Many people are surprised to find out that toenails are relatively fragile appendages of the body. Toenails can take a mild amount of abuse from tight shoe pressure, years of toe stubbing or objects dropping on them, damage from jogging and exercise, or changes due to chronic fungus infections. Over time though, the nail root cells that produce the nail plate itself will become damaged, and they will begin to permanently produce nail that is thick, deformed, often painful, and even severely ingrown on one or both sides. As a result, many people find themselves with one or several toenails that hurt with shoe pressure, or anything pushing on the nail (like bed sheets). Unfortunately, these changes are permanent. In the case of nail fungus, it is assumed medication can ‘cure’ the disease. While it is true anti fungal medication can kill fungus in some cases, once the nail reaches a certain point of damage, there is no restoring the nail back to normal.
Treating these painful and deformed nails can be fairly simple. There are topical medications designed to soften the nail and help make it thinner, but unfortunately these typically are ineffective on thicker toenails, and treatment has to be performed for life. A pedicurist or podiatrist can grind the nails down to make them thinner, but this has to be repeated frequently as such nails typically thicken again within a couple of months. A better, and more permanent, option is to simply remove the toenail for good. Many people seem initially put off by the concept of this procedure. Once one realizes the ease of the procedure and its recovery, the fact that under the nail is normal skin that is not cosmetically disfigured without the nail on top, and the fact that there will be no further pain from the nail, the procedure itself becomes a sensible and preferred option.
Removing a toenail is not difficult matter, and for most people the procedure is relatively painless outside of the brief discomfort of the shot needed to numb the toe. The entire procedure including the numbing period is performed in under 15 minutes in an office setting. Once the toe is numb, the problematic nail is easily removed and a chemical is used to kill the nail root cells so no more nail is ever produced in that toe. Called a ‘phenol matrixectomy’, this procedure has been performed for about a hundred years and has great results. The recovery is brief, usually lasting 2-3 weeks and there is no restrictions on activity or shoe use. Most people have no discomfort during recovery, and go about their normal day unaffected by the procedure. The nail bed skin that remains on top of the toe can even be polished to match intact toenails next to it, with no one being the wiser that the nail is gone.
Such a procedure is perfect for those with one or a few painful deformed nails, and is nearly always covered by insurance. I have performed many thousands of these procedures. In nearly every case my patients have confided with me they wished they knew it would have been that easy to get relief years earlier, as they would not have otherwise suffered with a painful nail for so long.
If you have this same problem, be sure to call your local podiatrist to discuss how removing the painful and deformed toenail permanently can lead to relief.
Scott R. Kilberg DPM 