Why Do Toenails Require Surgical Treatment?

Toenails, those often overlooked parts of our body, serve an important purpose beyond just being an accessory to paint or polish. They protect the sensitive tips of our toes and contribute to balance and stability when we walk. However, there are times when toenails can cause discomfort or require medical attention and sometimes even surgical treatment. Let’s dive into why toenails sometimes need more than just a pedicure to stay healthy.

A Look at Toenail Surgery

Toenail surgery is a common procedure performed to address various toenail conditions. It typically involves the partial or full removal of the nail, and in some cases, the nail bed itself might be treated. The procedure is usually swift and can often be performed in a specialist’s office under local anesthesia, ensuring minimal discomfort for the patient during the process.

Toenail surgery can provide relief from pain, help clear infections, and prevent further complications, especially for those with serious conditions that affect foot health. If you’re struggling with an ongoing toenail problem, it may be wise to consult with a professional about the possibility of undergoing toenail surgery.

Common Toenail Problems Leading to Surgery

Anyone can experience a toenail issue; from athletes to the elderly, toenail problems do not discriminate. Here are some of the most common reasons toenails might need surgical intervention:

1. Ingrown Toenails

  • Description: This occurs when the edge of a toenail, usually the big toe, grows into the adjacent skin, leading to pain, redness, swelling, and sometimes infection.
  • Surgical Intervention: In cases of recurrent or severe ingrown toenails, a procedure called a partial nail avulsion may be performed. This involves removing a portion of the nail or the entire nail along with the underlying tissue to prevent regrowth into the skin.

2. Fungal Infections

  • Description: Fungal infections of the toenails, known as onychomycosis, can cause thickening, discoloration (yellow or brown), and brittleness. They are often persistent and challenging to treat.
  • Surgical Intervention: In severe cases where conservative treatments like antifungal medications and topical solutions fail, surgical options such as nail removal (matrixectomy) may be considered. This involves removing the infected nail and sometimes the nail matrix to prevent regrowth.

3. Deformities and Abnormalities

  • Description: Toenail deformities can result from various factors, including injury, genetic predisposition, or underlying medical conditions. Onychogryphosis, characterized by thickening and curvature of the nails, is one such example.
  • Surgical Intervention: Surgical correction may involve procedures to reshape the nail, remove excess tissue, or address underlying issues contributing to the deformity. In some cases, the removal of a portion of the nail may be necessary.

4. Toenail Trauma

  • Description: Severe injuries to the toenail, such as crushing or avulsion, can result in significant damage. If not addressed promptly, trauma can lead to infection, hinder proper healing, and cause ongoing pain.
  • Surgical Intervention: In cases where conservative treatments are insufficient, surgical options may include nail removal or repair procedures. This helps to eliminate infection, promote healing, and prevent complications.

When Is Toenail Surgery Necessary?

Toenail issues can often be treated conservatively with medication or lifestyle changes, but there are situations where these measures are not enough. Surgery may be considered when pain and discomfort disrupt daily activities, when repeated infections occur, or when quality of life is significantly affected. Additionally, those with underlying health conditions, like diabetes, may be advised to proceed with surgery to prevent further health complications.

Signs You Might Need Toenail Surgery

Here are some indicators that it might be time to consider surgical options for your toenail woes:

  • Persistent Pain: If you’re in constant discomfort or pain due to your toenail, it might be time to see a specialist.
  • Infections that Don’t Resolve: Repeated or long-lasting infections can indicate a problem that conservative treatments won’t fix.
  • Significant Impact on Daily Life: When your toenail condition is affecting your ability to engage in routine activities, it’s crucial to seek help.
  • Poor Response to Other Treatments: If your toenail condition hasn’t improved with other treatments, surgery may be the next step.

Post-Surgical Care and Recovery

As with any surgery, there is a recovery period for toenail surgery. Here’s what you can generally expect:

  • Bandaging and care for the surgical site
  • Limited physical activity for several days
  • Possible prescription of antibiotics or pain management medication
  • Follow-up appointments to ensure proper healing

Proper aftercare is essential to prevent infection and ensure the best possible outcome. Your healthcare provider will give you detailed instructions based on your specific situation.

Special Considerations for Diabetic Patients

Diabetic patients need to pay extra attention to their foot health, as they are at a higher risk for complications. Diabetes can cause neuropathy, which reduces sensation in the feet, and peripheral vascular disease, which can impede healing. 

Therefore, even minor foot-related issues like a toenail problem can lead to severe consequences. Regular check-ups and maintaining a regimen recommended on their website for diabetic foot care can be pivotal in preventing serious complications.

Prevention and Maintenance Techniques

Keeping your toenails healthy is essential for preventing problems that might require surgical treatment. Here are some tips:

  • Practice good foot hygiene by washing and drying your feet thoroughly each day.
  • Trim toenails straight across to avoid ingrown toenails.
  • Wear properly fitting shoes that provide enough space for your toes.
  • Keep an eye on any changes in your toenails and consult with a professional if you notice anything unusual.

The Role of Custom-Made Orthotics

For those persistently battling with toenail issues and foot pain, custom-made orthotics can provide relief. Orthotics are designed to correct foot posture and redistribute pressure across the foot, which can help in the prevention of toenail problems. 

If you reside in the area and suffer from foot ailments, you might consider consulting with a professional about custom orthotics in Mississauga. These specially tailored devices can be a game-changer for your foot health.


Toenails might seem trivial, but they play a vital role in our daily lives, from contributing to our balance to protecting our toes. Surgical treatment may become necessary when conservative methods fail to address ongoing issues or when conditions pose potential risks for more severe health problems. Understanding when to seek help, ensuring proper post-surgical care, and taking preventive measures can lead to healthier toenails and a better quality of life. Remember, being attentive to your toenail health is just as important as the rest of your body’s well-being.