should not be taken lightly, it is essential to consult with a qualified healthcare professional to discuss the potential benefits and risks. With proper post-procedure care, including following the doctor’s instructions and maintaining good foot hygiene, individuals can experience long-lasting relief.

If you are tired of dealing with chronic toenail issues and are looking for a permanent solution, permanent toenail removal may be worth considering.

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