Post-Nail Removal: Nail Growth and Healing Issues - Surgery

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Nail issues after nail avulsion?


Hello Dr.
Lee, on July 10th, I injured my right big toe by kicking something, causing the entire toenail to lift off.
I underwent a nail avulsion procedure in the outpatient department.
It has now been three months, and there is a thick layer of new nail growth, with another layer slowly growing underneath.
The growth rate is very slow, and it has grown less than half of the nail.
My question is regarding the top of the thick layer, which is currently uneven and often catches on things.
There is also a depression of about 2-3 mm.
I have trimmed the excess thick layer, but I am unsure if this situation is normal and whether it will affect the normal growth of the toenail.
Thank you for your response.

Niming, 30~39 year old female. Ask Date: 2022/10/18

Dr. Li Zhonghuai reply Surgery


Hello! It is recommended to have the nail bed repaired in the outpatient clinic.
It takes about one month for the toenail to grow back.
The shape of the nail bed can affect the shape of the toenail, but this is purely an aesthetic issue and does not impact growth.
Take care! Changhua Hospital cares about you!

Reply Date: 2022/10/18

More Info


Hello! Thank you for reaching out with your concerns regarding the healing process of your toenail after the nail removal procedure. It's understandable to have questions about nail growth and the healing process, especially after experiencing an injury that required surgical intervention.

Firstly, it's important to recognize that toenails can take a significant amount of time to fully heal and regrow after an injury or surgical procedure. Typically, toenails grow at a rate of about 1 millimeter per month, which means that it can take several months to a year for a toenail to completely regrow, depending on the extent of the injury and individual healing factors.

From your description, it sounds like you are experiencing a common issue following nail removal. The thick membrane you mentioned is likely a protective layer that forms as part of the healing process. This layer can sometimes appear uneven or bumpy, and it may take time for the nail bed to normalize as the new nail grows in. The presence of a 2-3 mm indentation or unevenness is not unusual, especially in the early stages of regrowth. However, it is crucial to monitor the area for any signs of infection, such as increased redness, swelling, or discharge.

Regarding your concern about whether this situation will affect normal nail growth, it is possible that the irregularities in the nail bed could influence the appearance of the new nail as it grows. However, in many cases, the nail can still grow normally despite initial irregularities. As the nail continues to grow, it may gradually smooth out, but this process can take time.

Here are some recommendations to help support your healing process:
1. Keep the Area Clean and Dry: Ensure that the area around your toenail is clean to prevent infection. You can gently wash it with soap and water, and then pat it dry.

2. Avoid Trauma: Be cautious to avoid bumping or hitting your toe, as this can exacerbate any existing irregularities and potentially lead to further injury.

3. Moisturize: Applying a gentle moisturizer to the area can help keep the skin around the nail supple, which may aid in the healing process.

4. Monitor for Changes: Keep an eye on the growth of the nail and the condition of the nail bed. If you notice any significant changes, such as increased pain, swelling, or signs of infection, it would be wise to consult with your healthcare provider.

5. Consider a Follow-Up Appointment: If you have ongoing concerns about the appearance of your nail or if the irregularities worsen, it may be beneficial to schedule a follow-up appointment with your healthcare provider or a dermatologist. They can assess the situation more thoroughly and provide tailored advice or treatment options.

In summary, while the irregularities in your nail growth may be concerning, they are not uncommon following a nail removal procedure. With time and proper care, your toenail should continue to grow, and the appearance may improve. However, if you have any doubts or if the situation does not improve, do not hesitate to seek professional medical advice. Your health and comfort are paramount, and a healthcare professional can provide the best guidance tailored to your specific situation.

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