Nail surgery is a medical operation that removes all or part of a toenail. There are different types of nail surgery operation but all of them are carried out by qualified health care professionals, usually podiatrists or podiatric surgeons.
If you have a rheumatic condition, there may be extra things that you need to think about when choosing whether to have nail surgery.
This guide is designed to help you choose whether to have nail surgery. This guide is also designed to help you look after your feet if you have had nail surgery. You should always discuss your choice about nail surgery with your podiatrist.
What is nail surgery?
Nail surgery is a medical procedure. The surgery can be done by a podiatrist, podiatric surgeon, or other qualified health professional.
The aim of nail surgery is to remove some or all a toenail because it is causing a problem that has not gone away with usual nail care. Sometimes a chemical will be used to try and stop the nail from growing back again. Sometimes more of the nail growing area is surgically removed to stop the nail growing back again.
When might nail surgery be recommended?
Nail surgery can be recommended if you have a painful, problematic or an ingrowing toenail; this is when the outer edge of the nail grows into the skin at the side causing a wound. Some people also get an infection around the ingrowing toenail. Surgery is often recommended if you get an ingrowing toenail or infection repeatedly.
For nail surgery to be recommended you need:
- A good blood supply to and from the feet
- To not be experiencing a flare of your rheumatic condition.
What are the alternatives to nail surgery?
The alternative treatment options may be:
- To do nothing; this may be until you are in the best health to go ahead with a surgical procedure
- To change your footwear to a wider and deeper fit of shoe to reduce pressure on your toenails.
- To see a podiatrist for help with cutting and filing your toenails.
What are the risks of nail surgery?
The process of nail surgery means that you will have a small surgical wound.
There is a risk that the wound can be slow to heal; this is increased if a chemical is used to stop the nail from growing back.
There is a risk that your wound can become infected. Infection is a serious event that can result in you needing to stop your arthritis treatment or in severe cases can become life-threatening and need hospital treatment.
When you have nail surgery it is important to discuss the risk of infection with your podiatrist and what you can do to reduce this.
What are the benefits of nail surgery?
Nail surgery can provide a solution for problem nails that cause pain or are in-growing. In most cases, no other treatment is needed once the nail surgery has been completed and the surgical wound has healed.
I have been told I am going to have nail surgery. What will happen?
Nail surgery is usually performed in health centres or hospital settings.
There is normally no need to stay in hospital.
- You will be told about what is going to happen and given opportunity to ask any questions
- You will be asked to sign a consent form
- You will be given an anaesthetic - this is usually a local anaesthetic which means you will stay awake but will not feel any pain in your toe. In some cases, you may have a general anaesthetic
- A podiatrist, podiatric surgeon or other qualified health professional will complete the procedure
- You will have a large bandage put on your toe - you will not be able to get a closed-in shoe back on
- You will be given advice about how to look after the bandage and manage any discomfort you may notice once the anaesthetic wears off
- You will be given after care advice to help aid healing and about spotting any signs that this might not be happening as expected.
I have a rheumatic condition. What else might I need to consider?
Some types of arthritis can cause your surgical wound to heal more slowly.
Some of the medications that are used to treat arthritis can cause your surgical wound to heal more slowly. In some cases, the timing of your surgery and any changes to your medication are carefully considered by all the health professionals involved in your care. This is to make sure that your arthritis is well controlled and that you have the best chance of healing quickly after your surgery.
Some of the medications that are used to treat arthritis reduce your body’s ability to stop infection. This means that you may be at an increased risk of developing an infection after your surgery. If you are at an increased risk of getting an infection you may need to visit a podiatrist regularly after your surgery until the wound has healed. It is important to know that there is limited research available to fully inform you about the potential risk of infection after nail surgery if you have a rheumatic condition. You should discuss the potential risks and benefits of surgery with your podiatrist or podiatric surgeon.
Nail surgery is a medical procedure that removes all or part of a toenail.
Download our leaflet on Toenail surgery for people with a rheumatic condition
This series of information leaflets was developed, approved and ratified by the following organisations:
- Università degli Studi de Milano-Biococca
- Cardiff Metropolitan University
- Royal College of Podiatry
- GIDIF RNM, Universidad de Malaga
- The National Axial Spondyloarthritis Society
- Homerton University Hospital NHS Foundation Trust
- Midlands Partnership NHS Foundation Trust
- Solent NHS Trust
- Walsall Healthcare NHS Trust
- National Rheumatoid Arthritis Society (NRAS)
- University of Leeds
- University of Southampton