A nail that has been severely and persistently damaged by a fungal infection is sometimes treated by avulsion, or surgical removal of the nail.
How It Works
The idea behind nail removal is that it makes it easier to get rid of the fungus causing the infection. Just taking off the nail isn’t enough, however. The skin under the nail must also be treated post-surgery with topical anti-fungal creams. In very stubborn cases, oral anti-fungal medications are also prescribed.
Sometimes—particularly when a patient has an autoimmune disorder that makes it very difficult to get rid of a fungal infection—doctors recommend destroying the nail bed along with the nail. A chemical is used to do this. In these cases, the nail does not grow back.
Nail removal is a minor surgical procedure that can usually be done in your doctor’s office. Your doctor will first numb the area to be treated with a local anesthetic. He or she will then use surgical instruments to separate the nail from the surrounding nail folds (skin). You can expect the surgery to take about 15 minutes per nail.
In some cases, the nail is first softened with a special ointment that’s applied to the skin and worn under a dressing for 7 to 10 days before the procedure. Your doctor will discuss this option with you.
After the surgery, an antibiotic ointment will be applied to the treated nail area to prevent infection, and then the entire area will be covered with a gauze bandage. You will need to clean and dry the wound until it heals completely, which may take a few weeks. Your doctor may also prescribe a painkiller for the first few days after surgery.
During the recovery process, you’ll be prescribed antifungal medications. If you want to make sure the fungal infection does not return, be diligent about their use.
Nails grow back slowly. A fingernail that has been removed may take six months to grow in fully. A toenail will take longer—up to 18 months.