About Your Nail Procedure

This information will help you prepare for your nail procedure in your doctor’s office, such as a nail avulsion or nail biopsy.

A nail avulsion is a procedure to remove your nail plate (the hard part of your nail) from your finger or toe. Your doctor may recommend this type of procedure if you’re having nail problems that haven’t gotten better with other treatments.

A nail avulsion may be done to:

  • Treat an infection of your nail.
  • Remove a growth from your nail.
  • Treat a severe injury to your nail.
  • Treat an ingrown toenail.

A nail avulsion may also be done to treat nail problems (such as redness, swelling, oozing, pain, infection, or odor) caused by your cancer treatment. Taxane-based chemotherapies and some targeted therapies can cause nail problems.

A nail biopsy is a procedure to take a sample of tissue of the skin under your nail. It may be done to check for abnormal cells.

Before Your Procedure

  • Buy bandages that are made specifically for fingers or toes. You will need to use these after your procedure. You can buy them at your local drug store.
  • If your procedure will be done on your toe, you may want to bring open-toed shoes to wear after your procedure.
  • If you’re driving to your appointment, bring someone who can drive you home after your appointment.

Shower the night before or the morning of your procedure. You can eat and take all of your medications as usual.

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What to Expect During Your Procedure

About 5 to 10 minutes before your procedure, your doctor or nurse will give you an injection (shot) of local anesthesia (medication to make an area numb) close to the affected nail(s). They will also wash the affected area with a surgical soap or alcohol.

Once the area is numb, your doctor will remove a piece of your nail plate or your whole nail plate.

After the nail is removed, your doctor or nurse will put an antibiotic ointment and dressing (bandage) on your wound. Your doctor may also give you a prescription for an antibiotic to take at home.

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Caring for Your Wound

  • Keep your bandage on for _____ hours after your procedure. Keep it dry.
  • After _____ hours, change your bandage. Follow the instructions in the “Changing your bandage” section.
  • It’s normal for the affected area to feel numb for 1 to 2 hours after your procedure. This is from the local anesthesia.
  • If your procedure was done on your toe, avoid wearing tight clothing for about 1 to 2 weeks after your procedure. If your clothing is too tight, you might pull the bandage off when you take your clothes off.
  • Don’t swim, do any strenuous exercise (such as jogging and tennis), or lift more than 5 to 10 pounds (2.3 to 4.5 kilograms) for _____ weeks after your procedure.

It takes about 6 months for a fingernail to regrow and about 1 year for a toenail to regrow. The new nail usually looks normal.

 

Changing your bandage

Change your bandage _____ hours after your procedure. Follow these steps:

  1. Soak your affected finger or toe in lukewarm water for 15 minutes. This helps keep your bandage from sticking to your wound.
  2. Gently take the bandage off.
  3. Wash your wound with soap and water. Pat it dry with clean gauze.
  4. Check for blue or purple discoloration or redness. If you see any discoloration or redness, call your doctor’s office.
  5. Apply ___________ ointment to your wound and cover it with a new bandage. Keep the tip of your finger or toe open to the air so that you can keep checking for discoloration or redness.

Change your bandage once or twice a day until your wound is healed. This usually takes 5 to 7 days.

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Managing Side Effects

You may have throbbing, pain, swelling, bleeding, discharge, or sensitivity in your affected finger or toe after your procedure. Follow the guidelines below to help with these side effects.

  • For the first 48 hours after your procedure, raise your affected arm or leg as high as possible above heart level. This will help decrease pain and swelling. Try to keep your affected arm or leg raised as often as you can for 1 week.
  • If you have any bleeding, press firmly on your wound with a clean gauze pad for 15 minutes. If the bleeding doesn’t stop after 15 minutes, press firmly for 15 more minutes. If the bleeding still doesn’t stop, call your doctor’s office.
  • You can take acetaminophen (Tylenol®) or extra strength acetaminophen (Extra Strength Tylenol®) to help with pain or discomfort, if you choose. Don’t take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil®) or naproxen (Aleve®). These medications may increase bleeding.
    • Follow the dose directions on the package. If this dose doesn’t relieve your pain, call your doctor’s office.
    • If you’re allergic to acetaminophen or if you can’t take it due to a medical condition, ask your healthcare provider what you can take instead.
    • If you’re in a cancer treatment clinical trial, ask your oncologist (cancer doctor) what pain medications you can take.
  • You can also hold an ice pack over your wound to reduce pain, swelling, and bruising. Place an ice pack on your wound for 15 to 20 minutes every hour, or follow your healthcare provider’s instructions.
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Call Your Doctor if You Have:

  • A temperature of 100.4° F (38° C) or higher
  • Chills
  • Any of the following symptoms at your wound or the area around it:
    • Increased redness or swelling at the tip of your finger or toe
    • Increased pain or discomfort
    • Skin that’s hard, warm, or hot to the touch
    • Bright yellow or green drainage
    • Foul odor (smell) from your skin or nails
    • Bleeding that doesn’t stop after applying pressure
    • Blue or purple discoloration of the tip of your finger or toe
  • Skin symptoms that don’t get better or worse
  • New or worsening symptoms after starting therapy to treat your skin
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