Surgery Overview

Surgical nail removal can be done for severe
or returning
fungal nail infections. The entire nail (avulsion) or
only part of the nail (debridement) can be removed.

Surgical nail
removal can be done in a clinic or your doctor’s office. Your doctor will give
you an injection in the finger or toe to prevent pain. He or she will then
loosen the skin around the nail (nail folds) from the nail and separate the
nail from the skin by using a tool under the nail. If only part of the nail is
diseased, only the diseased part is removed.

If you want to avoid
future infection by preventing the nail from growing back, your doctor can
destroy the nail matrix. This is accomplished by applying a chemical to the
cuticle area after the nail plate is removed.

An ointment is applied to the wound, which is then covered with gauze and
tape.

What To Expect After Surgery

If your doctor told you how to care for your wound, follow your doctor’s instructions. If you did not get instructions, follow this general advice:

  • After the first 24 to 48 hours, wash around the wound with clean water 2 times a day. Don’t use hydrogen peroxide or alcohol, which can slow healing.
  • You may cover the wound with a thin layer of petroleum jelly, such as Vaseline, and a nonstick bandage.
  • Apply more petroleum jelly and replace the bandage as needed.

The wound
should heal within a few weeks. Fingernails may take 6 months to grow back, and
toenails may take 12 to 18 months to grow back.

Why It Is Done

Surgical nail removal is usually
performed only when a large portion of the nail is diseased and damaged or if
your nails are very painful. In some cases, only the diseased portion is
removed, not the entire nail. This procedure is rarely needed.

How Well It Works

After the diseased nail has been
removed, the infection can be further treated by applying an antifungal cream
to the remaining infected area or by taking oral antifungal medicine.

Risks

Risks of this procedure include:

  • Pain.
  • Infection. You can reduce the risk of infection by keeping the
    area clean.
  • Abnormal nail growth. When the nail grows back, it may be odd in
    shape and appearance.

What To Think About

Nail removal makes it possible to
apply an antifungal cream directly to the infected area, increasing the
likelihood that the infection can be cured.

For a chronic severe
fungal nail infection, you can choose to have the nail matrix destroyed during
the removal procedure. This treatment prevents a diseased or disfigured nail
from growing back.

Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.

Credits

ByHealthwise Staff
Primary Medical Reviewer Patrice Burgess, MD – Family Medicine
Adam Husney, MD – Family Medicine
Specialist Medical Reviewer Ellen K. Roh, MD – Dermatology

Current as ofOctober 5, 2017