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.
