Yep, gross and awesome at the same time – dead toenails.  A badge of honor in the running community and quite possibly the mark of record miles or vertical change.  Toenails are often lost for a number of reasons because of how your toes and feet are jammed up in your running shoes.  In my opinion, they are in the same category as blisters – because that’s how it always starts … with a (blood) blister on top the toe but underneath the nail.  Some are avoidable by wearing better-fitting shoes / socks (minimize “swimming” of your feet in the toe box) but others are unavoidable (running downhill, sweating a lot, running through water, etc.).  Blister underneath gives way to dead skin … that skin was previously used to connect your nail to your toe … nail lifts up towards the heavens and is susceptible to being removed.  Below is a short list of steps to follow if and when you are faced with taking those suckers out … learn from my 12+ years of doing it right, wrong, and everything in between.

1. Identify an oncoming blister

Feels just like any other blister except now it’s under the toenail creating more pressure and discomfort as fluid / blood accumulates.

2. Safely remove fluid from blister

Do not be in a hurry to do this right after you run / race, but after a day or so of your blister deadening the toenail skin use a sterile (burning hot) pin to prick and drain the fluid / blood.  Don’t use your dirty fingernails to pull or stretch the skin around as you’ll be at risk of infection.  You might have to drain a few times throughout the day depending how the skin is healing and how your current activity is affecting the area.

3. Clip upper portion

When I see that the upper half of my nail is simply resting on dead skin and I’m able to pry / pull it off the toe itself, I will clip the top portion of the toenail (see picture).  This helps prevent retaining any dirt / infection in an area that essentially has a dead nail resting on dead skin … removing it will also get a jump-start on healing the raw skin / toe underneath.  This raw exposed skin will be VERY tender; I usually wrap in sport tape / band-aids for a few days while I run as you’ll feel every little bump and poke.

4. Wait

This is by far the most important step!  After clipping any nail that is ready above DON’T RUSH pulling out the portion of the nail that is attached in the cuticle of your toes at the bottom.  Chances are that your toe is swollen and fighting off possible infection already from the above steps and this last bond is much slower to die and “let go”.  Wait for redness and swelling to minimize before even attempting to pull off the last portion of your toenail … if it feels like it’s really going to hurt, stop!  Waiting 2-5 days is my experience before moving on to the funnest and last step.

5. Pull off bottom portion

When ready, this honestly doesn’t hurt much at all.  After waiting a few days as outlined above, test to see if the base of your toenail is dead and ready to slide out.  It might take some tugging, but should really come out all in one piece and one motion … left to right.  The connections in the corners of your cuticle might tear some skin and cause some bleeding, but there should be no shooting pain and before you know it, you’ll have a new (awesome) dead toenail in your hand!

Feel free to collect them and/or shove them in your significant other’s face … just because.