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Nail Problems Message Board

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It is now slightly more than 4 months since the accident. It was a very good idea to have the toe nail removed, as leaving it in place would have impeded growth, as well as been painful when wearing shoes.

When a toe nail is removed, the entire nail bed is exposed. The nail "matrix" is below the cuticle line and is where the new nail will grow from. I had expected that the nail would start behind the cuticle, but this is not true.

After my toe nail area healed, to the point where the scabs wore down and crumbled away, I noticed a small band of it remained next to the cuticle. It was a different texture than the scab area, appearing more hardened. I soon realized that this was the new nail forming.

For nearly two months after the scab was gone, this "nail starter" part did not move. I began to fear that something went wrong and that my nail would not be regrowing. However, it has started to show signs of growth. Also, because of the scabbing that was in place before, the surface was not smooth. It was actually a bit jagged. So, I took out a nail file and smoothed it down somewhat. It is still raised a bit more than the nail was originally, but is less than it was before. It looks to me like in time, as the nail grows out, it will lie more flush to the nail bed. Thankfully it looks like the growth rate is good and that I should expect a full nail back in place by next December.

When I dealt with the doctor and asked about what to expect in all this, he couldn't provide me this level of detail. Nothing said about how the nail reforms, when I will start to see signs of it growing, and what I might do to help it (like filing it down to help prevent it from getting snagged). So, I've posted here in case anyone has suffered the same fate and wants to know what will happen. For each person, the experience may be slightly different. I have heard in some cases where the nail matrix is badly damaged, the nail can't grow back properly and may actually cause pain later... and in those cases, the nail matrix is cauterized to prevent re-growth. The good thing about a big toe missing the nail is that it's not very eye catching. However, from a practical standpoint, that toe is more vulnerable and so extra care should be taken.

I've also upped my protein intake, which seems to be helping. Eggs are a really good source, although be careful not to eat too many yolks (it has a fair quantity of the "bad" cholesterol, along with the good, so don't consume too much). I've also gotten into the practice of flexing my toe joint. It was painful to do it in the beginning, but gradually I'm seeing flexibility return. Strength has returned as well, but not as it was before. I expect it won't ever be quite the same, but as long as it isn't a significant difference that's OK. I was able to comfortably resume jogging about 3 months after the toe nail removal.

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