Treatment for thick toenails typically includes treating the underlying cause, which can include things like mechanical stress (such as poorly fitting shoes), fungal infection, or an autoimmune condition. Treatments may include remedies like antifungal medications and foot soaks.
Causes
Thick toenails come from a buildup of the cells that make up your toenails. Possible causes include increased age, nail fungus, peripheral vascular disease, and nail psoriasis (anautoimmune disease).
Aging
As you age, it is natural for your toenail thickness to change. Challenges with foot hygiene can also affect toenail health.
Nail Fungus
Nail fungus is the most common nail disease in the world. It occurs in 10% of the U.S. population and is more common in people living with diabetes, human immunodeficiency virus (HIV), and other conditions that affect the immune system.
Toenail fungus can spread from another foot fungus (e.g., athlete's foot), or it can spread from a surface like a shower floor or a shoe. Risk factors for toenail fungus include:
- Weakened immune system (e.g., from a chronic illness, cancer treatment)
- Footwear that crowds the toes
- Exercise
- Shared wet spaces like showers and pools
There are somespecific testsand several different toenail fungus treatment options available, though none is 100% effective. Healthcare providers typically recommend tioconazole or bifonazole for treating nail fungus, as these tend to be more effective than other antifungals. These are usually taken while being monitored with bloodwork to ensure safety.
Nail Psoriasis
Psoriasisis a chronic autoimmune disease that can cause irritated and inflamed patches of skin. In some people, psoriasis also spreads to the nails, causing them to become thick and brittle.
Psoriasis can make your nails weak. They may even fall off completely. There are a variety of treatments for nail psoriasis. Your healthcare team will work with you to determine which might be best in your case.
Toe Injuries
Runners and other athletes can injure their toenails easily due to the repetitive microtrauma of the nails hitting against their shoes.
If the skin around the nail that’s been injured is also hurt and gets infected, it’s called paronychia.
Yellow Nail Syndrome
A very rare condition called yellow nail syndrome can cause unusual nail changes, usually in older adults.
In addition to having thick, yellow-colored nails, people with the condition have swelling in their legs and respiratory problems.
Ram's Horn Nails
Onychogryphosis, also called Ram’s horn nails, occurs when the nails turn yellow or brown and get very thick, long, and curved. The big toenail is most often affected.
Anybody can get ram’s horn nails, but they're more likely to happen because of a foot injury, infection, chronic health condition of the skin (like psoriasis), or a condition that affects blood circulation (like peripheral artery disease).
Ram's horn nails tend to get worse over time and can lead to problems like ingrown nails and toenail infections.
Who Is at Risk of Developing Thick Toenails?
You are at greater risk of developing thick toenails if you:
- Wear shoes that do not fit well
- Swim, shower at the gym, walk barefoot in a locker room
- Have poor foot hygiene (e.g., leave on sweaty shoes, don't wash your feet, don't keep nails trimmed)
- Experience a foot injury
- Have a weak immune system (e.g., from a disease or medications)
When to See a Healthcare Provider
Having thick toenails usually won’t lead to any major health complications as long as they don’t get infected.
That said, you should let your healthcare provider know if you are seeing changes to your toenails, as it could be a sign of a health problem (including cancer). You may need testing done to reach a diagnosis.
While you might be reluctant to show your toenails, don't worry. Medical providers are comfortable looking at and evaluating all kinds of health concerns.
If you have a hard time keeping your toenails clean and trimmed, you may want to see aprovider who specializes in conditions of the feet and lower legs (podiatrist) for ongoing foot care.
Do thick toenails have an odor?
Most of the time, toenails should not have an odor, especially if they are healthy. Some fungal infections may lead to an abnormal odor in the feet or nails.
Cutting Thick Toenails
Thick toenails can be challenging to cut. Keep the following tips in mind:
- Try softening your nails before you cut them. Soaking in warm water for 10 minutes can help make them easier to cut.
- Use toenail clippers; avoid using clippers designed for fingernails or other tools like pocket knives or scissors, as these can cause damage to the nail or the toe.
- Don't clip out the corners or round the edges, as this can lead to ingrown toenails. Instead, cut your nail straight across.
- Make several short cuts to help prevent breakage or splintering.
- Avoid cutting your toenails too short.
- When finished, file your toenail with an emery board to remove sharp edges.
Treatment
There isn’t much you can do to quickly get rid of thick toenails. Repairing thick or damaged toenails takes a long time because they grow slowly.
It can take up to a year to fix some toenail problems, even with ongoing treatment.
Self-Care Strategies
The simplest way to deal with thick toenails at home is to do a foot soak:
- Mix up some baking soda, Epsom salt, or white vinegar in warm water and let your nails soak in it for a while.
- If you think the ingrown nail is infected, make a soak using a few capfuls of hydrogen peroxide mixed with some water.
If you're looking to try a foot soak for thick toenails, it's important to prepare the mixture at the right concentration. To avoid skin irritation or dryness, experts recommend the following measurements:
- Vinegar: One part vinegar to two parts water
- Epsom salt: Three to 4 tablespoons per gallon of water
- Baking soda: One tablespoon per two gallons of water
Research shows that adding essential oils, such as oregano and tea tree oil, may help improve nail fungal infections. However, they should not be applied directly unless they are properly diluted. Also, you should avoid this type of treatment if you have an allergy or sensitivity to any of these oils.
There’s some evidence that using Vicks VapoRub, the over-the-counter product for congestion, may actually help with toenail thickening. Just put a little on your affected toe once a day.
Make sure your shoes fit well and do not put pressure on your toes.
You may also want to avoid putting any nail polish on your toenails while they’re healing.
If you have had an injury to your toe and your nail is temporarily thick, it may get better over time. As a new, healthy nail grows out, you can see if it gets better.
Medical Care
Don't try to thin your toenail yourself. This can damage the nail bed beneath the nail plate, which can lead to further thickening of the nail or nail loss.
Your healthcare provider may recommend procedures or medications that can help reduce the thickness of your nail and treat the underlying problem. Some of these include:
- Debridement: This is a medical procedure where a podiatrist uses tools to remove extra layers of your toenail to help reduce the thickness. They may also trim your toenail. After debridement, you may still require treatment for the cause of the nail thickening.
- Topical medications: These include OTC creams or liquids that get painted on the nail.Check with your provider before trying any of these treatments.Topical OTC nail treatments may not cure nail fungus because the medication may not be able to pass through the nail to the fungus underneath.
- Oral medication: If your nail fungus requires systemic medication (medication that works throughout your body), your provider may recommend oral pills.The pills for fungus treatment can have some serious side effects, so follow your provider’s instructions.
- Laser therapy:This treatment can be used for nail fungal infections and nail psoriasis.Researchers are learning about different types of lasers that can be helpful in treating toenail fungus. Talk with your provider about how many treatments you may need and what kind of results to expect.
What specialist treats hard toenails?
A podiatrist is a provider who specializes in foot and leg conditions. Some even specialize in the treatment of toenail conditions.
Prevention
There are a few ways that you can try to avoid getting ingrown toenails, and it all starts with keeping your feet healthy.
Prevent Fungal Infections
Good foot care can help to reduce your risk of getting a fungal infection and prevent it from returning once you have treated it. Some hygiene tips for your feet include the following:
- Keep your toes clean and dry.
- Keep your nails short.
- Don't share nail hygiene tools (like nail clippers).
- Wear shoes when in shared spaces like locker rooms or pools.
- Avoid shoes that are too tight or too loose.
Nail fungus often enters under the nail, so short nails help reduce the risk of infection. Consider sanitizing your nail clippers with rubbing alcohol each time you use them.
Washing and disinfecting your socks and treating your shoes are important parts of hygiene, too—especially if you have nail fungus. This helps to prevent the fungus from reinfecting your toes.
Support Healthy Toenail Growth
Toenails are an important part of your body’s natural outside barrier. They grow an average of 1 millimeter per month. Overall, nail growth tends to slow as you get older.
There are a few things you can do to promote healthy toenail growth:
- Keep nails trimmed.
- Wear well-fitting shoes.
- Minimize or prevent injury to your toenails, such as by being careful walking in the dark and when running or performing vigorous exercise.
Summary
Thick toenails have a variety of causes, including advanced age, nail fungus, and psoriasis. They are rarely a major health problem but can cause discomfort. Sometimes, they can be a sign of a condition that needs treatment.
Properly fitting shoes and good foot hygiene will go a long way in preventing and fixing thick toenails. Still, you should see your healthcare provider. They can help you understand any changes to your toenails and recommend a complete plan of care.