Many people have lost or damaged toenails and this can be unsightly and embarrassing. There are a variety of causes. 
• Missing due to nail surgery 
• Damaged through fungal nail infection 
• Missing due to trauma 
• Missing or incomplete due to nail pathology 
• Damaged through medication 
The first picture here is from a female patient (permission granted). Three and a half years ago a horse stood on her right big toe causing a lot of trauma resulting in the nail coming off completely. 
Embarrassed to wear sandals the patient had an acrylic nail applied to the nail bed several times. There are many reasons not to do this. But thankfully there are products available through podiatrists trained in the correct procedure. 
See the table here to compare acrylic and gel toenails. 
Prosthetic toenail reconstruction is much more accessible now as demand rises and more podiatrists are training. The chemical makeup of the products makes them tough and gentle allowing them to go through the daily challenges of a toe. I use Wilde-Pedique and toes I have applied prosthesis to have been skiing, stood on and on boat trips. 
The lady whose toe appears in these pictures began to have Wilde-Pedique applied 18 months ago, a year and a half after the trauma and following several applications of acrylic nails. When I first saw the toe the nail bed was soft and had a vascular area that kept bleeding. After having Wilde-Pedique applied every 5 weeks, although she could wait 6-8 weeks we have noticed that there is a new nail growing right at the base, see picture 1. We deliberately keep the nail short as the lady is super sporty and it is left blank as she likes to paint all her nails regularly, see picture 2. 
Gel e.g. Wide-Pedique or Pedisafe 
Acrylic is hard and cannot cope with the forces of walking, running and footwear. 
Contains long polymers that are flexible and can withstand the forces a toe goes through on a daily basis. 
The application and removal process involved in acrylic nails is destructive to healthy nails never mind damaged ones. 
The application and removal process is a key part of the success of the gel nail and is gentle to the nail bed. 
Is in opposition with the nail bed and can pull and tear it causing infections. 
‘Grows’ with the nail and can be painted and filed or left naked. 
Acrylic does not adhere to skin longer than a few days. 
Lasts 6-8 weeks 
Does not support new nail growth and is more likely to cause a fungal infection as moisture gets trapped underneath. 
Can be used on nails damaged through trauma, surgery or fungal involvement and supports the growth of a new nail, a fungal nail infection can be treated while it is on. 
Tagged as: Toenails, Wilde-Pedique
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