Toenail removal may be recommended if your toenail is thickened and painful.  Sometimes, the doctor may recommend this as part of a complete fungal treatment plan.  Toenail fungus actually lives not only on the nail but also on the nailbed itself.  If the toenail is removed, this exposes the nailbed so that topical medications can penetrate the nail bed as the nail is growing back, which may result in a better efficacy of topical nail medications. Our practice recommends Tocylen.   However, the toenail may grow back thickened, and if this is the case, there are other options that our doctors will be able to discuss with you.  In rare cases, permanent nail removal can be an option depending on your circumstances.  Your best bet is to make an appointment with one of our doctors for a full evaluation.  You may not need to have that fungal toenail removed!