Nails are removed for a variety of different conditions in podiatry care, and the procedure to do this is a fairly simple one. Nails often become diseased beyond the point of medical treatment to restore them back to their natural state. This can occur when nails become fungally infected, and medical treatment is either ineffective or the nail is too thick and painful from the infection process to bear. Nails also change over time, becoming thickened and misshapen as we age. This process is hastened along when there is an injury that bruises the nail or causes it to fall off, resulting in permanent damage to the nail root cells that generate the nail tissue. When the nail begins to grow again, it can become thick, grow upward or outward, or become ingrown and c-shaped. This damage can never be repaired. Even simple things like shoes that are too big or too small can bring about gradual changes to the toenails, especially the big toe and the toe next to it.

When a nail, for whatever reason, is thick, severely ingrown on both sides, or otherwise painful, the logical step is to remove the nail. Toenails serve no anatomic purpose at this point in human development, and the tissue underneath is simply normal skin. One does not lose anything by having a toenail removed. It is preferable in this situation to remove the toenail permanently, as allowing it to grow back will result in the exact same problem. The procedure to do this takes under ten minutes from start to finish in the office, and involves numbing the toe with a local anesthetic. This is the only part of the procedure that is uncomfortable, and the stinging from the medication lasts under 20 seconds. The toe is then cleansed with an antiseptic, and the toenail is gently removed. The nail root cells are then usually destroyed with a acidic chemical, although some physicians may use sharp instruments or laser to destroy the root cells. A dressing is then applied, and one can go home with little in the way of restrictions. Daily soaking and dressing with ointment and a small bandage or band-aid is done at home, and the toe skin under the nail generally heals and toughens up within 3-4 weeks. Pain is usually minimal, mostly a little discomfort, and limited to only a few days after the procedure. Complications are uncommon, and usually only related to poor home care or a minor infection. Once the skin heals, one will have to look carefully to notice that the nail is gone, and cosmetic-minded women can still paint the skin to match the polish on the other intact nails.