When you notice a toenail getting thicker, it’s easy to jump to the conclusion that it’s a fungal infection. And that’s often the case. But, a thickened toenail isn’t always a sign of fungus.
This article will explore some of the other reasons why your toenails might be thickening. We’ll also look at what you can do to treat and prevent thickened toenails that aren’t caused by fungus.
Knowing what’s causing the problem is the first step toward finding a solution, so let’s dive in and take a closer look at the possible causes of a thickened toenail that’s not fungus.
What causes thickened toenails (besides fungus)?
Sometimes, a thickened toenail isn’t a sign of a fungal infection.
Trauma and injury
Toenails can thicken due to repetitive trauma or a one-time injury, such as what might occur when hiking (learn more about hiker’s toenail treatment). Stubbing your toe or wearing shoes that don’t fit well can damage your nails. They may thicken as a way to protect themselves.
Also, blood under the nail (called a subungual hematoma) can cause thickening and, eventually, the nail may fall off.
Nail psoriasis
Nail psoriasis is a long-term autoimmune condition that can affect your nails, causing:
- pitting
- ridges
- discoloration
- thickening
Nail psoriasis can look very similar to a fungal infection, so you may need to see a doctor to get an accurate diagnosis.
Aging
Toenails often thicken and grow more slowly as you get older. This is because blood flow decreases, and cells don’t regenerate as quickly. Your nails may also become more brittle and likely to split.
Other medical conditions
Peripheral vascular disease (PVD) can affect blood flow to your feet and toes, which in turn affects nail growth and thickness.
Yellow nail syndrome is a rare condition that can cause nails to thicken and turn yellow. People with this syndrome may also have respiratory and lymphatic issues.
Diabetes can also affect the health of your toenails.
Uncommon causes of thickened toenails
While fungal infections are the most common cause of thickened toenails, other, less common conditions can also cause this symptom.
Ram’s horn nails (onychogryphosis)
This condition can cause a nail to become extremely thick and curved, like a ram’s horn. Onychogryphosis is often caused by:
- trauma
- neglect
- genetics
This condition is more common in older adults.
Paronychia
Paronychia is an infection of the skin around the nail. Usually, it’s caused by bacteria or fungi, but chronic paronychia (long-term inflammation of the nail folds) can lead to nail thickening. Chronic paronychia can be caused by:
- irritants
- allergies
- underlying health conditions
Diagnosing the cause of thickened toenails
It’s really important to see a doctor, especially a podiatrist or dermatologist, if you have a thickened toenail. They can figure out what’s causing the thickening and suggest the best treatment. They’ll need to rule out a fungal infection first, because that’s the most common cause.
To determine the cause, your doctor might:
- Examine your nail and the skin around it.
- Take nail clippings to test for fungus.
- Ask about your medical history and current medications.
Some questions they might ask include:
- Have you hurt your toe recently?
- Does anyone in your family have psoriasis?
- What medicines are you taking right now?
Treating thickened toenails (that aren’t fungus)
If your thickened toenail is not from a fungal infection, you’ll need a different approach to treating it.
Self-care strategies
Here are some things you can do on your own:
- Soak your feet in warm water. This can soften the nails and make them easier to trim. You can add Epsom salts, baking soda, or vinegar to the water for extra relief.
- File the nail. Use a nail file or emery board to gently file down the nail plate and reduce its thickness. Be careful not to file too deep, or you might damage the nail bed.
- Moisturize. Apply moisturizer to your nails and the skin around them to prevent dryness and cracking.
Medical treatments
Sometimes, you need a podiatrist (foot doctor) to help with thickened toenails. Here are some of the things they might do:
- Debridement. A podiatrist can professionally trim and thin the nail using special tools.
- Topical medications. If you have nail psoriasis, your doctor might prescribe a corticosteroid cream.
- Oral medications. For severe cases of nail psoriasis, oral medications like methotrexate or biologics might be necessary.
- Surgical removal. In really bad cases of onychogryphosis (ram’s horn nails) or other conditions, the doctor might need to surgically remove the nail.
- Treat underlying conditions. If you have something like peripheral vascular disease (PVD) or diabetes, managing those conditions can improve your nail health.
Cutting thick toenails
Cutting thick toenails can be tricky, but here are some tips:
- Soften the nails first by soaking your feet.
- Use toenail clippers, not fingernail clippers. Toenail clippers are stronger and can handle the thickness better.
- Cut straight across. Avoid rounding the corners or clipping them too short, as this can lead to ingrown toenails.
- Make several small cuts. Instead of trying to cut the nail in one big chunk, make several short cuts to avoid breaking the nail.
- File the edges. After cutting, use a file to smooth out any sharp edges.
Preventing Thickened Toenails
The best way to deal with thickened toenails is to prevent them in the first place. Here’s how:
Proper Footwear
- Wear shoes that fit well, with plenty of room for your toes to wiggle.
- Avoid shoes that are too tight or put pressure on your toes.
Nail Care
- Trim your toenails straight across.
- Don’t cut them too short!
- Sanitize your nail clippers regularly to avoid spreading bacteria.
Foot Hygiene
- Keep your feet clean and dry, especially between the toes.
- Wear breathable socks, like cotton or wool.
Protect Your Toes
Be careful! Avoid stubbing your toes and dropping heavy objects on them. Simple, right?
Frequently Asked Questions
What is the white hard stuff under my toenails?
The white, hard substance accumulating under your toenails is often a buildup of dead skin cells, debris, and keratin (the protein that makes up nails). It can be exacerbated by improper nail trimming, poor hygiene, or trauma to the nail. In some cases, it might also indicate a yeast or bacterial infection.
Can you file down thick toenails?
Yes, filing down thick toenails is often recommended to manage discomfort and improve appearance. Use a nail file or emery board (or even an electric nail file) to gently thin the nail. Be cautious not to file too aggressively, as this can cause pain or damage the nail bed. If you have diabetes or poor circulation, consult a podiatrist before attempting this.
What autoimmune disease causes thick toenails?
Autoimmune diseases like psoriasis are a common cause of thickened, discolored, and pitted toenails. Other autoimmune conditions, while less common, may also contribute to nail changes. If you suspect an autoimmune issue, consult a doctor for proper diagnosis and treatment.
What does Vicks VapoRub do for thick toenails?
Some people use Vicks VapoRub on thickened toenails due to its antifungal and anti-inflammatory properties from ingredients like camphor and eucalyptus oil. While anecdotal evidence suggests it can soften the nail and potentially inhibit fungal growth, it’s not a proven cure and may only provide temporary relief.
What do lupus toenails look like?
Lupus can affect the nails in various ways, including causing pitting, ridging, discoloration, and even nail loss. “Lupus nails” are not specifically defined, but nail changes in lupus are often associated with inflammation around the nail bed (paronychia) and can sometimes mimic fungal infections or psoriasis. A dermatologist can assess nail changes and help determine if lupus is a contributing factor.
Final Thoughts
Thickened toenails can be caused by things other than fungus. Trauma, psoriasis, getting older, and other health problems can all cause your toenails to thicken.
It’s important to get the right diagnosis and treatment for your thickened toenails. A doctor can help you figure out what’s causing the problem and how to manage it.
Taking care of your feet can help keep your toenails healthy. Wearing the right shoes, caring for your nails, and practicing good foot hygiene can all make a difference.