Understanding Toenail Resection

Understanding Toenail Resection: Causes, Procedure, and Recovery

Our toenails might seem like small, simple parts of the body, but they play an important role in protecting our toes and providing support when we walk or run. Unfortunately, toenails can sometimes become painful or infected, leading to conditions that require medical treatment. One such treatment is toenail resection—a minor surgical procedure to remove part or all of a toenail. Whether caused by chronic ingrown nails, fungal infections, or injury, toenail resection can provide lasting relief when other treatments fail.

What Is Toenail Resection?

Toenail resection, also known as partial or total nail avulsion, involves the surgical removal of a section of the toenail or the entire nail plate. The goal is to eliminate pain, treat infection, and prevent recurrence of problems such as ingrown toenails or nail deformities. Depending on the underlying issue, a podiatrist or minor surgery specialist performs the procedure under local anesthesia, meaning you’ll be awake but the toe will be numb and pain-free.

There are two main types of toenail resection:

Partial Nail Resection (Wedge Resection): Only the affected edge of the nail is removed. This is commonly done for ingrown toenails, where the corner of the nail grows into the surrounding skin.
Total Nail Resection: The entire nail plate is removed. This may be necessary when there’s a severe fungal infection, repeated trauma, or damage to the nail bed.

In some cases, a chemical such as phenol or sodium hydroxide is applied to the nail root to stop that portion of the nail from growing back. This is known as a matrixectomy, and it can permanently prevent the problem from returning.

When Is Toenail Resection Needed?

Doctors typically recommend toenail resection only when conservative treatments fail. Common reasons include:

Chronic ingrown toenails: Persistent pain, redness, or swelling around the nail that doesn’t improve with soaking, trimming, or antibiotics.
Fungal infections (onychomycosis): When antifungal medications or topical treatments are ineffective, removing the nail allows better access to treat the underlying infection.
Nail trauma: Injury causing nail deformity or bleeding under the nail that cannot heal properly.
Thickened or curved nails: Often due to aging, repetitive pressure, or genetic factors.
Severe inflammation or infection: Especially when pus forms or walking becomes painful.

If left untreated, these conditions can worsen, causing chronic discomfort or even secondary infections in the surrounding tissue.

The Procedure: What to Expect

Toenail resection is typically done in a clinic and takes about 15 to 30 minutes. Here’s what usually happens:

Preparation: The toe is cleaned thoroughly, and a local anesthetic is injected to numb the area.
Resection: The surgeon uses sterile instruments to lift and remove the damaged section or the entire nail.
Chemical Application (optional): If permanent removal is desired, a chemical is applied to the nail matrix to prevent regrowth.
Dressing: The wound is cleaned, and a sterile dressing or bandage is applied to protect the area.

Most patients can walk out of the clinic immediately after the procedure, though wearing open-toe footwear for a few days is usually advised.

Recovery and Aftercare

Recovery from toenail resection is generally straightforward, but proper aftercare is essential to prevent infection and ensure healing. Here’s what to expect:

Pain: Mild discomfort or throbbing is normal for the first few days. Over-the-counter pain relievers like ibuprofen usually help.
Dressing changes: Your doctor will instruct you on how to change the bandage—typically once daily for about a week. Keep the area clean and dry.
Footwear: Avoid tight shoes or activities that put pressure on the toe until it’s healed.
Follow-up: A check-up is often scheduled after one to two weeks to monitor healing.

Healing time varies—two to four weeks for a partial resection, and six to eight weeks for a total nail removal. The nail may regrow slowly over several months unless the matrix has been permanently destroyed.

Possible Complications

While toenail resection is generally safe, there are potential complications, especially if aftercare instructions aren’t followed. These include:

Infection at the surgical site
Delayed healing or persistent drainage
Nail deformity or irregular regrowth
Recurrence of the problem if the nail matrix was not fully removed

To minimize risk, patients should avoid soaking the toe too early, follow all hygiene advice, and report any signs of infection—such as increased redness, swelling, or pus—to their healthcare provider.

Living Comfortably After Toenail Resection

Most people experience a significant improvement in comfort and mobility once healed. To maintain healthy nails afterward, consider these preventive tips:

Trim toenails straight across instead of rounding the corners.
Keep feet clean and dry to prevent fungal growth.
Wear shoes that fit properly and offer enough toe space.
Avoid trauma or repeated pressure on the toenails.

In some cases, toenail resection provides a permanent solution to chronic nail pain, allowing patients to return to normal activities without discomfort.

Final Thoughts

Toenail resection might sound intimidating, but it’s a simple, low-risk procedure that can dramatically improve quality of life for those suffering from chronic nail pain or infection. With proper medical care and attentive aftercare, most people recover quickly and enjoy lasting relief. If you’re struggling with an ingrown or infected toenail that doesn’t respond to home remedies, it’s worth consulting a podiatrist to see whether toenail resection could be the right option for you.

Understanding Toenail Resection