Fungal Nail Surgery: What to Expect

Medically Reviewed by Gabriela Pichardo, MD on November 27, 2022
3 min read

If you’ve tried everything to get rid of your fungal nail infection, but it just won’t go away (and it really hurts), it might be time for surgery.

There are procedures that use lasers or light therapy to kill the fungus, but doctors need more research to find out how well they really work.

So, at this point, your doctor may suggest surgery to remove the nail. It’s not a common surgery, but it’s an option when all else fails. When you have your nail taken out, a new one usually grows back. But nails grow slowly. It could take up to 18 months for yours to grow all the way back.

Nail surgery can be done in your doctor’s office. Before it starts, your doctor numbs the area around your nail. If you’ve ever had your gums numbed at the dentist’s, it’s very similar. You’ll be awake for the surgery, but you won’t feel any pain.

Once the area around the nail is numb, your doctor uses special tools to remove the entire nail or just the infected piece.

In severe cases, they may have to destroy the nail matrix, which is what makes your nail grow back.

After the surgery, your doctor usually applies antibiotic cream and a bandage around your nailbed, which is the area under where your nail used to be. The antibiotic helps make sure you don’t get a bacterial infection.

The surgery usually takes less than an hour.

Before the surgery, your doctor will probably give you a physical exam and talk to you about your medical history, such as other illnesses and surgeries you’ve had. They will also want to know if you have:

On the day of your surgery, you can shower, eat, and take your usual medicines, unless your doctor has said not to.

In the first few hours after the surgery, expect the area around your nail to feel numb. After that, you may feel pain and throbbing. You may also notice swelling, bleeding, or fluid coming from your wound.

For 48 hours after the surgery, keep your arm or leg elevated above the level of your heart as much as you can. This helps with the pain and keeps the swelling down.

As you heal, you’ll need to change your bandages on a regular basis. Your doctor will show you how to do this and may also give you an antifungal medicine to put on your nailbed to kill any fungus that’s left.

People heal at different rates, but expect at least 2-3 weeks for the nailbed to heal. Your doctor will let you know when you can get back to your normal physical activity.

Fingernails usually come back in six months, and toenails in 18 months, but it could take longer.