Toenail fungus eventually leads to toenail avulsion if it's not treated. I've been dealing with this problem for many years. I'm actually thinking about getting the infected part of my toenail cut out at the doctor's office because topical treatments and medications are not working.
My doctor said that the procedure is easy and painless. Apparently, a cream is applied to the nail for a week or ten days to soften it and then it is carefully cut out or peeled. And then a fresh nail grows out.