Thick Toenails: Causes, Symptoms, And Treatments

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Medical News TodaySubscribeWhat causes thick toenails and how are they treated?

Medically reviewed by Adam Hotchkiss, DPM — Written by Jenna Fletcher — Updated on July 4, 2024

Symptoms and appearance
Causes and risk factors
Complications
Prevention
Contacting a doctor
Diagnosis
Treatment
Cutting thick toenails
Summary

Thick toenails can be unsightly and cause discomfort. Fungal infections, older age, psoriasis, and other factors can cause toenails to thicken. Treatment depends on the severity of nail changes and the underlying cause.

Fingernails and toenails act as a strong barrier between the soft tissue of the nail bed under them and the environment beyond. They also assist with the sensory functions of the fingers, providing a hard contrast against the softer skin of the fingertip.

There are many potential causes of thick nails. By understanding the causes, a person may be able to prevent thick nails from forming and treat them quickly if they do develop.

This article examines the causes, symptoms, prevention, and treatment options for thick fingernails and toenails.

Symptoms and appearance

Two blond children painting a grownup's toenails in bright colors — Ali Lanenga/Stocksy

A person may overlook thick toenails in the early stages. However, as the nails get more obviously thicker, they may notice several symptoms, including:

brittle, easy-to-break nails
bad odor from the nail
nails lift easily from the nail bed or do not seem fully attached to the nail bed
difficulty cutting or trimming nails
splitting or cracking of the nail occurs easily
dirt or other debris gets under the nails
pain or discomfort

As the toenails thicken, they may appear rough, ridged, or scaly on the surface.

The nails may also take on a yellow, green, or brown hue.

Causes and risk factors

There are various reasons why nails may thicken. Many of the causes relate to either infections or other medical conditions connected to nail thickening.

Below are some of the most common causes.

Fungal and yeast infections

Primarily, fungal infections affect a person’s toenails rather than fingernails.

A type of fungal infection called onychomycosis is a common causes of thick nails.

Fungal infections often grow in toenails because they thrive in warm, moist environments. They are easily spread and can develop quickly, causing many of the symptoms described above.

Some people are more prone to fungal infections than others. Some causes of fungal infections in the toenails include:

constant exposure to wet areas
smoking
constrictive footwear
damage to or next to the nail

In addition, some health factors can increase the risk for fungal nail infections, such as:

athlete’s foot
psoriasis
diabetes
immune deficiencies
circulatory problems
undergoing chemotherapy

To help prevent fungal infections, people should avoid walking around barefoot in public places, especially locker rooms and showers. It is also important to keep footwear dry.

Doctors do not usually consider fungal nail infections to be serious. These infections can often improve with treatment.

It is not always possible for the nail to return fully to its prior appearance. But treating the fungal infection can help a person reduce discomfort and improve the look of the nail.

Injury

Toenails can thicken as a result of sudden or repeated trauma or injury. Mostly, this happens to people involved in sport or exercise, such as soccer players, runners, and dancers. It can also affect people who wear ill-fitting shoes.

A person may mistake thick nails due to injury as a fungal infection.

Seeking medical treatment for a nail injury may help the nail to grow back more normally. If treatment helps, the improvement is likely to happen slowly. It may take several weeks to heal.

Yellow nail syndrome

This rare cause of thick nails affects both fingernails and toenails. The condition causes the nails to yellow and become curved and thickened.

A person with yellow nail syndrome typically experiences respiratory problems and swelling in the arms and legs. This is due to a buildup of fluid around the lungs and in the limbs.

Although doctors do not know the exact cause of yellow nail syndrome, some believe there could be a genetic connection. The condition may also be associated with some cancers and immune disorders.

There is currently no cure for yellow nail syndrome, and treatments for affected nails have limited effectiveness.

Psoriasis

Psoriasis is an autoimmune disorder that typically causes red, scaly patches on the skin. Psoriasis of the nails often accompanies the condition, affecting both the fingernails and toenails.

In addition to thickening, psoriasis can also cause changes to the nail, such as:

discoloration
lifting from the nail bed
pitting

People with nail psoriasis may have symptoms that come and go intermittently. Treatment can reduce inflammation and improve the condition of the nails over time, but healing is usually a slow process.

Paronychia

Paronychia is inflammation that causes redness and swelling of the skin around the nail. Inflammation of the nail area over a long period of time is known as chronic paronychia. This can be caused by infections or exposure to irritants, such as cleaning solutions.

Over time, both fingernails and toenails may become thick. A person may notice that layers of the nail start to peel off.

People can develop paronychia from frequently sucking on their fingers, dishwashing, and trimming the nails or cuticles too much.

Several occupations are also more of a risk for developing thick nails due to paronychia. These jobs include:

dishwashers
bartenders
laundry workers
cleaners
cooks
nurses
fishers

The condition usually affects multiple fingers or toes. Chronic paronychia can be managed by:

avoiding contact with irritants
treating inflammation
allowing the nail’s natural barrier to heal over time

Aging

Thick nails are not necessarily an indicator of health conditions. Often, as a person ages, the nails on their toes start to thicken.

Healthcare professionals believe that the nails thicken as people get older due to changes to blood circulation or long-term UV exposure, according to older research from 2011.

The thick nails and the ridges that form on the nail due to aging are not treatable. However, a person can buff them slightly to smooth their appearance, if they want to for aesthetic reasons.

Other causes

Rare causes of thickened nails include the following:

pachyonychia congenita, a rare genetic condition
pityriasis rubra pilaris, a rare group of inflammatory skin conditions
severe scabies infection

Complications

Thick nails are often the symptom of another infection or disorder.

In most cases, thick nails are unlikely to cause further complications. But if left untreated, they can continue to worsen, may cause pain, and may make wearing footwear uncomfortable. Severely thick fingernails may cause some loss of dexterity in the hands.

Seeking a medical diagnosis for thick nails can help to prevent other complications that could arise. For example, a person may need treatment for an underlying condition that is affecting the health of the nails, such as diabetes.

Prevention

People can prevent some causes of thick nails. Thick nails are less likely to happen if hands and feet are kept clean and dry, with nails clipped short.

Nail infections can enter the nail through cuts or cracks in the surrounding skin. Individuals can avoid some nail infections by keeping hands and feet moisturized to prevent cracks and treating cuts or other skin issues.

To prevent thick nails, a person should avoid the following situations:

working in wet environments without gloves
sharing nail clippers
sharing towels
walking barefoot in public areas such as the locker room or shower at the gym

People should always wear gloves while working in a wet area, such as dishwashing.

Anyone who visits nail salons should learn about licensing and certification for these businesses. Licensing may differ by state. It is important to choose a reputable nail salon that follows all necessary sanitation practices. Manicure and pedicure instruments must be properly sterilized between uses to avoid spreading nail fungus or other infections.

Other prevention tips include wearing well-fitting shoes and keeping socks and shoes dry.

When to contact a doctor

Since underlying conditions often cause thick nails, a person should consult a doctor if they notice their fingernails or toenails thickening or changing color or texture.

Conditions that cause thick nails may require treatment. If a known underlying condition is the cause, a doctor may wish to review the person’s existing treatment plan.

People who experience yellow, thickened nails without knowing the reason should talk with a doctor to ensure it is only a fungal infection and nothing more serious. Nail fungus can be persistent, so those who wish to treat it should start as early as possible.

Diagnosis

A doctor will ask about a person’s medical history and symptoms and examine the nails. If their thick nails are due to an underlying condition, the doctor may prescribe further therapies to help address the new symptom.

For those with fungal infections, the doctor may need to swab under the nail or take a clipping to test for fungal growth. It is important to diagnose a fungal infection early, to improve the chances of curing the condition.

Treatment

Thick nails do not always require treatment. For example, if nails are thickening due to age, a person does not need to treat them but may want to buff the rough surfaces to smooth them.

In other cases, a doctor will need to prescribe treatment. The goal may be to improve the condition of the nail or prevent it from worsening.

Treatment options for thick nails may include:

prescription creams or ointments
oral medications
laser therapy or light therapy
injections
surgery to remove the nail and allow it to regrow

A doctor will choose the appropriate treatments based on the cause of the thickened nails.

How to cut thick toenails

People may want to try the following tips to trim thick toenails:

clean any nail grooming tools before using them
avoid cutting cuticles, as they help prevent infection
trim straight across the top, not down the edges
avoid cleaning under the nail with sharp objects

A person may also consider using a nail file to maintain their toenails between trimmings. People should speak with a doctor if they are having difficulty trimming their nails at home.

Summary

In some cases, the cause of thick nails may be benign, such as aging. In other cases, a person will require treatment to address the underlying condition.

Thick nails can sometimes be a sign of other health concerns. It is important for people to seek medical advice and treatment when they notice thickening or discoloration of the nails. If left untreated, thick nails can worsen over time.

Read the article in Spanish.

Dermatology
Psoriasis
Infectious Diseases / Bacteria / Viruses
Seniors / Aging

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

12 nail changes a dermatologist should examine. (n.d.).https://www.aad.org/public/everyday-care/nail-care-secrets/basics/nail-changes-dermatologist-should-examine
Abdullah L, et al. (2011). Common nail changes and disorders in older people: Diagnosis and management.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038811
Bodman MA, et al. (2024). Onchomychosis.https://www.ncbi.nlm.nih.gov/books/NBK441853
Brahs AB, et al. (2023). Histology, nail.https://www.ncbi.nlm.nih.gov/books/NBK539733
Cheslock, M, et al. (2022). Yellow nail syndrome.https://www.ncbi.nlm.nih.gov/books/NBK557760
How to care for an injured nail. (2023).https://www.aad.org/news/how-to-care-for-an-injured-nail
Last O, et al. (2018). Subungual and ungual scabies: Avoiding severe presentation in high-risk patients.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301576
Leggit JC. (2017). Acute and chronic paronychia.https://www.aafp.org/afp/2017/0701/p44.html
Muneer H, et al. (2024). Psoriasis of the nails.https://www.ncbi.nlm.nih.gov/books/NBK559260
Nail fungus: Overview. (n.d.).https://www.aad.org/public/diseases/a-z/nail-fungus-overview
Pachyonychia congenita. (2021).https://www.niams.nih.gov/health-topics/pachyonychia-congenita
Pityriasis rubra pilaris. (2024).https://rarediseases.info.nih.gov/diseases/7401/pityriasis-rubra-pilaris
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Medically reviewed by Adam Hotchkiss, DPM — Written by Jenna Fletcher — Updated on July 4, 2024

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Tag » How To Soften Toe Nails

Thick Toenails: Causes, Symptoms, And Treatments

Symptoms and appearance

Causes and risk factors

Fungal and yeast infections

Injury

Yellow nail syndrome

Psoriasis

Paronychia

Aging

Other causes

Complications

Prevention

When to contact a doctor

Diagnosis

Treatment

How to cut thick toenails

Summary

How we reviewed this article:

Latest news

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