I started running marathons back in the summer of 2006 and for a while I had a similar problem that other people had, the dreaded black toenail. It goes black, looks gross, is uncomfortable and takes weeks to fully recover. After losing enough of them, I decided to be proactive and just get rid of them. Permanently.
Black toenails come from a variety of causes, including dropping a 50 pound box on your toe. (Long story. It was college…) If your toenail dies, basically it means it has undergone a trauma and is no longer ‘connected’ to the skin underneath, your body begins a process to build a new toenail under the old one. WIth the old one no longer in the loop, so to speak, it becomes black and remains only as a shield protecting the new one. When the new one is ready to see the world, the blackened toenail falls off, usually with little pain.
My dying toenails were coming from running my marathons relatively (to my training runs) ‘fast’. With each step, my toes were getting jammed into the toebox, the sexy term for the front of shoe. After 3ish hours of this, the toenails got so much banging around that I got blisters literally underneath the toenail and just outside of them. It was this blister that caused separation of the toenail from the rest of the toe and hence ‘killed’ the toenail.
This process can take a few weeks to recover and that whole time your nail is tender. If you press down (or kick something with it) on the nail you are putting pressure on that newish, and hence tender, burgeoning toenail. You end up trying to baby it so as to not disrupt the delicate recovery. Well, once you have had more than a few of these and you are running 1-2 marathons a month losing a toenail or two every race, you get impatient.
So, after losing maybe a dozen or so nails, I started to be a little proactive. I was experienced enough to know immediately following a race upon removing my shoes and socks which toenails, if left for 2 weeks, would blacken and fall off. What I decided to do was speed up the recovery process by further traumatizing the nail. I cut it off. Clip, clip, pull. It might take a few tries maybe even a day or so, but since there was blister under there, I could remove it soon after the race before the toenail would try, and invariably fail, to get back to where it was. Again, I knew from experience that it would try, fail, and then it would turn on the ‘make a new toenail’ operation and I was just helping out.
Now here was the beauty of the system. The blackened toenail is a covering that protects the new nail underneath whilst it grows. By completely removing that protection, the exposed area (no protection! no nail!) goes into hyper overdrive and a new, albeit weak, nail appeared quickly and after 2 days, it was not tender at all. Yes, I could go from traumatized toenail that was going to die to new toenail with no real pain in about 48 hours. That 48 hours, however, was rough.
Think of it this way. You have to go through so much pain/recovery to get your new nail. You can take your time, weeks in most cases, with it being slightly uncomfortable and tender much of that time, or you can have lots of pain for 2 days and be done. I would load it up with neosporin and wrap it in sterile bandages and walk funny for a day, and ta-da! New nail!
So now I have a method to my madness, as predicted, people think I am off my rocker doing this minor surgery on my own. One time, I was removing one of my big-toe toenails (which hurt way more than the others, but losing those was rare) my young daughter who was maybe 7 years old at the time really wanted to watch me do the removal. I knew that this one was going to hurt really bad and I said to her “Salacia, what do you do if after I do this, I fall over and look like I fell asleep?” (aka pass out) She turns her head slightly to the side and says “call 9-11?”. That still remains my favorite two sentence conversation I have ever had with my daughter.
Soon after, my soon-to-be wife finds this article about Marshall Ulrich where he talks about how he had all his toenails permanently removed because he had similar problems to mine. She reads it and thinks ‘What a crazy dude’, and then immediately forwards it to me knowing I will appreciate the article. My eyes were opened! Genius! There was just one small problem. Recovery from having all 10 nails removed at once is long (several months) and you essentially have to stop running for a least a few weeks. I can’t handle that.
The procedure is both simple and common, when done by a podiatrist. It is a common procedure for people with really bad ingrown toenails, a fact that is nice to know as my health insurance would cover all of my ‘procedures’. The procedure goes like this: local anesthetic is applied through the entire toe, which really freaking hurts, but then, when numb, they remove the nail and then apply some phenol to the area. As a chemist I know the value of phenol as a basic organic reactant (the simplest aromatic alcohol, don’t ya know) but I certainly did not learn THIS reactivity in Orgo.
Remember what happens when you just rip off a toenail without a new one underneath ready to go? Your body turns on the ‘hurry up! we need a new toenail, quick!’ operation because something that is never supposed to be ‘exposed’ now is. Well, phenol seems to block that entire physiological process. and your body does weird stuff. The recovery is several weeks (uncomfortable for a few days) because it keep trying to make a new nail and failing so it resorts to basically just scabbing it over. What you have is sortof like a scab-toenail combination. You peel that off, and another one appears, more scab like, less toenail like. After 3-4 generations of that, you have toughened skin (no scab) where you use to have a toenails growing. It is the same color as the rest of your skin and it doesn’t look that bad. You actually have to be staring at my toes for a while before you would even notice I have no toenails. Its really (now) not that gross.
So recovery for this procedure is rough, especially if the toenails you are removing were nice and healthy when you came into the podiatrist that day. Doing all 10 at once? No sir, not me. But I did the next best thing. I had a standing ‘date’ with my podiatrist. I would run races on the weekend, and by Sunday night I would know if I was going to lose any nails. If there were such death-row toenails, I would call up his office Monday morning and go in and have that one or two removed (and treated with phenol) on Monday afternoon, before the new toenail growth process got going. This process took about 12 months of racing, needles, ripping, treating, pain killing drugs until I had reduced the number of toenails I possessed down to zero. With each treatment, there is a 10% chance it will come back in some form, like a partial real nail growing back, and sure enough, one of my toes needed to be treated twice. So technically, I have had 11 toenails removed.
Since I lost my last one a few years ago, I have gotten very few blisters on my toes, possibly due to better form or better shoes but I know at least it is partially due to my toes now being nail-less. People wonder why I did it, and I always ask the follow up question ‘why do you need your toenails? You ain’t climbing trees barefoot anymore, so why not make my life easier?’ Nobody ever has a good response to that one.
Of course, if I become a barefoot runner, getting rid of my toenails was a moot point. Oh well.