Is Removing a Toenail a Big Deal? Understanding the Procedure

September 25, 2025 •

5 min read

Podiatrists perform thousands of toenail removal procedures annually, and the vast majority are considered minor surgery. For many, a procedure to address a problematic nail is the fastest path to relief, which is why people often ask, "Is removing a toenail a big deal?"

Quick Summary

Removing a toenail is not typically considered a major operation but a routine, minor surgical procedure performed under local anesthetic. While it requires proper aftercare and has a distinct recovery period, it is a common and effective solution for various nail issues, providing significant relief for patients.

Key Points

Minor Procedure: Removing a toenail is a minor, in-office surgical procedure performed under local anesthetic, not a major operation.
Common Causes: The procedure is often necessary for chronic ingrown nails, severe fungal infections, or significant trauma that conservative treatments cannot fix.
Partial vs. Full Removal: The procedure can be partial, targeting only the problematic edge, or full, which often includes treating the nail matrix to prevent regrowth.
Manageable Recovery: Recovery typically takes a few weeks and requires careful aftercare, including elevation, cleaning, and wearing appropriate footwear.
Low Risk: While minor risks like infection and abnormal regrowth exist, the procedure is very safe, with most complications being easily treatable.
Long-Term Relief: For patients with persistent or severe nail problems, removal offers a permanent solution to chronic pain and recurring issues.

Is Toenail Removal Considered a Major Operation?

Despite the potential discomfort and the dramatic sound of it, a toenail removal is generally a minor, in-office surgical procedure. It is far less complex than major surgery, which involves general anesthesia and a hospital stay. This procedure is typically performed by a podiatrist using a local anesthetic to numb the area completely, meaning the patient is awake and feels no pain during the removal itself.

The perception that it might be a big deal often stems from fear or a lack of understanding about the process. However, for those suffering from chronic issues, the procedure is often a welcome, final step toward resolving long-standing pain and infection.

Reasons a Toenail Removal May Be Necessary

Multiple conditions can lead a podiatrist to recommend a partial or complete nail avulsion. The procedure is not a first-line treatment but is used when more conservative measures fail to provide relief.

Chronic Ingrown Toenails

This is perhaps the most common reason for removal. When the side of a toenail repeatedly grows into the surrounding skin, it can cause persistent pain, swelling, and infection. If left untreated, it can lead to more serious complications, especially for individuals with diabetes or poor circulation.

Severe Fungal Nail Infections

In cases where topical and oral antifungal medications have failed to clear a deep-seated infection, surgical removal of the nail can help. Removing the infected nail plate allows for more direct application of medication to the nail bed and matrix, increasing the chances of eradicating the fungus.

Traumatic Nail Injury

An injury, such as dropping a heavy object on the toe, can cause a subungual hematoma (blood pooling under the nail). If the pressure from the blood is severe, the nail may need to be removed to drain the blood and relieve pain. In some cases, the nail may be damaged beyond repair and is best removed to promote healthy regrowth.

Nail Deformities

Conditions like onychogryphosis, or ram's horn nail, which cause the nail to thicken and curve, may require removal. Similarly, certain congenital or acquired nail dystrophies can be addressed with removal to improve comfort and function.

The Procedure: What to Expect

Knowing the steps involved can help demystify the process and reduce anxiety. The procedure is typically straightforward and quick.

Numbing the area: A local anesthetic is injected into the base of the toe, numbing the entire area. This is the only part of the procedure that a patient feels and is often described as a brief stinging sensation.
Preparing the site: The podiatrist will clean the toe with an antiseptic and place a tourniquet at the base to control blood flow.
Removing the nail: Depending on the issue, the doctor will either remove a small section of the nail (partial avulsion) or the entire nail (total avulsion) by gently separating it from the nail bed.
Applying a chemical (if necessary): For a permanent solution, especially with chronic ingrown nails, a chemical like phenol may be applied to the nail matrix (the root) to prevent that portion of the nail from growing back.
Dressing the wound: The toe is dressed with an antibiotic ointment and a sterile bandage to prevent infection and protect the sensitive nail bed.

Recovery and Aftercare After Toenail Removal

Recovery is a crucial phase and involves diligent care to prevent complications. The immediate throbbing pain subsides as the local anesthetic wears off, but over-the-counter pain medication can manage any lingering discomfort. Most patients can return to work or school within a day or two, though strenuous activities should be avoided.

Detailed Aftercare Instructions

Keep it elevated: For the first 24–48 hours, keep your foot elevated to help reduce swelling and throbbing.
Change dressings: Follow your podiatrist's instructions on when and how to change the dressing. Typically, the first change is after 24 hours.
Soak the foot: After the initial 24 hours, daily soaks in warm saltwater can help promote healing. Your doctor will advise on the frequency.
Wear appropriate footwear: Open-toed shoes or loose-fitting, comfortable footwear is best to avoid pressure on the healing toe.
Watch for infection: Keep an eye out for signs of infection, such as excessive redness, swelling, pus, or increased pain, and contact your doctor if these occur.

Comparison: Partial vs. Full Toenail Removal


Feature	Partial Toenail Removal (Avulsion)	Full Toenail Removal (Matrixectomy)
Purpose	To treat chronic ingrown toenails by removing the problematic edge.	To permanently stop a severely damaged or chronically infected nail from regrowing.
Aesthetic Result	The nail plate is narrowed, leading to a smaller but functional nail.	The nail is completely gone, leaving a permanent space where the nail once was.
Risk of Recurrence	Lower risk of recurrence if the matrix is treated, but still possible.	Virtually zero chance of recurrence if the matrix is successfully destroyed.
Recovery Time	Often slightly shorter recovery than a full removal.	Longer recovery due to more extensive tissue disruption.
Considerations	Recommended for patients who prefer to retain a natural-looking nail.	A permanent solution for stubborn, recurring issues or irreparable damage.

Addressing Potential Risks and Complications

While toenail removal is generally safe, no procedure is without risk. Potential complications are usually minor and manageable, especially when aftercare instructions are followed carefully.

Infection: The most common risk, which can be mitigated with proper cleaning and dressing changes. Symptoms include pus, excessive redness, and increased pain.
Abnormal Regrowth: If the nail matrix is not fully treated during a permanent removal, the nail can sometimes regrow deformed or thickened.
Pain and Swelling: Some degree of pain, swelling, and throbbing is normal, but severe or worsening symptoms should be reported to a healthcare provider.
Allergic Reaction: Rarely, a patient may have an allergic reaction to the local anesthetic or antiseptic.

For more detailed, authoritative information on foot health and care, visit the American Podiatric Medical Association (APMA).

Conclusion: Is it a Big Deal? A Final Word

Ultimately, whether is removing a toenail a big deal? is a personal perception. From a medical standpoint, it is a standard, low-risk, and effective procedure. For the patient, it represents a definitive end to chronic pain and discomfort. The process is a short-term intervention that leads to long-term relief, and with proper care, recovery is manageable. While the initial thought might be intimidating, the benefits of resolving a serious foot issue typically outweigh the temporary disruption. Consulting with a podiatrist is the best way to determine if toenail removal is the right course of action for your specific situation.

Frequently Asked Questions

During the procedure, you will not feel any pain, as the toe is completely numbed with a local anesthetic. As the anesthetic wears off, you may experience some throbbing or soreness, but this can usually be managed effectively with over-the-counter pain medication.

Recovery time varies depending on whether it was a partial or complete removal. Generally, it takes about 2 to 6 weeks for the nail bed to fully heal. You can typically return to normal, low-impact activities within a couple of days, but strenuous exercise should be avoided for a few weeks.

Not necessarily. If the removal is intended to be permanent, a chemical like phenol is applied to the nail matrix (the growth center) to prevent the nail from growing back. In simple avulsions without chemical application, the nail will grow back over several months, though sometimes it may grow back with a slightly different shape.

You should not drive immediately after the procedure, especially if your right foot was operated on. The local anesthetic can affect your ability to feel the pedals. It's best to arrange for a ride home and wait until the numbness has completely worn off and you feel confident and comfortable driving.

While some urgent care clinics offer toenail removal services, it is generally recommended to see a podiatrist. A podiatrist specializes in feet and ankles and has more experience with the nuances of nail care, offering a more precise and specialized treatment, especially if a permanent solution is needed.

Aftercare involves keeping the wound clean and dry for the first day. Afterwards, daily soaking in warm saltwater is often recommended. You will need to change the dressing regularly and wear comfortable, loose-fitting shoes to avoid pressure on the toe. Your doctor will provide specific instructions tailored to your case.

You should consult a doctor if you experience chronic pain, persistent redness, swelling, or pus around the nail. These are signs of a deep-seated problem that likely won't resolve on its own. For individuals with diabetes, it's crucial to seek medical attention for any foot issues immediately.