If you are having, or have recently had, nail removal surgery, knowing what happens afterwards can make recovery much easier to manage. Healing varies depending on whether part or all of the nail was removed, whether the nail-producing area was treated to prevent regrowth, and your own health and rate of healing.
If you are still researching the procedure itself, including why it may be recommended and what happens during toenail removal and nail surgery, that is covered separately. Here, we are focusing specifically on what happens afterwards: aftercare, healing, possible signs of infection and what to expect if your toenail is going to grow back.
What To Expect After Nail Removal
After undergoing nail removal surgery, the post-operative care and healing process will vary depending on whether you had the entire nail or only a portion of it removed.
Your podiatrist will explain how to care for the surgical site, including how to manage your dressing, keep the area clean and protect the toe during the healing phase. If follow-up care is required, the surgical site can also be checked to make sure it is healing as expected and that there are no signs of complications.
Depending on whether the entire nail or only part of it was removed, the potential for nail regrowth will also be different. If the nail-producing area was not permanently treated, the nail bed will gradually heal and new nail growth may occur over time.
It is important to remember that healing and nail regrowth are two separate processes. The wound itself can heal within weeks, while replacing a toenail can take many months.
Immediate Aftercare and Managing Pain
Following surgery, immediate aftercare is important for a smooth recovery.
Your toe will usually have a dressing in place when you leave the clinic. Keep it protected and follow the specific instructions you have been given about wound care and when the dressing should be changed. If a dressing becomes wet or dirty, it may need replacing sooner.
Some discomfort is normal once the local anaesthetic wears off, although severe or prolonged pain is not usually expected. Resting and elevating the foot after surgery can help reduce swelling and bleeding while the wound initially settles.
Your podiatrist will advise you about appropriate pain relief and any activities you should temporarily avoid based on the surgery you have had and your individual circumstances.
Healing After Nail Removal Surgery
The toenail removal healing process is gradual, and there is no single timeline that applies to everybody.
The First Few Days
During the first few days, the toe may feel tender once the anaesthetic has worn off. Some bleeding or weeping from the wound can also occur as it begins to heal.
The area may look more dramatic than you expect when the dressing is first changed because the nail plate is no longer covering the tissue underneath. Some redness, warmth and light discharge can be part of normal early healing rather than automatically meaning the toe is infected.
Keeping pressure off the area where possible and following your dressing instructions will help protect the healing tissue.
The Following Weeks
As healing progresses, soreness and wound discharge should gradually reduce and new tissue forms over the exposed area.
Healing time depends partly on how much of the nail was removed. NHS podiatry guidance gives an average healing period of around 4–8 weeks after partial nail removal and 8–12 weeks after total nail removal, although individual recovery can be shorter or longer.
Phenol, which may be used during surgery to prevent part of the nail growing back, can also slow the healing process. Your general health, medication, footwear, activity and pressure on the toe can all affect how quickly the wound settles.
As the toe becomes less tender and the wound dries, you can gradually return to normal footwear and activities according to the advice you have been given.
What Is Normal During Toenail Removal Recovery?
A healing surgical wound does not necessarily look completely dry and normal straight away.
Some tenderness, localised redness, mild swelling and wound fluid can occur during toenail removal recovery. Light-yellow discharge can also occur while a phenol-treated wound is healing and does not automatically indicate infection.
What matters is the overall direction of recovery. These symptoms should gradually settle rather than becoming progressively worse.
Signs of Infection After Toenail Removal Surgery
It is important to monitor the wound while it heals.
Increasing pain, heat or swelling, redness that is spreading or worsening, pus, an unpleasant smell or a toe that appears to be deteriorating rather than healing can indicate infection or another problem that needs assessment.
If you experience unexpected symptoms or have concerns about how the wound looks, contact your podiatrist or another appropriate healthcare professional rather than waiting for the problem to resolve by itself.
Each individual’s recovery is slightly different, so follow the post-operative instructions you were given for your own procedure rather than comparing your toe too closely with somebody else’s recovery.
Will Your Toenail Grow Back After Removal?
Whether your toenail grows back depends on what happened during surgery.
If the nail was removed but the nail-producing matrix was left intact, new nail growth may gradually occur. Toenails grow slowly, so the nail can take many months to replace even though the surgical wound itself has healed much earlier.
If phenol was applied to prevent a section of the nail growing again, that treated section is not expected to return. After partial removal, this generally leaves the remaining nail narrower. If the whole nail was permanently removed, there will be no natural nail plate growing back over the area.
Early toenail regrowth after removal may not immediately look like the finished nail. New growth can initially appear uneven as it develops and moves forward from the base of the nail.
If the nail was removed following significant nail trauma, previous damage to the structures responsible for nail growth can also influence how a new nail develops.
Continue monitoring the nail as it grows. If new growth becomes painful, markedly distorted or begins causing problems again, it is worth having it assessed rather than waiting until the problem becomes more difficult to manage.
Toenail Reconstruction After Nail Removal
After your surgery and the appropriate healing period, you may be concerned about the appearance of a nail that has been left uneven, damaged or partially missing.
In suitable cases, toenail reconstruction can use a flexible specialist material to recreate the appearance of a more natural nail. Suitability depends on the condition of the toe and whether there is an appropriate nail or surface for the reconstruction material to adhere to.
The surgical area needs to be sufficiently healed before reconstruction is considered.
Looking After Your Feet After Nail Surgery
After your nail removal surgery, your podiatrist may also give you advice to help reduce the risk of the original problem returning where this is relevant.
Continue to keep an eye on the toe even after the wound has healed. Changes such as renewed pain, inflammation, abnormal regrowth or another persistent nail problem are easier to address when they are assessed early.
If you are concerned about your recovery or have an ongoing problem with your toenail, book an appointment.
