Fungal Nail Surgery: Do I Need It?

Fungal nail infections, known as onychomycosis, are common yet often frustrating foot conditions. These infections can cause nails to become discolored, thickened, brittle, or even painful. While many try to treat fungal nail infections with over-the-counter treatments or home remedies, these methods are only sometimes effective, especially when the infection is severe or long-standing. In such cases, fungal nail surgery is an option. This article will explore what fungal nail surgery entails when needed and what the process involves. We'll also discuss other treatment options and how to determine if surgery is the right choice for you.

What is a Fungal Nail Infection?

Fungal nail infections are caused by fungi that invade the toenails or fingernails, leading to a range of symptoms, including discoloration, thickening, crumbling, or distortion of the nails. The infection can develop slowly, often starting with a small area of discoloration, but if left untreated, it can spread, causing pain and discomfort. Fungal infections thrive in warm, moist environments, so they are commonly seen in individuals who wear tight shoes, have diabetes, or have compromised immune systems.

While topical or oral antifungal medications can treat fungal nail infections, these treatments often take several months to work and may not always fully eliminate the infection. When the disease is severe or chronic, surgical intervention might be necessary.

When is Fungal Nail Surgery Needed?

Fungal nail surgery is typically considered when other treatment options have failed or when the infection is severe, causing significant pain or complications. Here are some reasons why you might need fungal nail surgery:

Chronic or Persistent Infection

For many individuals, fungal nail infections can be chronic. The infection may persist despite using antifungal creams, ointments, or oral medications. In cases where the infection has not responded to other treatments, surgical removal of the infected nail may be necessary to eliminate the fungus and prevent recurrence.

Pain or Discomfort

If the fungal nail infection has progressed to the point where it's causing pain, walking may become difficult, and wearing shoes may be uncomfortable. Surgery may be the most effective way to remove the infected nail and provide relief. When the toenail becomes thickened or distorted, it can lead to pressure against the shoe, causing further irritation and potential injury.

Infection Spread

In some cases, a fungal nail infection can spread to other toenails or even to the skin of the feet. If the infection spreads or causes other complications like cellulitis (a skin infection), surgery may be needed to remove the infected nail and prevent further damage.

Cosmetic Concerns

While the primary reason for fungal nail surgery is to eliminate the infection and alleviate pain, some individuals seek the procedure for cosmetic reasons. Discolored, thickened nails can be embarrassing, and surgery can help restore the appearance of the nails. However, surgery should be considered only after other treatments have failed, as it is a more invasive option.

Underlying Health Conditions

Certain underlying health conditions, such as diabetes or compromised immune systems, can increase the risk of severe fungal nail infections. If you have a preexisting condition and the infection is not improving with conservative treatment, a toenail fungus doctor may recommend surgery as a preventive measure to avoid more serious complications, such as secondary infections.

What Does Fungal Nail Surgery Involve?

Fungal nail surgery typically involves the removal of the infected toenail or the part of the nail that is severely damaged. The procedure is usually done under local anesthesia, meaning you'll be awake but won't feel any pain during the process. There are two main types of surgical options for fungal nail removal:

Partial Nail Removal

In some cases, only a portion of the infected nail is removed. This is often done when only part of the nail is affected by the infection, and the surrounding nail tissue is still healthy. The procedure is generally less invasive and has a shorter recovery time.

Complete Nail Removal

A podiatrist nail fungus may recommend completely removing the nail for more severe infections. This option is typically reserved for cases where the infection has caused significant damage to the nail or surrounding tissue. After removing the nail, the toe may be treated with antifungal medication to ensure the infection does not return.

Sometimes, a chemical is applied to the nail bed to prevent the nail from growing back. This can be helpful for individuals who have recurrent infections or who do not want to deal with the risk of the infection returning once the nail grows back.

Recovery After Fungal Nail Surgery

After fungal nail surgery, following post-operative care instructions is essential to ensure proper healing. Here are some general steps involved in recovery:

1. Wound Care: The surgical site must be kept clean and dry to avoid infection. You may be instructed to apply antibiotic ointment and cover the wound with a sterile bandage.
2. Pain Management: Mild pain and swelling are common after surgery. Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage discomfort. If necessary, your doctor may prescribe stronger pain medication.
3. Foot Elevation: Elevating the foot for the first few days after surgery can help reduce swelling. You should also avoid putting weight on the foot for the initial healing period.
4. Follow-Up Appointments: Your podiatrist will schedule follow-up visits to monitor the healing process and ensure that the infection has been eliminated. If you had a complete nail removal, they will also check for any signs of regrowth.
5. Avoid Tight Shoes: After surgery, it's important to avoid tight shoes or high heels, which can pressure the healing area. Opt for comfortable, open-toed shoes or sandals until the site has fully healed.

Other Treatment Options for Fungal Nail Infections

Before considering surgery, exploring other treatment options for fungal nail infections is essential. These include:

• Topical Antifungal Treatments: Over-the-counter or prescription antifungal creams, ointments, and lacquers can help treat mild to moderate fungal infections. These treatments require regular application over several months to be effective.
• Oral Antifungal Medications: In cases of more severe fungal infections, oral antifungal medications may be prescribed. These medications can be effective, but they often come with potential side effects and require a more extended treatment period.
• Laser Therapy: Some patients opt for laser treatment to eliminate fungal nail infections. This treatment involves directing laser energy at the infected nail to destroy the fungus.

Conclusion

Fungal nail surgery is typically reserved for severe, persistent infections that have not responded to other treatments. While surgery may seem drastic, it can be highly effective in removing the infection, alleviating pain, and restoring the nail's appearance. If you have a fungal nail infection that isn't improving with topical treatments or are experiencing pain, it's a good idea to consult a toenail doctor. A podiatrist nail fungus specialist can assess your condition, discuss your options, and determine whether surgery is best for you. As with any medical procedure, weighing the benefits and risks is essential, but for many individuals, fungal nail surgery provides the relief they need to enjoy healthier feet.

For any kind of foot and ankle surgery, visit following Clinic: 

Valley Foot & Ankle Center