Removing a toenail can help cure fungus by exposing the infected nail bed, allowing topical antifungals to work better, but the fungus can return as the nail regrows, so it's usually part of a larger treatment plan involving antifungal medications or procedures like laser therapy to prevent recurrence. It's often a last resort for severe, painful cases, with doctors preferring treatments that clear the fungus and let a new, healthy nail grow.
A lot of people believe that if the fungal nail is removed and allowed to grow back it will be normal. This treatment is a common recommendation from primary care doctors who do not see a lot of this problem. Unfortunately, the nail will grow back the same as before the procedure. No change … and no gain.
Treating fungal nails during pregnancy requires caution, with topical treatments preferred over oral medications, but even topical options like medicated nail polish (ciclopirox) need doctor approval, while oral antifungals (like fluconazole, itraconazole) are generally avoided due to potential fetal risks, and laser therapy is also not recommended; always consult your doctor for the safest approach.
This is usually only considered as a last resort. If the toenail is removed, it must be followed up with antifungal therapy or the fungus will come back as the nail regrows.
Toenail fungus is tough to kill permanently, but the most effective treatments are prescription oral antifungal drugs (like terbinafine), followed by strong topical antifungals, often used together, while laser therapy and sometimes nail removal (surgery) are options for persistent cases, though home remedies rarely provide a complete cure and professional help is key for lasting success.
If toenail fungus goes untreated, it worsens, causing the nail to thicken, discolor (yellow/brown), become brittle, crumble, and potentially separate from the nail bed, leading to pain, odor, and difficulty walking; it can spread to other nails/skin (athlete's foot) and, in rare cases, lead to serious bacterial infections like cellulitis, especially for those with diabetes or weakened immunity, potentially causing permanent nail damage or systemic issues.
“Each evening, patients go to a bathroom or other place with a vinegar-resistant floor, don old cotton socks, pour a few spoons of plain or apple-cider vinegar and a few spoons of water over the toes, and sit and read for 10-15 minutes. They then doff the socks, apply topical antifungals, and go to bed.
After a fungal infection has been treated, the nail may still appear thickened, discolored, or brittle. These changes occur because the infection can permanently damage the nail matrix—the area responsible for nail growth.
Surgery Overview
Your doctor will give you an injection in the finger or toe to prevent pain. Then your doctor will use a tool to loosen the skin around the nail and separate the nail from the skin. If only part of the nail is diseased, only the diseased part is removed.
Full regrowth can take up to 18 months. If the nail will continue to be problematic, your podiatrist can treat the nail bed to stop regrowth. In this case, the removal will be permanent and you won't have a toenail.
I generally encourage healthy adult patients with mild toenail fungus to not treat it or to treat it just using topical measures. For example, you can buff the nail down with a file to keep it thin, so the fungus has a less of a home to live in. You should also keep the nail trimmed.
Dermophytes can also cause ringworm and fungal scalp infections. Toenail fungus doesn't usually spread to inside your body, like the stomach. The fungi require keratin, found in your hair, skin and nails. They survive best on the skin.
Fungal spores can persist for up to 1–2 years in unopened nail polish bottles under ideal conditions. Once exposed to air, fungi may survive for several months, though growth rates can decrease due to oxygen exposure.
It's normal to worry about how painful nail surgery might be. Reassuringly, the only slightly painful part is the injection used to administer anaesthetic - very similar to the one you may have in your gums at the Dentist. Once the toe is numb, you will not experience any pain while the nail is removed.
Your health care provider may prescribe antifungal drugs that you take by mouth (orally) or apply to the nail.
After a nail separates from the nail bed for whatever reason, it will not reattach. A new nail will have to grow back in its place. Nails grow back slowly. It takes about 6 months or longer for a fingernail and up to 18 months for a toenail to grow back.
For prompt, effective treatment of your toe nail condition, you should see a podiatrist as soon as possible, especially if you notice certain changes to your nails. These abnormalities may include toenail deformities, discoloration, or thickening.
Depending on how severe the nail fungus is, yes UV lamps can possibly kill the fungus. Be cautious using the UV lamp too often and too long though because it can burn the skin. If it's your toe nails, make sure to kill off the fungus inside of your shoes as well because the fungus can re-infect the nail.
Matrixectomy – introducing a chemical substance to the nail matrix to prevent that section of the toenail from growing back permanently.
Over time, untreated fungal infections can permanently change the shape of the affected nail.
Keratin granules are areas of damage to the top layers of the nail. They show up as small, chalky white spots or rough patches and happen when nail polish, especially if left on too long, dries out and weakens the surface of the nail.
If left untreated, fungal toenails can progress to a more severe stage, characterized by: Further discoloration, with the nail turning yellow, brown, or even black.
It's also important to note that socks can retain fungal spores even after washing. So if you've had athlete's foot, wearing the same pair again – even if it looks clean – could trigger reinfection. The safest approach is to wear fresh socks daily and allow your shoes to dry out completely between wears.
The Best Treatments to Kill Toenail Fungus Instantly
Oral Antifungals (like Terbinafine or Itraconazole) – These work from the inside out, attacking the infection at its source. Topical Antifungal Solutions – Prescription-strength treatments penetrate the nail for faster and more effective results than OTC options.
If you want to try this remedy, apply a bit of Vicks Vaporub to your affected toenails daily. It can still take several weeks to a couple of months for results to appear.