Sophia Delgado
Are your toenails thicker than your fingernails? Well, they should be—toenails are two to three times thicker than fingernails. This is because toenails endure more friction from socks and shoes and bear our body weight when we stand and walk. However, if your toenails or fingernails seem thicker than usual, it could be a sign of a fungal infection, trauma or injury, or an underlying condition such as psoriasis or a congenital disorder.
| Characteristics | Values |
|---|---|
| Average thickness of toenails | Two to three times thicker than fingernails |
| Causes of thickening | Infection, trauma, congenital disorders, chronic illnesses, aging |
| Symptoms | Discoloration (white, yellow, green, brown, black), curling, scaling, pain |
| Treatment | Medical treatment, home remedies, antifungal medication, nail trimming |
| Prevention | Keeping nails trimmed and clean, wearing comfortable shoes, exercising |
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What You'll Learn
Onychauxis: a nail disorder causing abnormal thickening
Onychauxis is a nail disorder that causes abnormal thickening of either the finger or toenails. While it is not a dangerous condition on its own, it can lead to other complications and may be indicative of other underlying issues.
Onychauxis is characterised by thickened nails that may change in colour and/or texture. Nails affected by onychauxis may turn white, yellow, red, or black. As the disorder progresses, nails may also become curled and difficult to trim, causing pain and discomfort.
The exact cause of onychauxis is often unclear, but it is believed to be associated with various factors, including trauma, pressure damage, ill-fitting shoes, and underlying medical conditions. In some cases, it may be hereditary, with a higher risk if one or both parents have the condition. Additionally, certain fungal infections can also lead to onychauxis. However, it is important to note that onychauxis itself is not caused by a fungal infection, although it may increase the risk of developing one.
Treatment options for onychauxis include medical interventions and home remedies. Podiatrists can help manage the condition by offering treatments to reduce nail thickness and improve their appearance. They may use special tools to effectively trim and maintain thickened nails. In more severe cases, nail avulsion or chemical/surgical matricectomy may be considered. Early treatment is crucial to effectively manage onychauxis and prevent further complications.
To reduce the risk of developing onychauxis, it is recommended to keep nails trimmed and clean, wear comfortable and properly fitted shoes, and engage in activities that boost circulation in the lower extremities, such as walking or riding a bicycle.
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Mycotic nails: a fungal infection causing discolouration
Fingernails and toenails can thicken as a result of several factors, including trauma or injury, yeast or fungal infections, and certain medical conditions. While onychauxis is a nail disorder that can cause nail thickening, it is not caused by a fungus.
Mycotic nails, on the other hand, are specifically characterised by a fungal infection that causes discolouration, thickness, and fragility. The word "mycotic" refers to an infection with a fungus or a disease caused by a fungus. This type of infection can affect anyone, but certain factors increase the likelihood of developing mycotic nails. For instance, individuals with diabetes, psoriasis, or athlete's foot are more susceptible. Additionally, ageing increases the chances, with 20% of people over 60 and 50% of those over 70 experiencing mycotic nails at some point.
Fungal organisms that cause mycotic nails can enter the toenail or fingernail through small cracks in the keratin or the surrounding skin. These organisms include dermatophytes, which cause 80-90% of mycotic nail cases, and nondermatophyte moulds, which account for 2-10% of cases. Other contributing organisms include yeast (2-11% of cases), epidermophyton floccosum, microsporum species, and various types of trichophyton.
The discolouration associated with mycotic nails can manifest as brown, white, or black hues. Additionally, the nail may separate from the nail bed, and debris may become trapped under the nail. While mycotic nails can affect both fingernails and toenails, they are more commonly found on toenails due to the warm, dark, and moist environment created by enclosed shoes, which promotes fungal growth.
Mycotic nail infections are notoriously resistant to treatment, and over-the-counter ointments are typically ineffective against the fungus. While prescription ointments and oral medications may be prescribed, they must be used with caution as they can have serious side effects, including potential liver damage. Laser treatments have been successful in treating mycotic nail infections without causing damage, but even with treatment, these infections have a tendency to recur. Therefore, individuals must be diligent in their efforts to prevent recurrence.
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Trauma or injury: repeated friction can thicken nails
Trauma or injury to the nail can occur when any part of the nail becomes injured, including the nail, nail bed, cuticle, or the skin around the sides of the nail. This can be caused by a blow to the nail, closing the finger or toe in a door or drawer, tearing, smashing, or cutting with a sharp object. Repeated trauma to the toenails, caused by ill-fitting shoes, can lead to deformities and thickening of the nails. This type of nail injury is common among athletes, such as soccer players, runners, and dancers, who experience repeated friction and impact on their nails.
Nail biting and cuticle biting are also common habits that can cause trauma to the nails over time. Additionally, repetitive behaviours such as picking at the nail and cuticle with another finger can produce horizontal hatch marks in the middle of the nail. These habits can lead to acute paronychia, a bacterial infection that causes swelling and irritation around the nail.
Nail injuries can result in a range of complications, from cosmetic concerns to more serious issues. Blood under the nail, known as subungual hematoma, is a common occurrence after trauma to the nail. If the bleeding occupies more than half of the nail area, it could indicate an underlying bone fracture or tissue tear, requiring medical attention. In some cases, the nail may need to be removed, and the nail bed repaired through sutures or special glue.
To manage nail injuries effectively, it is crucial to have a good understanding of nail anatomy. Proper management can promote healing and prevent late deformities. For example, if the nail lifts off the nail bed, it can be temporarily replaced and secured with a bandage. However, nails will not reattach to the nail bed once they have separated, and regrowth may take several weeks or even months.
To prevent nail trauma, it is important to wear properly sized shoes and avoid ill-fitting footwear. Keeping fingernails trimmed and avoiding nail-biting or cuticle-biting habits can also reduce the risk of nail injuries.
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Psoriasis: an autoimmune disorder causing inflammation
The thickness of nails can be influenced by various factors, and both finger and toenails can thicken. That being said, toenails are generally thicker than fingernails.
Psoriasis is an autoimmune disorder that typically causes red, scaly patches on the skin. It is a common chronic inflammatory skin condition that can also affect the joints. A subtype of psoriasis, nail psoriasis, affects the fingernails and toenails, causing inflammation and discomfort.
Nail psoriasis can manifest in several ways, including nail discoloration, nail lifting from the finger, and a thin line of blood beneath the nail. Other symptoms include ridges, grooves, and tiny dents (pits) in the nail. The condition can cause physical discomfort, making it difficult to perform daily activities, and it can also impact patients' social and psychological well-being.
There is no cure for nail psoriasis, but treatments can help alleviate symptoms and reduce inflammation. Treatment options include prescription and over-the-counter medications, as well as home remedies. For example, corticosteroids, calcipotriol (derived from vitamin D), and tazarotene (derived from vitamin A) are commonly used to treat nail psoriasis. Additionally, natural anti-inflammatory substances like aloe vera gel and turmeric can be applied topically to relieve symptoms.
It is important to consult a dermatologist or healthcare provider for a proper diagnosis and treatment plan. Early treatment is crucial to prevent nail psoriasis from worsening and to reduce its impact on patients' lives.
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Paronychia: an infection of the skin around the nail
Paronychia is an infection of the skin around the nail. It is caused by bacteria entering broken skin near the cuticle and nail fold, leading to inflammation. This inflammation results in redness and swelling of the skin around the nail. While it can affect both finger and toenails, it is more common in finger nails. Paronychia usually occurs when the skin around the nail is irritated or injured, allowing germs to enter and cause an infection.
There are two types of paronychia: acute and chronic. Acute paronychia symptoms appear over a few hours or days, and the infection is limited to the nail fold. It usually clears up within a few days with treatment and rarely recurs. On the other hand, chronic paronychia develops more slowly and can last six weeks or longer. It often starts in one nail fold and spreads to several other fingers or toes. The affected skin may be red, swollen, and tender, with some pus under the cuticle. The nail plate thickens, distorts, and develops transverse ridges.
The treatment for paronychia involves the use of antibiotics to kill the infection. In some cases, pus may need to be drained, and the fluid cultured to identify the specific bacteria causing the infection. Topical corticosteroid ointments, tacrolimus ointment, and intralesional steroid injections are also used in treatment. Antiseptic or antifungal lotions may be applied for several months if needed.
To prevent paronychia, it is important to keep the nails and surrounding skin clean and well-maintained. Avoid biting or picking nails, and trim them regularly without cutting them too short. It is also crucial to wear gloves when working with chemicals or when the hands will be wet for an extended period to protect the skin and nails.
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Frequently asked questions
Toenails are two to three times thicker than fingernails.
Toenails are thicker because they take more of a "beating" from socks, shoes, and weight-bearing. They are also more susceptible to fungus, which can cause them to thicken.
Thick toenails can be caused by a variety of factors, including fungal infections, trauma or injury, and certain medical conditions such as psoriasis or congenital disorders.
