Why Do You Have to Remove Toenail Polish Before Surgery?

When preparing for surgery, there are several important pre-operative steps to ensure a safe and successful procedure. One often overlooked aspect is the removal of toenail polish. While it may seem like a trivial detail, the removal of toenail polish is actually crucial for several reasons.

1. Accurate Monitoring: During surgery, healthcare providers closely monitor a patient’s oxygen levels, skin color, and blood circulation. Toenail polish can interfere with accurate monitoring, as it can hinder the ability to observe changes in skin color and capillary refill time.

2. Oxygen Saturation: Pulse oximeters are commonly used during surgery to measure oxygen saturation levels. These devices are typically placed on the finger, but in some cases, they may be placed on the toe. Toenail polish can interfere with the accuracy of these readings, potentially leading to inaccurate monitoring of oxygen levels.

3. Allergic Reactions: Many individuals are unaware of potential allergic reactions caused by certain nail polish ingredients. During surgery, patients are exposed to various chemicals and medications, making it important to minimize the risk of additional allergens. Removing toenail polish helps mitigate the potential for adverse reactions.

4. Infection Control: Maintaining a sterile environment is crucial during surgery to minimize the risk of infection. Toenail polish can harbor bacteria and other microorganisms, increasing the chances of post-operative infections. By removing the polish, the risk of introducing bacteria into the surgical site is reduced.

5. Oxygen Delivery: Anesthesia is commonly used during surgery, requiring an anesthesiologist to monitor the patient’s vital signs continuously. Pulse oximeters are essential tools for monitoring oxygen delivery to the body’s tissues. Toenail polish can interfere with the accuracy of these readings, potentially compromising patient safety.

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6. Blood Pressure Monitoring: Accurate blood pressure monitoring is essential during surgery. Blood pressure cuffs are typically placed on the upper arm or wrist, but in some cases, they may be placed on the ankle or toe. Toenail polish can hinder the proper placement and function of the blood pressure cuff, leading to inaccurate readings.

7. Surgical Site Identification: Clear identification of the surgical site is crucial to prevent errors and ensure the correct procedure is performed. Toenail polish can obscure the surgical site, making it difficult for healthcare providers to accurately locate and mark the intended area for surgery.

8. Skin Integrity: Surgical procedures often require the application of adhesive dressings, surgical tapes, or other devices to secure incisions and wounds. To ensure proper adhesion, it is essential to have clean, polish-free skin. Toenail polish can create a barrier between the skin and adhesive materials, compromising their effectiveness.

9. Post-Operative Care: After surgery, patients may require wound care, including the application of ointments or dressings. Toenail polish can potentially interfere with the proper application and adherence of these materials, hindering the healing process.


1. Can I remove the toenail polish myself before surgery?
Yes, you can remove the toenail polish yourself using nail polish remover or by scraping it off gently.

2. How long before surgery should I remove the toenail polish?
It is recommended to remove the toenail polish at least 24 hours before surgery to ensure complete removal and allow any potential allergic reactions to manifest.

3. Will removing toenail polish prevent infection during surgery?
While it cannot guarantee prevention, removing toenail polish reduces the risk of introducing additional bacteria into the surgical site.

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4. How can toenail polish affect oxygen saturation readings?
Toenail polish can hinder accurate readings by interfering with the light absorption and reflection necessary for pulse oximeters to measure oxygen saturation levels.

5. Can healthcare providers remove the toenail polish for me?
In most cases, it is the patient’s responsibility to remove the toenail polish before surgery. However, if necessary, healthcare providers may assist in its removal.

6. Can I use a clear nail polish instead?
Clear nail polish should also be removed before surgery, as it can still interfere with monitoring devices and potentially harbor bacteria.

7. Is it necessary to remove fingernail polish as well?
Though the focus is on toenail polish, it is generally recommended to remove fingernail polish as well, as it can also interfere with accurate monitoring and potentially introduce bacteria.

8. What if I forget to remove my toenail polish before surgery?
Inform your healthcare provider immediately if you forget to remove your toenail polish. They may be able to assist in its removal or take necessary precautions during surgery.

9. Is there any alternative to removing toenail polish?
If you are concerned about the appearance of your bare nails, you can consider using a non-permanent nail cover or a breathable nail polish specifically designed for surgical settings. However, consult with your healthcare provider before using any alternative options.