Permanent toe nail removal, otherwise known as matricectomy, is the procedure to surgically, chemically or electrically ablate or destroy the nail matrix. Multiple reasons exist to undergo this process, most notably to treat ingrown toenails.
Other reasons for matricectomy are chronic nail dystrophies, including onychauxis, onychogryphosis, onycholysis, psoriatic nail and symptomatic onychomycosis that are unresponsive to aggressive antifungal therapy. Moreover, some extreme runners opt for this body modification procedure so that they no longer have to contend with the hallmark of a runner's trade: bruised, ingrown and lost toenails, as described in magazine The Globe and Mail.
When more conservative forms of treatment are ineffective, doctors usually perform a partial removal of the nail bed, referred to as a wedge resection, before choosing the more drastic method of complete removal. To perform a wedge resection, physicians first inject the area with a local anaesthetic in order to create a numbing effect. Once the area is numb, doctors cut along the nail edge that is growing into the skin. The nondesirable sections of nail are then removed and the wound is covered in petroleum jelly and gauze. This entire process occurs in the physician's office and generally takes 30 to 45 minutes. Patients are permitted to leave immediately following the procedure; recovery is approximately two weeks to two months.
If the more invasive procedure of complete removal is warranted through surgery, patients experience significant pain, morbidity and lengthier healing times. Pain management is usually acetaminophen with codeine.