Toenail/fingernail Removal

What is toenail or fingernail removal?

Nails are the hard, flat coverings on the ends of your fingers and toes. Your nails protect the tissue underneath called your nail bed. Blood vessels, cells, and nerves are found in your nail bed. Your nail is attached to your finger or toe by the nail matrix. Your nail matrix is where your nails grow from. During toenail or fingernail removal, all or part of your nail will be removed. Your caregiver may also need to remove all or a part of your nail matrix. Having your nail removed may decrease your pain and swelling, and allow you to resume your usual activities.

Why may I need my toenail or fingernail removed?

The most common reasons for toenail or fingernail removal are:

• Infection: Nail removal may be needed for a nail infection to prevent nail damage. Nail infections are commonly caused by a fungus or bacteria.
  
  
• Ingrown nail: Ingrown nails occur when your nail edge grows into your skin. Ingrown nails may cause pain, redness, and swelling. The pain from an ingrown toenail may make it hard for you to walk.
  
  
• Injury: An injury to your nail, fingertip, or the end of your toe may require nail removal. Removing your nail may help heal your injury and prevent further nail damage.

What happens during toenail or fingernail removal?

• A tourniquet (tight band) may be tied around the base of your finger or toe, to decrease bleeding. Your caregiver will give you one or more shots of local anesthesia into your skin, around your nail. Local anesthesia is medicine to numb the area and control your pain. A special tool will be inserted under your nail to separate it from your skin. If only part of the nail will be removed, scissors will be used to cut your nail. Your nail will then be gently pulled out.
  
  
• A blue dye may be placed on your finger or toe if your nail matrix will be removed. This dye helps your caregiver see your nail matrix better. Your caregiver may make an incision (cut) in your skin to remove your nail matrix. An electric current, laser beam, or a special chemical may also be used to remove your nail matrix. Any injured tissue on the side of your nail will also be removed. Your nail may be sent to a lab for tests. Your incision may be closed with stitches or thin strips of tape.

What happens after toenail or fingernail removal?

Medicine to fight germs may be put on your toe or finger before it is covered with a pressure bandage. You may be taken to a room where you can rest. Your hand or foot may be raised or propped up with pillows. Your caregiver may change your bandage if it becomes soaked with blood. You may be given a shot of medicine to keep you from getting tetanus. You should have a tetanus shot if you have not had one in the past 5 to 10 years. Your arm can get red, swollen, and sore after getting this shot. When your caregiver says it is OK, you will be able to go home.

What are the risks of having your toenail or fingernail removed?

• You may have an allergic response to the anesthesia, antibiotic, or pain medicine used for your surgery. An allergic response may cause you to have trouble breathing. After your surgery, you may bleed more than expected or get an infection. Your toe or finger may become red, swollen, or painful. You may have fluid or pus that drains from your incision site. Chemicals, lasers, or electrosurgery may burn your skin and decrease healing. If a tourniquet is used and left on too long, it may cause tissue damage. If your nail grows back it may be misshapen or narrow, and your symptoms may return.
  
  
• Without surgery, your finger or toe may become very swollen, infected, and painful. You may not be able to do your usual activities. A painful toe may make it hard for you to walk. An infection in your finger or toe may make your nail thick, rough, or change color. The infection may even spread to your bones and nearby tissue.

How can I help myself?

• Avoid rounding the corners of your toenails to prevent ingrown toenails.
  
  
• Avoid wearing narrow-toed or tight-fitting foot wear.
  
  
• When trimming your nails, avoid cutting them too short.
  
  
• Quit smoking if you are a smoker. Smoking decreases the blood flow to your fingers and toes increasing your risk for problems.

Where can I find more information?

Contact the following:

• American Academy of Family Physicians
  11400 Tomahawk Creek Parkway
  Leawood , KS 66211-2680
  Phone: 1- 913 - 906-6000
  Phone: 1- 800 - 274-2237
  Web Address: http://www.aafp.org
  

When should I call my caregiver?

Call your caregiver if:

• Your finger or toe is red, painful, or swollen.
  
  
• You have discharge coming from your toenail or fingernail.
  
  
• You have questions or concerns about your condition, treatment, or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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