Permanent Nail Removal
Toenail fungus is stubborn and resists most attempts at treatment. Sometimes, even the surgical removal of the nail isn't enough to rid you of the condition. As the nail grows back, the fungus returns. That's why some patients and their doctors advise a matrixectomy, in which the root of the nail is destroyed so that the nail can never grow back.
Hide 'N Seek
Fungus prefers a damp, dark, and airless place. Our feet spend a lot of time encased in shoes where there is little air and light. Add sweat to the mixture and it's easy to see how this area is a prime location for a fungal infection. However, fungi are more selective in their venue for attack, and like to get under the toenails, where there is even less air and light, and even more moisture than on the rest of the foot. The toenail serves to protect the fungus, as it provides a barrier to creams and powders. A matrixectomy provides a permanent removal of this protective hiding space, ensuring that the fungus can never come back.
Once a nail is removed and its root destroyed, the fungus is cured. With no nail to protect it, the underlying skin toughens up so that the loss of the nail's protective function is minimal. Some feel that the appearance of the nail is better than a toenail with fungus.
In the past, matrixectomy was accomplished through surgery. Some podiatrists still feel that this method is best, as the appearance of the toe, just after surgery, is better, and there is less drainage with this procedure. While the immediate appearance of the toe is improved as compared to chemical matrixectomy, the procedure tends to create more scar tissue. This method causes more pain and because the root is removed close to the bone, there is the chance of developing a bone infection.
Chemical removal of the nail root involves its cauterization through the application of strong chemicals. The advantages of this method is that it's almost painless, there's little scarring, and the long-term appearance of the toe is much better than with surgical methods. In addition, since the chemical procedure doesn't affect the underlying bone, there's little chance of developing a postsurgical bone infection.
Despite these advantages, the procedure causes a minor chemical burn in this area so that there is drainage. Soaking the toe and changing the bandage often is part of the postsurgical care for chemical matrixectomy.