Question
Hi,

Thanks for getting back to me. I actually reside in palm beach gardens FL. I see that you are in Tampa... that is only about a 3 hr drive from here (used to live there myself).

So it seems that permanetly removing the nails would be the best option. But I have just been researching into it further and have been reading that once the nail has been removed your body develops this hardend skin in that area and that even once that area has healed that you will always have this hard layer of skin where the nail used to be and that this skin is dry and looks cracked. I read that women can put nail polish over this hard skin... I don't know why on earth anybody would wear nail polish on top of that dry hard skin if they don't have nails... just doesn't sound like it would be very attractive! But that doesn't matter since he is a man and does not wear any nail polish so no worries with that issue.

But he is concerned about what the hardend skin will look like where the nails used to be? Will it be really dry and cracking all the time? I was under the imspression that once the nails were removed and it has had planty of time to heal that the skin where the nails used to be would be NORMAL and SOFT skin. But I guess I was completely wrong in thinking that. So now I am wondering if the hardened skin that will grow in that area will look bad? And if weekly pedicures are taken... can they scrub that area to make it look like normal soft skin?

I wish I could see pictures of permanent toenail removal once it has healed.... I have searched online but only came up with a few and the images were of bad quality and you cannot really see.

Thanks for your time and assistance,
Ashley







-------------------------------------------
The text above is a follow-up to ...

-----Question-----
Hi,

I have a question regarding toenail fungus and permanent toenail removal and would be grateful if you could provide me an answer to my questions I have about it. My boyfriend who is 46 yrs old has had toenail fungus for quite some time now. His toenails quite frankly look very gross!!! I don't mean to be rude but they area HUGE turn off... they just look very appauling.

All of his toenails are affected by it. I take great care of my own feet with weekly pedicures and I expect my partner to as well but he refuses to get treatment for his toenail fungus because he has crohn's disease (takes medication for the crohn's) and cannot take the oral medications to attempt to eradicate the toenail fungus because those medications would put his already at high risk liver into too much jeopardy.

Therefore he cannot take the oral medications to eradicate the toenail fungus. Also I feel even if he did take the oral medications and managed to eradicate his toenail fungus it would be entirely pointless because the fungus would come back eventually for certain. I say this because he is a stubborn man and refuses to wear sandals and insists on walking around the entire day in these sweaty boat shoes with no socks! When he takes these shows off you can tell that they are a breeding oasis for bacteria just by the way it smells! Why anybody would do that who is prone to toenail fungus is beyond me. It just boggles my mind and I am reaching my wits end. And of course those ointments you can put on the actual nails are not effective.

Therefore I brought up the subject of PERMANENT toenail removal to him. Not temporary removal because that does not get rid of the fungus of course (but permanent toenail removal) for ALL of his toenails since he is unable to or refuses to take care of them whatsoever and the fungus has been there for a long time and is slowly getting worse. So my main question is... is this a GOOD solution do you think... to have permanent toenail removal done on all of his toenail? Basically I want him to be de-clawed like a cat!

But what I'm mostly concerned about is will the skin be perfectly normal after the toenails have been removed and it has healed? Or will the skin be very strange in that area where the nails used to be? And what about the cuticle... when you do permanent nail removal how do you ensure that the cuticle NEVER grows back? Because that would be very strange to not have any nails but have cuticles still growing on your toes when you don't have any nails on them. Or am I incorrect in thinking this and the cuticles would also be prevented from growing back along with the nail??? When you remove the nail bed I suppose the cuticle is also permanently stopped from returning,  am I correct?

And my other main question was... in general how much does it cost to have 10 toenails removed?

Thanks for your time,
Disgusted :)











-----Answer-----
Hi Ashley,

Fungal nails can be a major problem.  I agree that Lamisil is not an option for him with the Crohn's disease.  Some creams/solutions work but he would likely need to use them forever.

Permanent nail removal is likely the only option and does work well.  Typically, normal skin will grow on the nail bed.  There may be some callous and minimal cuticle.  It may not look perfect but will be a major improvement, no doubt.

Does he have insurance?  Permanent removal can range from 200 to 500 per toe.  However, typically I do all of the nails as a single package price and it would be much less.

Where do you live?

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com
www.fix-my-foot.com

Answer
Hi Ashley,

After permanent toenail removal, dry skin can develop.  Typically I will have patients apply certain creams and use a pumice stone if it is bothersome.  At times we use antifungal creams or creams that allow the skin to peel off easily.

The dry skin is not unsightly and you will be getting rid of a toenail fungus and skin infection.  Some people develop normal skin or very little dry skin.

I could try and find some pictures but everyones result is different.  If I happen to come across a good picture I will send it your way.

Good Luck.

Marc Katz, DPM
Advanced Podiatry
Tampa, FL
www.thetampapodiatrist.com
www.tampacryosurgery.com
www.fix-my-foot.com