WARNING: The Embarrassing Bodies website contains images of an explicit medical nature and nudity in a medical context.

Video

Voiceover:
20-year-old Elizabeth came to see Dr Pixie about her manky toenails.

Dr Pixie:
They’re a bit pongy, I’ll be honest.

Voiceover:
They’ve been sent to the Embarrassing Bodies laboratory for Professor Val to investigate further.

Professor Val:
Well, I did see something down the microscope, and I have seen a fungus, but not what I was expecting. This is an Alternaria, which is what you can get in the bathroom. It’s certainly not the fungus that would normally cause problems in nails, but this girl’s nails must be really bad.

Voiceover:
Elizabeth’s fungus-infected toenails require specialist care. Today she’s got an appointment with foot and ankle surgeon Mr Anthony Perera at the Spire Hospital in Cardiff.

Mr Perera:
Let’s have a look at this. Now you have got some, um, ingrown toenails on this side and this side, and here as well, which do leave you prone to having repeated infections.

Voiceover:
Ingrowing toenails occur when the nail cuts into the side of the skin. The cause is unknown, but cut your nails straight across, rather than short and low at the sides, and you’re less likely to develop them.

Mr Perera:
The problem is that the whole of your nail is affected, and so you may wish to consider having the nail taken off.

Elizabeth:
I just want them gone, I really hate them.

Voiceover:
If surgery is successful, Elizabeth’s toenails will never grow back. Although this operation is usually performed under a local anaesthetic, Elizabeth has opted to be put to sleep. First, Mr Perera makes a tourniquet, which reduces blood flow to the toe and ensures a relatively bloodless operation.

Mr Perera:
So to start off with, what I’m going to do is numb the toe so it’s nice and comfortable. And this is really important, it’ll keep her comfortable for a few hours as well, and so she won’t feel a thing. So the first thing we need to do is to take this nail off. So the way we do this is to curve, clip underneath the nail, and then we actually avulse the nail off. Now, you can see where the debris collects in the gutters on either side. I’m going to clean out those gutters and also take away the growing part of the nail bed, where the nail grows from. And that’s just this white line just beneath the nail fold, underneath here. I’m going to do that first of all by scraping out the germinal cells that sit there. Then I’m going to use some phenol to destroy them as well. Sometimes we just cut this area out, but it’s reasonably close to one of the tendons that uh, lifts the toe up. We just need to be a little bit cautious. So this is the phenol, and this is quite a noxious substance, and it’s designed to uh, destroy the germinal epithelium, this growing layer of, layer of cells, and I’ll keep this down in the corner a little bit, as you see that is a troublesome area.

Voiceover:
Then the toe is rinsed in a saline solution before being bandaged up.

Mr Perera:
This is just some petroleum covered gauze, and it just helps to uh, put a dressing on that doesn’t stick to that raw surface of the nail bed once we take this dressing off. And so she’ll just need to keep this elevated for the next hour or so, but she’ll be able to um, walk home. I’m just going to wrap it around her foot just to try and keep this on. She’ll need to have this dressing just kept on for a few days, and then she’ll just need to take some simple painkillers overnight.

Voiceover:
With one toe finished, the procedure is then repeated on the other foot.

Mr Perera:
Elizabeth’s surgery has gone really well today. Fortunately she hasn’t got any infections since the last time I saw her, so this was a fairly straightforward procedure, the nails came off very easily, and we’ve got a good clean out of the sides of the, the nail bed, been able to really scrape out the growing area of nail and then use the phenol to really try and cauterise this area—it’s a real double, double safety technique, just to make absolutely certain that uh, the nail doesn’t grow back. I’ve advised her to keep her feet elevated for the next few hours, she’s going to be driven home by her mum a little later on today, and she’ll be able to walk around the house quite comfortably. Over the next few days she’ll get increasingly comfortable, and when she has her next dressing change, it’ll be a much lighter dressing, and she’ll be able to hopefully return back into normal shoes and really start to get back into normal function.

Voiceover:
When 20-year-old Elizabeth got an infection in her toenails, she didn’t change her dressings for six months. It’s been five weeks since her surgery, and now she’s back to show Dr Pixie the results. But is it a case of deja vu?

Dr Pixie:
That dressing…stinks. How frequently have you been changing them?

Elizabeth:
Last week.

Dr Pixie:
Did you? We’re going to just take this one off…it does smell.

Elizabeth:
This one as well is still leaking, I don’t know what it is.

Dr Pixie:
It’s normal after you’ve had this procedure done to need to dress the toes, because they get a bit boggy and oozy, and that’s just part of the healing process. If you don’t look after them and you don’t dress them regularly and keep them clean, and also give them a bit of air time, get them out into the air and get them aerated, you’re going to get an infection.

Elizabeth:
Okay.

Dr Pixie:
You have to start looking at them and looking after them.

Elizabeth:
Now I’ve looked at them, I’ll be fine, I’ll be able to look at them again.

Dr Pixie:
They’re your toes.

Elizabeth:
I know.

Dr Pixie:
So you’re going to have to, you’re going to have to do it, ‘cause look at that, that’s not…that was on too long, so you should be changing them on a regular basis. Do you think you’ll be able to do that?

Elizabeth:
Yeah. I think now I’ve looked at them.

Dr Pixie:
So. Dressings please.

Read the video transcript

Elizabeth is particularly ashamed of the state of her toenails, so-much-so that she’s kept them hidden for 6 months. Dr Pixie diagnoses an ingrown toenail whilst tests on clippings also find fungal infection Alternaria. Elizabeth is soon whisked off to see foot and ankle surgeon Anthony Pinnera who suggests having the nails completely removed which Elizabeth quickly agrees to. Elizabeth undergoes treatment to remove both nails and clean out the infected areas. 5 weeks later Elizabeth returns to the clinic to discuss the results of the procedure. On examining Elizabeth’s toes, which are still healing, she notes that Elizabeth has not been changing the dressings frequently enough and that she really must if she doesn’t want the same symptoms to occur.

Patient Name: Elizabeth Patch
Condition: Ingrown toenails
Specialist: Mr Anthony Perera, Orthopaedic Foot & Ankle Surgeon
Hospital: Spire Cardiff Private Hospital
Length of operation: Approx 20 minute

Did you find this useful? YesYes NoNo

257 of 351 people said they found this useful

Comments and Questions

Comments & Questions are now archived, but if you see anything on the site that worries you, please report it and one of our moderators will look at it as soon as possible.
Please note: Unfortunately Channel 4 cannot respond to individual inquiries. If you have any concerns, you can check out NHS Choices, but ultimately it is always best to check with a health professional.

My big toe nail has been falling off for about 3 years. The nail looks dry and yellow, the nail bed is bruised, but I've not banged my toe. My Dr prescribed Amorolfine Medicated Nail Lacquer in June 2014, saying it would take about 6 months to have any effect. My nail has started to grow back and come off twice since then. My toe is very painful and does not look good. Any suggestions or advice?





This will be published. Surnames, nicknames or usernames are not allowed


Your email address will be kept confidential and will NOT be published – it is only being collected here in case Channel 4 need to contact you in relation to your comment.


Please don’t swear or be rude in your comments, as they will not be added to the site. Please do not use your full name when posting comments. If in doubt, refer to the community guidelines

By posting on this website you are agreeing to abide by our community guidelines

I am having my big toe nails removed and going away within the month abroad will i be alright to travel





This will be published. Surnames, nicknames or usernames are not allowed


Your email address will be kept confidential and will NOT be published – it is only being collected here in case Channel 4 need to contact you in relation to your comment.


Please don’t swear or be rude in your comments, as they will not be added to the site. Please do not use your full name when posting comments. If in doubt, refer to the community guidelines

By posting on this website you are agreeing to abide by our community guidelines

i live in america and over there we're very protected as in they don't show us explicit pictures on television





This will be published. Surnames, nicknames or usernames are not allowed


Your email address will be kept confidential and will NOT be published – it is only being collected here in case Channel 4 need to contact you in relation to your comment.


Please don’t swear or be rude in your comments, as they will not be added to the site. Please do not use your full name when posting comments. If in doubt, refer to the community guidelines

By posting on this website you are agreeing to abide by our community guidelines

which is ok your way is very different and im not trying to offend you or your country im just saying this for some who dont know

I have had nail fungal infection for many years only last year realised what it was just thought it was normal as my grandad had really hard nails. I always get ingrowing toe nails on my big toes which are the infected nails. Would like to know what people recommend. I've trtied covering it up with nail polish but doesn't help with the pain of ingrowing nails.





This will be published. Surnames, nicknames or usernames are not allowed


Your email address will be kept confidential and will NOT be published – it is only being collected here in case Channel 4 need to contact you in relation to your comment.


Please don’t swear or be rude in your comments, as they will not be added to the site. Please do not use your full name when posting comments. If in doubt, refer to the community guidelines

By posting on this website you are agreeing to abide by our community guidelines

what can i do ive had a corn underneath my foot for 15yrs or more its like having a stone permenantly in my shoe very painful had it frozen several times by charopodists and by doctors but had no sucess what can i do im busy always on my feet and by the end of the day im limping and in agony :-(





This will be published. Surnames, nicknames or usernames are not allowed


Your email address will be kept confidential and will NOT be published – it is only being collected here in case Channel 4 need to contact you in relation to your answer.


Please don't swear or be rude in your answers, as they will not be added to the site. Please do not use your full name when posting answers. If in doubt, refer to the community guidelines

Questions submitted to the site will be answered by other site users, not by medical professionals, so if you have a medical concern, please book an appointment with your GP.

By posting on this website you are agreeing to abide by our community guidelines

I have very painful corn small toe

Both off my big toes has the nail very thick and the nail is beeing pushed up,and is coming away from the bed,the doctor says its not a fungus, 4yrs nowplease can you help it hurts.





This will be published. Surnames, nicknames or usernames are not allowed


Your email address will be kept confidential and will NOT be published – it is only being collected here in case Channel 4 need to contact you in relation to your answer.


Please don't swear or be rude in your answers, as they will not be added to the site. Please do not use your full name when posting answers. If in doubt, refer to the community guidelines

Questions submitted to the site will be answered by other site users, not by medical professionals, so if you have a medical concern, please book an appointment with your GP.

By posting on this website you are agreeing to abide by our community guidelines

I have a fungal infection under my nail from kicking my toe into something in the dark of night 4 yrs ago. I've asked to have it removed and my doctor did not want to do it. It grows very thick and pushes down at the nail bed from my enclosed shoes - causing bleeding. It has changed the bone structure in my foot. It's causing other problems for walking. I know that these changes can effect the bones in the knee and the hip, which essentially affects the whole body. I am now going through Myofascial Release treatments as my body quit responding to Chiropractic adjustments. The muscles just kept pulling the bones into the wrong position - causing pain. Not all the problems stem from the toe fungus... but it has not helped! If you can have them removed, I'd say Do It!





This will be published. Surnames, nicknames or usernames are not allowed


Your email address will be kept confidential and will NOT be published – it is only being collected here in case Channel 4 need to contact you in relation to your comment.


Please don’t swear or be rude in your comments, as they will not be added to the site. Please do not use your full name when posting comments. If in doubt, refer to the community guidelines

By posting on this website you are agreeing to abide by our community guidelines

I had my toe nail removed 2 years ago it was fine glad i got it removed the pain everyday with the nail digging into my toe i couldnt take much more so if you can sick a 15min toenail removeal it is soo worth it was off my feet for a few days but everyones differnt would do it again if i had too.





This will be published. Surnames, nicknames or usernames are not allowed


Your email address will be kept confidential and will NOT be published – it is only being collected here in case Channel 4 need to contact you in relation to your comment.


Please don’t swear or be rude in your comments, as they will not be added to the site. Please do not use your full name when posting comments. If in doubt, refer to the community guidelines

By posting on this website you are agreeing to abide by our community guidelines

does the toenail grow back?

I had both my big toe nails removed years ago as they were very badly ingrowing. Everything went fine, but now im wondering if there's anyway I can have false nails fitted? The actual nail bed has shrunk quite a lot so that there is only a small space left to fit a nail to. Any suggestions of how I could get normal toe nails fitted?





This will be published. Surnames, nicknames or usernames are not allowed


Your email address will be kept confidential and will NOT be published – it is only being collected here in case Channel 4 need to contact you in relation to your comment.


Please don’t swear or be rude in your comments, as they will not be added to the site. Please do not use your full name when posting comments. If in doubt, refer to the community guidelines

By posting on this website you are agreeing to abide by our community guidelines

I have had the sides of my toes packed and am in lots of pain. Does anyone know if this is normal?

I had both my big toe nails removed years ago as they were very badly ingrowing. Everything went fine, but now im wondering if there's anyway I can have false nails fitted? The actual nail bed has shrunk quite a lot so that there is only a small space left to fit a nail to. Any suggestions of how I could get normal toe nails fitted?





This will be published. Surnames, nicknames or usernames are not allowed


Your email address will be kept confidential and will NOT be published – it is only being collected here in case Channel 4 need to contact you in relation to your comment.


Please don’t swear or be rude in your comments, as they will not be added to the site. Please do not use your full name when posting comments. If in doubt, refer to the community guidelines

By posting on this website you are agreeing to abide by our community guidelines


More Information

  1. Episode 6

    In Episodes - Conditions being seen by the doctors in a jam packed Episode 6 incl…

  2. Nail Problems

    In Conditions - Conditions that can affect your fingernails and toenails; from ingr…

  3. Onycholysis

    In Conditions - The separation of the fingernail or toenail from the nail bed.

  4. Nail Psoriasis

    In Conditions - This is caused by the nail becoming pitted, discoloured and loose.

  5. Body Check: Feet

    In Videos - Dr Christian talks about common foot conditions and the importance…

  6. Athlete's Foot

    In Conditions - A common fungal infection that affects the foot.

  7. Doctor Responses: Bad Breath

    In Videos - Dr Pixie answers your common questions about curing this annoying c…

  8. Doctor Responses: Vaginal Discharge

    In Videos - Dr Pixie answers your most frequently asked questions about vaginal…

  9. Malassezia Fur Fur

    In Conditions - Malassezia fur fur is a type of yeast (fungal infection) that that…

  10. Doctor Responses: Skin Tags

    In Videos - Dr Pixie answers your most common questions about annoying (but usu…

  11. Palmoplantar Keratoderma

    In Conditions - Palmoplantar Keratoderma is a rare genetic disorder, resulting in…

  12. Consultation: Verrucas

    In Videos - Dr McKenna examines two patients with severe outbreaks of verrucas

  13. Consultation: Extreme Bunions

    In Videos - Dr Christian meets Patricia, a patient who is suffering from bunions

  14. Consultation: Bunions

    In Videos - A few particularly painful bunions are examined by Dr McKenna

  15. Palmar Plantar Psoriasis

    In Conditions - Palmar-Plantar Psoriasis also known as hand and foot psoriasis is a…


Am I Normal?

Share, explore, vote, watch… Am I Normal? is a bold new Channel 4 project that will redefine what you think of as ‘normal’.

Visit Am I Normal? >

Important Notice

The information provided on this website (including any NHS Choices medical information) is for use as information or for educational purposes only and is not a substitute for professional medical care by a qualified doctor or other qualified healthcare professional. We do not warrant that any information included within this site will meet your health or medical requirements. This Embarrassing Bodies site does not provide any medical or diagnostic services so you should always check with a health professional if you have any concerns about your health.


If you want to embed our videos in your site, read our embedding T&Cs here