Hello, a little backstory, so like a year ago, I had both my toenails nails with ingrown pushing to each other, I had a surgery where the doctor removed the nail, and used some device to "burn" the matrix of the corner/side that had the problem, the nail still grows, but not fully, I suppose you understand.

 

So anyways a few months later, my left (non dominant side) healed just fine, but my right leg toenail has a different problem of the same nature, its no longer on the side, but now the ingrown toenail is getting buried in "front", now im not too happy about it but Im willing to subject myself to the surgery once again, but when I asked my podiatrist (the same one mind you) he suggested me to not do that and instead (as far I understood anyways, I was in a rush) he is going to… cut the front part of my toe nail and lift my nail, so it will grow upwards and the nail will eventually outgrow my toe while it heal and it will be fine as long I don’t overcut it or something, details are quite vague.

 

Anyways my question is, when I asked him “cant I just burn the entire nail matrix so it wont grow again?” he said something among the words that it was not suggested, because the nail served as protection and I did not wanted my toe bone to actually cut through during physical activity or something among those words? Is this a thing? Is there any possible repercussions of permanent toenail remove (Its my dominant leg, so I can expect to use put more stress on it than suggested)

 

For the record Im getting the surgery on monday one way or another, so any info after that it probably wont help me, thanks for your time

 

Untitled-1

  • Comments (6)
  • I’m suffering the same problem as my big toenail bed has shortened greatly and I’m unaware as to what to do in order to provide the best growth for a new nail
  • From afar, this looks to me like "disappearing toenail bed syndrome", a poorly understood and studied entity not often considered and treated by most podiatrists.
    I would seek a DPM that has a special interest in toenail pathology for consultation (Dr Bates does not appear to be one of us). There are also Dermatologists that share this interest but they are not as hands on as the podiatrist and they are not surgeons.

    Untitled-1In disappearing toenail syndrome, the fleshy part of your toe has been repositioned and lifted on the sides and in front. That flesh is now causing your toenail to end its growth prematurely because it would grow into that elevated flesh. The exposed nailbed over time changes its morphology to normal skin and canno longer attach to a growing nailplate.

    Further Details:

    You may have a bone spur that is involved here that would be diagnosed on x-ray that can easily be removed. That would explain your toenail pain.

    Once diagnosed as disappearing toenail bed syndrome, there are conservative and surgical treatments available that should be discussed with a professional face to face IMHO.

    Good fortune.

    Dr Sha

  • Thanks for your replies, after talking it with my parents they said the treatment sounded too aggressive and I was not going to be having "that" surgery on Monday, I will be getting a second opinion instead, but from what I heard the solution was going to be something among the words of: "Extracting the nail, letting it grow again and huh... manicure it? as in with a nail file? (sorry English is not my first language) because I might not have mentioned it but the nail is growing... too thick at the moment, so it makes redirecting or blending it it over the toe hard (dont ask me, I dont understand why I cant manicure it right now).


    Anyways theres only so much my phone camera can do about close-ups and I got no access to a better one, hope this one works better.


    Anyways as you might (or not) be able to appreciate from the new pic, the black part and the toe itself is not as painful, but the nail itself is (It doesnt hurt when im resting or walking, but touching it or standing on my toes is out of the question)

     

    Regards.

     

    Untitled-1

  • Quote:

    Remove the entire toe nail permanently.  Relief of pain and treatment of infection are the only achievable goals.  Nobody can make this toe nail grow right.  Toenails are like wisdom teeth.  They do nothing for us.  They only cause trouble.

    While I cannot guarantee that I can make your toenail "grow right", I have succeeded with others presenting to my practice with toenails like yours in normalizing their toenails so that they can continue to serve in protecting their digits like polyurethane protects a wooden deck.

    I would consider an attempt at repair before removing toenails permanently as the only option.

    Dennis

  • Remove the entire toe nail permanently.  Relief of pain and treatment of infection are the only achievable goals.  Nobody can make this toe nail grow right.  Toenails are like wisdom teeth.  They do nothing for us.  They only cause trouble.

  • Mr Ayala:

    Great short notice question as your problem may be a bit sophisticated.

    From the somewhat "far away" photo (can we get closeups?):

    Itis difficult to see if the fibular nail plate is recurrent after the first burn procedure.

    If the toenail that was not supposed to regrow has....that should be addressed on Monday

    In addition to that,

    You may have disappearing nail bed syndrome.

    Your great toe is long and fleshy distally. You probably have a flexible forefoot functional foot type that has your big toe smashing its distal flesh that is repositioning the tissue upwards. This has resulted in the fact that the distal flesh has relocated at a higher level than the toenail that is growing forward. This is causing a portion of the viable nail bed to "disappear" resulting in  a "frontal ingrown toenail".

    I would discuss this possibility with your surgeon before the scheduled operation as an additional factor to consider, or get a second opinion with a DPM with an interest in onychodystrophy.

    Dennis