Surgical Removal Of Toenail Fungus

Know Not To Be Afraid

Surgery can be nerve-wracking and scary. Nobody likes pain, hospitals, scalpels, cuts, and anesthesia. The whole idea can be very unpleasanteven 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 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!

What If Nail Removal Is Considered

With laser therapy, topical medications, and oral antifungals in our arsenal, we almost never have to actually remove toenails to treat a fungal infection. It does still remain a rare possibility, however, if the case is extreme or continues to come back.

Why not consider nail removal earlier? Because when nails are fully removed, it doesnt necessarily guarantee that the new nail will grow in properly. The nail can grow back misshapened, thickened, or even with fungus re-infecting the toenail – leading you back to square one.

If the new nail comes back in an unpleasant manner or the fungus just continues coming back no matter what, we can treat the underlying nail matrix to prevent new nail from ever growing again . This does not place your nails at any real disadvantage, but its still nice to be able to keep your toenails if you can!

What You Should Know About Toenail Removal

Toenail removal is a minor surgical procedure that removes either the entire toenail or a portion of the toenail that is diseased, damaged, or very painful. People who have experienced trauma to a toenail, have an ingrown toenail, or have severe or recurring toenail fungus may often resort to toenail removal when other, more conservative treatments havent worked.

If you have a difficult to treat fungal nail infection, or if you have a suppressed immune system or diabetes, your podiatrist may recommend removal of the affected toenail to prevent the infection from spreading to other toenails or beyond your feet.

Partial nail removal may also be done for diagnostic purposes to allow your doctor to more closely examine the nail bed and surrounding tissue before deciding whether to conduct a biopsy.

What Happens During A Toenail Removal Procedure

Toenail Removal Recovery

For the first few weeks after having your toenail removed, you will need to keep the wound clean and dry while it heals. You will most likely wear a bandage for about two weeks, and your mobility may be somewhat limited during this time. It may take several months for your toenail to completely grow back. Side effects and complications are minimal after the procedure. The most common problems experienced after toenail removal surgery are pain, infection, and a nail that grows back with an abnormal shape or appearance.

How To Prepare For Toenail Removal

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What Is The Outcome For Someone Who Has Nail Fungus

With treatment, many people can get rid of nail fungus. Even when the fungus clears, your nail may look unhealthy until the infected nail grows out. A fingernail grows out in 4 to 6 months and a toenail in 12 to 18 months.

To clear the fungus, its important to:

• Use the treatment exactly as prescribed

• Apply the medicine for as long as prescribed

• Keep all follow-up appointments with your dermatologist

Nail fungus can be stubborn. If you had a severe infection, its possible to clear the infection. A healthy looking nail, however, may be unrealistic, but you can expect the nail to look better and feel more comfortable.

Even with clearing, nail fungus can return. Youll find steps to reduce your risk in Tips: 12 ways to prevent another nail infection.

ImageGetty Images

ReferenceGold LFS and Rosen T. Onychomycosis: Diagnosis, treatment, and prevention strategies. Dermatology News . March 2016:2-15.

Know It May Have To Be Permanent

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.

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.

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What Happens During The Surgery

Nail surgery can be done in your doctorâs office. Before it starts, your doctor numbs the area around your nail. If youâve ever had your gums numbed at the dentistâs, itâs very similar. Youâll be awake for the surgery, but you wonât feel any pain.

Once the area around the nail is numb, your doctor uses special tools to remove the entire nail or just the infected piece.

In severe cases, they may have to destroy the nail matrix, which is what makes your nail grow back.

After the surgery, your doctor usually applies antibiotic cream and a bandage around your nailbed, which is the area under where your nail used to be. The antibiotic helps make sure you donât get a bacterial infection.

The surgery usually takes less than an hour.

Is Onychomycosis Still A Problem

The great majority of superficial fungal infections are caused by dermatophytes, which belong to one of three genera , with T. rubrum being the most prominent cause of nail infection . Table 1 summarizes the prevalence of various superficial fungal infections in different geographic areas . Among superficial fungal infections, by far the most difficult to cure is toenail onychomycosis . The prevalence of onychomycosis has been reported to be as high as 23% across Europe and 20% in East Asia . In North America, the incidence of onychomycosis is up to 14% , with fungal infection responsible for 50% of all nail disease . With millions of dollars being spent annually on oral and topical prescriptions, laser treatments, over-the-counter products, and home remedies, it is obvious that people are still bothered by their fungal toenail infections and are determined to get rid of them. Unfortunately, this is easier said than done. To successfully cure toenail onychomycosis requires long treatment duration that may extend to a full year. Even then, complete cure, defined as clinical cure plus mycological cure , is often unattainable.

Distal subungual onychomycosis of the great toenail.

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Risks Of Surgical Treatment Of Nail Fungus

Like most surgical treatments, procedures for surgically removing nail fungus from fingernails or toenails have multiple risks involved. These include:

• Excessive Bleeding Before the surgery, a blood test will be taken to assess a patients risk of excessive bleeding. The patient may have to discontinue certain medications if they are identified to be at risk of bleeding complications.
• Infections Another risk is of bacterial infection in the wound after surgery. In order to prevent infection, it is recommended that patients take antibiotic cream medication post-surgery.
• Abnormal Nail Growth One thing to consider is possible abnormal nail growth after the surgery. Complications can arise if nail curvature is distorted or thickened, and it can get worse with repeated procedures.

How Do You Get A Fungal Nail Infection

Most fungal nail infections occur as a result of the fungi that cause athletes foot infecting the nails.

These fungi often live harmlessly on your skin, but they can sometimes multiply and lead to infections. The fungi prefer warm, dark and moist places like the feet.

Youre more likely to get a fungal nail infection if you:

• dont keep your feet clean and dry
• wear shoes that cause your feet to get hot and sweaty
• walk around barefoot in places where fungal infections can spread easily, such as communal showers, locker rooms and gyms
• have damaged your nails
• have a weakened immune system
• have certain other health conditions, such as diabetes, psoriasis or peripheral arterial disease

Fungal nail infections can be spread to other people, so you should take steps to avoid this if you have an infection.

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Common Symptoms Of Toenail Fungus

Many cases of toenail fungus are mild and may not bother you, so you may not even realize you have a fungal infection. A toenail fungal infection can begin as a white or yellow spot under the toenail and present no other symptoms. As the condition worsens, it may become painful or uncomfortable when you walk in shoes, and you may notice a change in the appearance of the nail.

The following symptoms are common if you have a fungal nail infection:

• Nails that turn white or yellow or have yellow or white stripes
• Thickened or oddly-shaped toenails
• Nails that are brittle or crumbling
• Nails that separate from the nail bed or fall off completely
• Foul odor from the infected toenail

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How Long Will It Take For The Toenail To Grow Back

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 for any pain or discomfort. Avoid aspirin or NSAIDS , 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 theyre 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.

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How Do I Get Ready

Before the surgery, your doctor will probably give you a physical exam and talk to you about your medical history, such as other illnesses and surgeries youâve had. They will also want to know if you have:

• Allergies to latex or tape
• Bleeding disorders
• Medicines you take on a regular basis, including over-the-counter supplements and pain relievers like aspirin

On the day of your surgery, you can shower, eat, and take your usual medicines, unless your doctor has said not to.

> > > Best Toe Fungus Treatment Available

If you suspect your nails are infected with fungus, it is important to see a doctor. You should consult a doctor for treatment. A nail fungus can be treated with home remedies. Baking soda and vinegar can also help to eliminate the fungus. In some cases, you can even apply a diluted solution of one of these solutions. You should avoid touching the affected area as it may cause further complications.

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The Lamisil Terbinafine Antifungal Cream Treats Fungus All Over The Body

Sarah is a freelance writer with a focus on health and wellness. She has written for publications like Womens Health, Healthline, and Parents. She taught creative writing for five years, and has a bachelors degree in English from Southern Connecticut State University.

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Verywell Health / Peter Ardito

Toenail fungus is a common fungal condition that often starts after a rash on the foot spreads to the nails. When mild, it looks like white and yellow spots growing under the nail beds. If left untreated, the fungus can grow severely by hardening the nails and spreading to other toes.

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Following Toenail Removal Seek Medical Attention If You Have:

• lingering or worsening pain
• temperature of 100.4° F or higher
• bleeding or discharge from the toe
• skin thats 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
• 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.

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Laser Therapy For Fungal Toenails

Do you have thick, yellow, discolored toenails? Are you embarrassed to wear your open-toed shoes in public?

Chances are you have fungal toenails, a condition also known as onychomycosis.

Fungal toenails are caused by an organism that grows in and under the nail.The fungus likes to grow in warm, moist places like your shoes. Many patients pick up fungal toenail infections in the gym locker room, from a nail salon, wet shoes or from trauma.

Fungus can stay in the nails for many years and can be passed from one person to another.

There are currently three treatment modalities for this condition. They include

• topical medications

• oral medications

• the newest modality, laser therapy

At our podiatry practice, Dr. Darlyne Cange uses a laser, which focuses a concentrated beam of laser light through the nail to eradicate the fungus living under and in the nail. The procedure is performed right in our office, requires no anesthesia and is painless. Most patients require only three treatments and can once again enjoy wearing open toed shoes.

If youre tired of looking at those unsightly toenails, please contact our office to determine if you are a candidate for laser therapy.

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How To Prevent Toenail Fungus

Here are some tips to help prevent infection or a recurrence of an infection:

• Wash your feet daily with soap.
• After showering, always carefully dry your feet, making sure to dry between your toes.
• Check your feet and toenails regularly. Look for signs of a toenail infection or any changes in your feet or nails.
• Keep your toenails trimmed. When cutting your nails, be sure to cut them straight across and short.
• Choose socks that can wick away moisture to keep your feet dry even if they sweat. Change out your socks if they become damp.
• Do not go barefoot in public. If you are in a wet public area such as a locker room, shower, or pool area, wear shower shoes or flip flops to protect your feet.
• Choose breathable styles of footwear that have mesh or ventilation and are made from a material such as canvas. Alternate footwear, so you are not wearing the same shoes every day. This gives the shoes time to breathe and dry out between wears.
• Do not share personal items with other people. Items such as socks, towels, nail clippers, or nail files should only be used by one individual.
• After using an item such as a nail clipper, disinfect it with rubbing alcohol.
• Use caution when getting a pedicure and choose a salon that disinfects the equipment used on your feet and has sanitary measures in place.

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Recovery From Toenail Surgery

In most cases, you heal quickly after toenail removal. Your wound will close in about a week, and it should heal completely in about two weeks.

Your doctor will give you detailed instructions on aftercare following the surgery. Typically, you keep the bandage on for 24 hours. After you remove the bandage, soak the affected toe in warm water and Epsom salts for 20 minutes a day.

Youll be able to walk normally after two or three days.

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