Nail Removal for Fungal Infection: What You Need to Know

fungal nails nail removal Dec 05, 2024

Fungal nail infections, or onychomycosis, are a common yet often stubborn condition affecting toenails and, less frequently, fingernails. These infections can lead to thickened, discoloured, and brittle nails, often causing pain or discomfort. While many infections can be treated with topical or oral antifungal medications, some cases prove resistant. When this happens, nail removal may become the best course of action.

In this blog, we’ll dive deeper into why nail removal is sometimes necessary, especially when other treatments have failed, the types of procedures available, and what to expect during recovery.

Why Consider Nail Removal?

1. Persistent Infection Despite Treatment

Fungal infections are notoriously difficult to treat. Topical antifungals, while effective for mild infections, struggle to penetrate thickened or hardened nails. Oral antifungals can be more effective but may not work in all cases. When these treatments fail, nail removal provides direct access to the nail bed, allowing for more targeted treatment and improved outcomes.

2. Thickened or Deformed Nails

Severe infections often cause nails to thicken, making it painful to wear shoes or walk. In some cases, the nail may become so deformed that it lifts from the nail bed, a condition called onycholysis. Removing the nail relieves discomfort and prevents further complications.

3. Preventing Recurrence or Spread

A fungal nail infection that is left untreated or inadequately treated can spread to other nails or even the surrounding skin, causing conditions like athlete’s foot. Nail removal eliminates the primary source of infection, reducing the risk of recurrence or spread.

4. For Patients Who Cannot Tolerate Oral Medications

Oral antifungal medications can have side effects, including liver toxicity, and are not suitable for everyone, particularly those with pre-existing liver conditions or who take certain medications. Nail removal provides an alternative, drug-free option for such patients.

5. Enhanced Access to Antifungal Treatments

Without the physical barrier of the nail, topical antifungal treatments can reach the nail bed directly. This enhances their effectiveness, ensuring the infection is treated more thoroughly.

Types of Nail Removal Procedures

Nail removal can be done in several ways, depending on the severity of the infection and the patient's needs:

Partial Nail Removal
Removes only the infected portion of the nail, preserving as much healthy nail as possible. This is less invasive and ideal for localised infections. (The nail will grow back with this procedure).
Complete Nail Removal (Avulsion)
In cases where the infection has spread throughout the nail, the entire nail may be removed to allow for comprehensive treatment of the nail bed. (The nail will grow back with this procedure).
Permanent Nail Removal (Matrixectomy)
If the infection is recurrent and significantly impacts quality of life, the nail matrix (the tissue responsible for nail growth) may be destroyed to prevent regrowth. This option is often considered for chronic infections in a single nail.

What to Expect During the Procedure

At Foot Corner the nail removal is performed under local anesthesia, Here's what happens during the procedure:

Preparation: The area is cleaned and numbed with a local anesthetic.
Removal: Using specialised tools, the infected nail or its portion is carefully removed.
Post-Procedure Care: The wound is dressed, and instructions for aftercare are provided.

The procedure is generally quick and minimally invasive.

Post-Procedure Care and Recovery

After nail removal, proper aftercare is essential to promote healing and prevent reinfection:

Keep the Area Clean and Dry: Follow our podiatrists instructions for dressing changes.
Use Antifungal: Topical antifungals may be applied directly to the nail bed.
Avoid Pressure on the Toe or Finger: Wear open-toe shoes or loose-fitting footwear.
Monitor for Infection: In some cases infection can occur, look out for any signs.

Healing time depends on the type of procedure. Partial nail removal typically heals in a few weeks, while complete removal may take several months for a new nail to grow.

Why Nail Removal May Be the Better Option

When conventional treatments fail, nail removal offers distinct advantages:

Direct Treatment of the Nail Bed: Without the infected nail, antifungal medications can penetrate more effectively.
Immediate Relief from Symptoms: Pain, pressure, and discomfort caused by thickened or deformed nails are resolved quickly.
Minimised Risk of Reinfection: Removing the source of infection creates a clean slate for healing and prevents the spread of fungus.
Higher Success Rates: Studies show that nail removal, combined with antifungal treatment, increases the likelihood of clearing stubborn infections.

For many patients, the combination of these benefits makes nail removal a preferable option, particularly when they’ve exhausted other treatments.

Preventing Future Infections

Once you’ve successfully treated a fungal infection, it’s essential to take preventive measures to avoid recurrence:

Maintain Good Foot Hygiene: Wash your feet regularly and dry them thoroughly.
Keep Nails Trimmed and Clean: Regular nail care can prevent the buildup of fungi.
Use Antifungal Products: Consider using antifungal sprays or powders, especially in warm, humid conditions.
Avoid Barefoot Walking in Public Spaces: Protect your feet in communal showers, gyms, and pools.

Conclusion

Nail removal is an effective solution for stubborn fungal nail infections, offering relief and a higher chance of complete recovery when other treatments fall short. If you’ve been struggling with persistent nail fungus, contact us at Foot Corner to explore whether nail removal might be the right option for you.