What is nail removal?
Nail removal, also known as a nail biopsy, is a medical procedure where a portion or the entire nail is removed for diagnostic or therapeutic purposes. It is usually performed when there are abnormalities or concerns related to the nail, such as infections, tumours, or chronic nail conditions.
The different types of nail removal include:
- Nail avulsion: removal of the nail plate. Usually done for ingrown toenails, fungal infections, or nail deformities.
- Nail matrix biopsy: biopsy of the baby nail. This procedure requires the removal of the nail plate, followed by lifting up the proximal skin, and then a biopsy is done on the tissue under the skin fold. This is usually done to rule out melanoma.
- Nail bed biopsy: biopsy of the tissue underneath the nail plate. Performed after removing the nail. Done on tumours that arise from the nail bed.
Nail removal may be a minor outpatient procedure and it typically involves minimal discomfort and a relatively quick recovery time.
How does nail removal work?
During a nail removal or nail biopsy procedure, you will first receive a local anaesthetic to numb the area around the affected nail. This ensures that you do not experience any pain or discomfort during the procedure. Once the area is numb, a portion or the entire nail is removed depending on the purpose of the procedure.
The nail is gently separated from the nail bed using specialised instruments. If a biopsy is necessary, a small piece of the nail tissue is collected for further examination. The removed nail tissue is then sent for analysis to determine the underlying cause of any nail abnormalities or concerns.
After the nail removal or biopsy, a sterile dressing may be applied to the area to protect it and promote healing. Your dermatologist will provide you with specific instructions for post-procedure care, which may include keeping the area clean, applying ointment, dressing changes, and avoiding activities that may put a strain on the treated nail.
Benefits of nail removal
- Identifies underlying causes
- Guides treatment decisions
- Helps monitor treatment progress
- Provides peace of mind
- Enables early detection
- Minimally invasive
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What conditions can nail removal treat?
Nail removal can be used to treat the following conditions:
- Fungal nail infections: help diagnose and guide treatment for fungal infections that affect the nails, such as onychomycosis.
- Bacterial infections: can help identify the specific bacteria causing an infection and guide appropriate antibiotic therapy.
- Nail tumours: crucial in evaluating and diagnosing nail tumours such as subungual melanoma or squamous cell carcinoma.
- Nail psoriasis: may be performed to confirm the diagnosis of psoriasis and assess the severity of nail involvement.
- Nail dystrophies: can be used to investigate and diagnose various nail dystrophies such as onycholysis, onychomadesis, or pachyonychia congenita.
- Nail trauma or injuries: in cases of severe nail trauma or persistent nail abnormalities following an injury, nail removal or biopsy can help assess the extent of damage and guide appropriate management.
- Nail abnormalities of unknown origin: when there are unexplained nail abnormalities or changes, nail removal or biopsy can be performed to investigate and determine the underlying cause.
What results can I expect?
After a nail removal or biopsy, you can expect several possible outcomes depending on the specific condition being treated or diagnosed:
- Diagnosis: the primary goal of nail removal or biopsy is to obtain a sample for laboratory analysis. You can expect to receive a definitive diagnosis or confirmation of a suspected condition based on the examination of the nail tissue.
- Treatment guidance: if the nail removal or biopsy was performed to guide treatment, the results will help determine the most appropriate course of action. This may include prescribing specific medications for fungal or bacterial infections or recommending further interventions based on the diagnosis.
- Prognosis assessment: for conditions like nail tumours or severe nail abnormalities, the results of the nail removal or biopsy can provide valuable information about the extent of the condition and help determine the prognosis. This knowledge can guide further management and follow-up care.
- Peace of mind: obtaining a clear diagnosis through nail removal or biopsy can bring peace of mind, especially when there have been unexplained nail changes or concerns. Having a definitive understanding of the underlying condition can alleviate anxiety and allow for appropriate treatment and monitoring.
How many treatment sessions are required?
The number of treatment sessions required for nail removal or nail biopsy varies depending on the specific condition being treated or diagnosed. In many cases, a single session may be sufficient to obtain the necessary sample or achieve your desired outcome. However certain conditions may require multiple treatment sessions for complete resolution or further evaluation.