Nail avulsion is a medical procedure that involves the partial or complete removal of a fingernail or toenail from its nail bed. This procedure is often performed to treat various nail conditions, including severe fungal infections (onychomycosis), ingrown nails, trauma to the nail, tumors, or other abnormalities that do not respond to conservative treatments. Nail avulsion can be done surgically, using a local anesthetic to numb the area, or chemically, where a chemical solution is applied to the nail to facilitate its gradual removal. The goal of nail avulsion is to alleviate pain, prevent infection, and allow a healthier nail to regrow. The causes of nail avulsion typically include chronic or acute conditions affecting the nail or its surrounding tissue. Ingrown nails, where the nail grows into the surrounding skin, can cause significant pain, swelling, and infection, necessitating avulsion. Fungal infections that do not respond to topical or oral treatments may require nail removal to eliminate the infected tissue. Trauma to the nail, such as crushing injuries, lacerations, or severe bruising, can damage the nail matrix or bed, leading to the need for avulsion. Other causes include tumors, like squamous cell carcinoma or melanoma under the nail, which may require removal for biopsy and treatment. Symptoms leading to nail avulsion often include pain, swelling, redness, and sometimes drainage from the affected nail. In the case of fungal infections, the nail may appear thickened, discolored, brittle, or crumbly. Ingrown nails typically present with pain and inflammation at the side of the nail, and there may be an overgrowth of skin along the edge of the nail. Trauma to the nail may cause immediate pain and visible damage, such as bleeding or detachment of the nail from the nail bed. Complications from nail avulsion are generally minimal but can include pain, bleeding, and infection at the site of the procedure. There may be temporary or, in some cases, permanent changes in nail growth or appearance. Some patients may experience delayed healing, especially if there is an underlying condition like diabetes or peripheral vascular disease that impairs blood flow to the area. Rarely, damage to the nail matrix during the procedure can result in a permanently deformed nail or a nail that fails to regrow. Proper care after the procedure, including keeping the area clean and dry, following up with a healthcare provider, and using any prescribed medications, can help minimize these risks and promote healing. Nail avulsion is an effective treatment for a variety of nail disorders, providing relief and preventing further complications.
