It seems that you and your doctor have taken the surgeon's approach to toenail infection!
Before we get to cutting or removing the nails, let me point out a few general facts. Individuals who suffer from diabetes are susceptible to toenail fungal infections and their complications. It is very important to treat the infection and achieve good glucose control. (This is not just a cosmetic problem for individuals who have diabetes.) Treatment depends on the stage of the infection and other factors. If there is only a white patch on the nail, an antifungal lacquer application will cure the infection. If there is nail thickening, brittleness, separation and inflammation, an oral (pill) antifungal agent can be effective as a single therapy or in combination with an antifungal lacquer. The usual discoloration of the toenail is a yellowish brown hue. If there are other organisms causing the change in the toenail, the discoloration may take on a dark green to black appearance. Black toenail can also be caused by trauma, autoimmune disorders and melanoma. So it is important to arrive at the right diagnosis before treatment. This can be done by a biopsy and culture of the toenail.
Removing the toenail completely is not recommended for individuals who have diabetes, since the risk of complication due to poor wound healing and infection is high. I would highly recommend that you go to your doctor or a podiatrist to manage the trimming and, if necessary, the removal of the nail. Reasons for removal include the following reasons: if leaving the toenail will cause further complication, if trimming does not achieve the desired result, and/or if you are not eligible for antifungal agents.
Since you have recurring athlete's foot, you might also consider the following guidelines:
* Keep your feet dry but not excessively dry. Use lotion to prevent excessive dryness, but do not use it between your toes.
* Be vigilant about careful drying after bathing or physical activity, or when you are in a warm humid environment. To help keep feet dry, you may use either regular or antifungal talc. Wear socks made of "breathing" fabric, which keep moisture off the skin.
* Make sure you examine your feet daily for minor skin breaks, rashes, and nail changes.
* Keep your shoes in a cool dry place.
* Because any trauma to the toes increases the chance of fungal infection, wear well-fitting shoes and seamless soft socks. Keep your toenails trimmed straight across and not too short.
* Do not walk barefoot.
* Clean your tub with bleach and use shower shoes when in a public gym or swimming pool.
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