Post-Procedure Care for Toenail Fungus Removal: What to Expect

Q: Post-Procedure Care for Toenail Fungus Removal: What to Expect

Hello： In response to your question, the current effective treatments for onychomycosis (fungal nail infection) include oral antifungal medications or topical formulations similar to nail polish. <br>Generally, dermatologists rarely perform nail avulsion unless there is an ingrow

Post-operative care after nail fungus removal?

Hello Dr.
Chen,
Two days ago, I went to the hospital to have the fungal-infected part of my big toe nail removed.
Since then, I have been taking the anti-inflammatory medication prescribed by the doctor and applying the topical ointment.
However, I have noticed that the nail bed appears to be slightly purulent.
I am unsure how to care for it.
Additionally, will the new nail that grows back be uneven? I only removed one-third of the outer part of the nail.
Thank you for taking the time to clarify these concerns for me.

Xiao Zi, 20~29 year old female. Ask Date: 2003/05/04

Dr. Chen Yiying reply Dermatology

Hello: In response to your question, the current effective treatments for onychomycosis (fungal nail infection) include oral antifungal medications or topical formulations similar to nail polish.
Generally, dermatologists rarely perform nail avulsion unless there is an ingrown nail, because if the fungal infection is not treated, the new nail will still be susceptible to reinfection.
You may also have a bacterial infection in the wound.
In addition to continuing the oral and topical medications prescribed by your physician, it would be best to return for a follow-up with the surgeon to evaluate the wound and confirm whether you have onychomycosis, and if oral antifungal medication is necessary.
As for removing only the outer third of the nail, this is a common treatment for ingrown nails.
If phenol or electrocautery is used to destroy the growth matrix, the nail will subsequently grow narrower and is less likely to become ingrown again, but it should not grow unevenly.

Reply Date: 2003/05/04

More Info

After undergoing a toenail fungus removal procedure, it is essential to understand the post-procedure care to ensure proper healing and minimize complications. Here’s a comprehensive guide on what to expect and how to care for your toenail after the procedure.

Immediate Post-Procedure Care
1. Wound Care: After the removal of the affected toenail portion, it is crucial to keep the area clean and dry. You should follow your doctor's instructions regarding the application of topical ointments and the use of any dressings. If you notice any signs of infection, such as increased redness, swelling, or pus, it is essential to contact your healthcare provider immediately.

2. Medication: Continue taking any prescribed anti-inflammatory medications as directed. These medications can help reduce pain and swelling. If you experience any adverse effects from the medication, inform your doctor.

3. Avoid Moisture: Keep the affected area dry. Avoid soaking your feet in water for prolonged periods, as moisture can promote fungal growth and delay healing.

Signs of Infection
You mentioned noticing some pus around the nail bed. This could indicate an infection, which is not uncommon after such procedures. Signs of infection include:
- Increased redness and swelling
- Warmth around the area
- Pus or drainage
- Persistent pain or discomfort
If you observe any of these symptoms, it is crucial to seek medical attention promptly. Your doctor may need to drain the area or prescribe antibiotics to treat the infection.

Nail Growth Expectations
Regarding your concern about the new nail growth, it is normal to worry about how the nail will look after a portion has been removed. Here are some points to consider:
1. Nail Growth Patterns: Nails typically grow back at a rate of about 1/8 inch per month. The new nail may initially appear uneven or ridged, especially if only a portion of the nail was removed. Over time, as the nail continues to grow, it should become more uniform.

2. Nail Health: The health of the new nail will depend on several factors, including the underlying nail bed's condition and how well you care for the area during the healing process. Keeping the area clean and protected will promote healthy nail growth.

3. Follow-Up Appointments: It is advisable to schedule follow-up appointments with your healthcare provider to monitor the healing process and the growth of the new nail. They can provide guidance on what to expect and how to care for your toenail as it grows back.

Long-Term Care
1. Preventing Recurrence: To prevent future fungal infections, maintain good foot hygiene. Keep your feet dry, wear breathable footwear, and avoid walking barefoot in communal areas like pools or locker rooms.

2. Moisture Control: Use antifungal powders or sprays if you are prone to fungal infections. These can help keep your feet dry and reduce the risk of reinfection.

3. Healthy Nail Practices: When your nail grows back, practice good nail care. Trim your nails straight across and avoid cutting them too short to prevent ingrown nails.

Conclusion
In summary, after toenail fungus removal, it is vital to monitor for signs of infection, adhere to prescribed medications, and maintain proper foot hygiene. While the new nail may initially grow unevenly, with time and care, it should return to a healthy appearance. If you have any concerns during your recovery, do not hesitate to reach out to your healthcare provider for advice and support. They are best equipped to guide you through the healing process and address any complications that may arise.

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