Thick Toenails | Causes, Treatment & Remedies

Healthy nails are an indicator of good health. As the name suggests, thick toenails are abnormal changes in toenails due to an underlying cause or infections. Thick nails are unappealing and can affect both fingernails and toenails. If left untreated the condition can worsen and even become infected and  painful.

What Causes Thick Toenails? How to treat them?

Changes in our toenails can often go unnoticed or neglected. We might see them as signs of aging and let nature do its job. However, significant changes in your toenail can be alarming and unpleasant. 

Your toenail may look abnormally thick, have a yellowish discoloration, redness, or swelling around the affected area. Thick toenails are your body whispering that something is not right.

Several causes result in developing thick toenails. The main cause is onychomycosis or fungal infection of the nails caused by dermatophytes (nail fungus). Physical trauma, Psoriasis,Lichen planus and diabetes may also cause thick nails to develop. 

Traditionally, oral antifungal treatments were prescribed. However, due to various side effects of these drugs, topical treatments, and laser treatments have also proven to be effective treatments. Complete treatment of nail fungal infections may take several months hence it is advisable to get effective diagnosis and treatments at an early stage.

Image of Thickened toenails.

Which Symptoms are associated with Thick toenails?

Thickening of the toenail is the primary symptom of the infection. It may be associated with the following changes, 

  • Change in toenail color to yellow, brown, or green
  • Foul-smelling
  • Brittle nails
  • Difficult to trim toenails
  • Toenails look scaly or chalky
  • Toenails with dirt and built-up dead cells underneath
  • Toenail appears lifted from the nail bed
  • Toenails crumble or split
  • Discomfort or pain is experienced

At an early stage, these symptoms are mild or may even go unnoticed. As the infection advances, the symptoms aggravate and lead to discomfort and pain.

What causes thick toenails?

Several causes contribute to thick toenails. It is important to diagnose and treat the disease at an early stage. Advanced fungal infections are more complex to treat and cause psychological stress as well as physical discomfort. The following are the main causes,

Onychomycosis 

Onychomycosis (nail fungus) is the main cause of thick nails, infecting more than 10% of the population. The fungus invades cracks in your toenails and grows under the nail bed. The infection grows if you wear sweaty or ill-fitted shoes.It is also more common in diabetics or those on other immuno-suppressant drugs. Walking barefoot in wet public places such as a sauna or locker rooms can put you at a high risk of contracting the disease. 

Diagnosis

The appearance of your toenail changes and it becomes thicker than usual. Depending on the type of fungal infection your toenails may appear yellow, white, or brown. The nail becomes difficult to trim and breaks easily. In some cases, the nail lifts from the nail bed and is often painful.The signs appear slowly over time. 

Treatment

Traditionally, oral antifungal medicines were used to treat onychomycosis although these medicines are used for longer periods and hence can be associated with side effects. Hence, topical medications are an alternative to treat the disease. A combination of oral medicines and topical medications works well to eradicate the fungus. In extreme cases, your doctor may have to remove a part of the infected nail to stop the spread. 

 

Yellow nail syndrome

Yellow nail syndrome is a less common cause of thick toenails. A person having yellow nail syndrome develops swelling in the arms and legs due to accumulation of fluid and chest symptoms like cough along with typical nail changes. This condition results in thick, yellow, and slightly curved toenails and sometimes fingernails too.

Treatment

Treatment includes oral Vitamin E and anti-fungal medication. Antibiotics can be prescribed for bronchiectasis to reduce chronic mucus production.

 

Psoriasis

Psoriasis is an autoimmune disorder that causes red, itchy, and scaly thick skin all over the body. It spreads to the nails and causes thick fingernails or toenails. It is painful and unsightly. Nail psoriasis occurs in upto 50 percent of people suffering from plaque psoriasis. 

Diagnosis

The toenail thickens abnormally, lifts from the nail bed, and appears yellowish. Tiny pits appear on the toenail.

Treatment

Over-the-counter treatments are not effective for nail psoriasis. Doctors prescribe oral drugs or topicals. Topical medication containing corticosteroids and retinoids are partially effective in reducing the nail changes. It is good to take preventive measures, trim your nails regularly and maintain good nail hygiene. 

 

Onychogryphosis

Onychogryphosis, also called Ram’s horn nails, is a nail disease-causing one side of the nail to grow faster, thicken, and appear curvy like horns or claws. It mostly affects the big toe. The nail plate is affected and it often gets painful

Diagnosis

The nails appear yellow or brown, thick, long, and curved. It can cause pain and ingrown nails. Older adults and people with poor nail care are more prone to ram’s horn nails. 

Treatment

Onychogryphosis can be painful and there are high chances of developing a secondary infection. Thick toenail treatment will mainly involve your dermatologist using drills, clippers, alongwith topical urea creams to manage the nail changes. 

 

Physical trauma

Repeated physical trauma to your toenails can also cause thick toenails. Athletes are more prone to physical trauma. Using ill-fitted or very tight shoes can cause the nail thickening.Repeated injuries to your toenails can damage the cuticles and can help the fungus invade the affected area and spread infection. Dropping heavy objects on your toenail can also contribute to the condition. 

Treatment 

Thick toenail treatment can get very complicated hence prevention is the best way to avoid the ailment. Selected well-fitted shoes, maintaining nail hygiene, and avoiding injuries can best alleviate the harm done by physical trauma. Keeping the nails trimmed and wearing foot protectants while lifting heavy objects can also help prevent the disorder.  

 

Ageing

Naturally, ageing does not make your toenails thick. However, due to less blood flow, trauma, or ill-fitted footwear people can develop thick toenails as they age.

Thick toenails are difficult to trim. You may accidentally cut your nails or skin while trimming, increasing your chance of contracting fungal infections. 

Who is at high risk of developing thick toenails?

People can contract thick toenail fungal infections due to the following,

  • Walking barefoot in damp or wet public places such as swimming pools, locker, rooms, etc
  • Ill-fitted shoes
  • Prolonged exposure to water
  • Damage or cracks in toenail
  • Wearing sweaty shoes 
  • Genetic predisposition
  • Autoimmune disorders
  • Smoking
  • Bad nail hygiene
  • Diabetes or an other immuno-suppresant drug

Home Remedies for thick toenails

Many people rely on home remedies as antifungal drugs can have side effects. The following are some home remedies to treat thick toenails,

1. Epsom Salts

 Epsom salt or magnesium sulfate foot soak can be prepared and used 1-2 times a day. Doctors recommend using hot water mixed with Epsom salt to treat thick toenails. 

 

2.  Vicks VapoRub

 Firstly, you need to trim and file your nails as much as possible. Secondly, you need to apply Vicks vapoRub twice a day and leave it for 10-15 minutes. This home remedy works  for few people and it is highly recommended that you consult your dermatologist before trying them at home. 

 

3.  Vinegar treatment

 Research and anecdotes suggest that vinegar is an effective remedy to treat thick toenails. A ratio of one part apple white vinegar and two parts warm water is recommended to       reduce fungal growth and spread. 

 

4.  Tea tree oil 

Applying tea tree oil to the affected and surrounding area softens the nail. Tea tree oil has natural antifungal properties. Applying the oil regularly twice a day can significantly reduc thick nails. 

 

When to see a doctor?

It is recommended to see a doctor when you see abnormal changes in the appearance or color of your toenails. It may indicate underlying causes such as diabetes, psoriasis or nail fungal infection. 

You may choose to try some home remedies but if the symptoms do not resolve, it  is advisable to see a dermatologist or a podiatrist. Treating thick toenails on your own at home is not advisable.

How to prevent thick toenails?

Regular Nail grooming prevents fungal infections 

You can prevent thick toenails by the following measures,

Keep your feet and hands clean by following good hygiene practices. Dry them immediately after a wash

  • Walking barefoot at home to let your feet breathe
  • Avoid walking barefoot in public places
  • Disinfect your nail trimming tool kit regularly
  • Avoid constant exposure to wet areas
  • Wear flip-flops in locker or sauna rooms
  • Use a foot powder to keep them dry and clean
  • Moisture your feet regularly using a thick moisturizer to soften your nails

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