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The process of “killing” or removing a toenail

Last Modified: August 25, 2022

Family Medicine

Toenail

This post was written by Ashley M. Bojrab, DPM, FACFAS, ABPM, CWS, PPG – Podiatry.

Sandal season is almost over, and, for some, this is a huge relief. While there is a significant amount of the population who loves a good pedicure and the opportunity to parade around with their polish and peek-a-boo shoes, there are also people who don’t like showing their toes and feel self-conscious about the appearance of their toenails

Damaged or discolored nails

Toenails that have been damaged via trauma, autoimmune diseases such as psoriasis, and or failed fungal treatment, among many other issues, can be unsightly in appearance. The toenails can be discolored, thickened, curving, and have crumbly debris under the nail. Depending on the severity of the condition, the patient could experience pain in the toes, especially when wearing shoes.

Addressing the problem

 So, what can be done? Unfortunately, toenails with this much damage can be a permanent problem, meaning nothing can be done to change the shape of the toenail. Treatment options would entail aggressive debridement of the thickness of toenails routinely, or, more aggressively, removal of the toenail.

Every patient is different, so it’s important that a podiatrist does an assessment to determine if the patient is a good surgical candidate, and that they will be able to achieve optimal healing. 

The process

When removing the toenail, there are two procedures that can be done in the office. The first is a temporary procedure that allows the toenail to grow back. The second is a permanent procedure called a matrixectomy. This procedure will “kill” the toenail, so it does not return.

A trained podiatrist will apply phenol, the chemical most commonly used for this procedure. It is 85% effective.

Once the procedure is complete, the patient will go home, rest, ice and elevate the surgical limb, and start lukewarm water soaks the next day. It’s important to clean and protect the area as infection could occur. 

If you have concerns about the appearance or pain associated with a toenail, please consider discussing the possibility of removing the nail with your podiatrist. It’s a great time to address the issue and rest up over the winter, before the next sandal season!