Noah Sinclair
Several factors can cause nails to thicken, including skin conditions like psoriasis, eczema, and fungal infections. Additionally, certain medications, severe illnesses, and injuries can also lead to nail thickening. In some cases, nail thickening may be a sign of an underlying health condition such as lung disease or rheumatoid arthritis. It is important to consult a dermatologist or healthcare provider to determine the cause and receive appropriate treatment.
| Characteristics | Values |
|---|---|
| Nail matrix damage | A severe injury could cause your nail to fall off. |
| Illnesses like COVID-19, pneumonia, or severe eczema can interfere with nail growth. | |
| Chemotherapy and other medications can cause Beau's lines or slow nail growth. | |
| Peripheral artery disease causes less blood flow to your legs and feet, which can affect nail growth. | |
| A nail infection can cause your nail to thicken. | |
| A fungal infection can cause nail separation (onycholysis). | |
| Keeping nails in water for too long can cause nail separation. | |
| Damage to the nail-growing cells can prevent the nail from growing back. | |
| Proximal nail fold damage | When the proximal nail fold is cut or damaged, it will grow thicker to protect itself. |
| If the cuticle and proximal nail fold seem to merge, this is usually caused by damage to the eponychium. |
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What You'll Learn
Nail matrix damage
The nail matrix is the "factory" where your body makes new fingernails and toenails. It is located at the base of the nail and is responsible for producing the cells that form your nail. Any changes to the appearance or texture of your nails could be a sign of a nail matrix problem.
Injuries and certain health conditions can damage your nail matrix and interfere with nail growth. For example, pinching or crushing your finger or dropping something heavy on your toe can injure your nail matrix. After a nail matrix injury, you may experience bruising, ridges, or discolouration. Your nail may even fall off. In some cases, severe nail matrix damage may result in permanent nail loss.
If you experience nail trauma, it is important to seek help from a skilled practitioner, such as a board-certified dermatologist. They can help you determine the best course of action to restore nail health and guide you on how to protect your nails from future trauma.
While nail matrix damage can cause visible changes to your nails, it is important to note that not all nail changes are due to nail matrix problems. Some nail issues affect the nail bed, nail plate, or nail folds, and not the nail matrix itself. A healthcare provider can help you determine the cause of your nail changes and recommend appropriate treatment.
In most cases, with the right treatment, healthy nails will grow back after nail matrix damage. However, it may take several weeks or even months for the new nail to appear, depending on the rate of your nail growth. During this time, you can protect your finger or toe during physical activity to prevent further injury.
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Illnesses and medications
Illnesses
Several illnesses can cause nail thickening and other nail abnormalities.
- Fungal Nail Infections: Fungal nail infections, also known as mycotic nails, are characterised by nail thickening, discolouration, and brittleness. The infection can cause the nail to separate from the nail bed, and it typically spreads from the edge of the nail. While it is not a serious infection, it can be challenging to treat and may take a long time to resolve.
- Nail Psoriasis: Up to 80% of people with psoriasis develop nail psoriasis, which can lead to nail changes such as white lines, pitting, crumbling, and thickening.
- Eczema: Severe eczema can affect the nail matrix and cause Beau's lines (horizontal ridges), pitting, and texture or colour changes.
- Iron Deficiency: Iron deficiency, which can lead to anaemia, may manifest as spoon-shaped nails that curve inwards (koilonychia).
- Serious Health Events: Significant health events, such as a heart attack, COVID-19, or pneumonia, can interrupt nail growth and result in Beau's lines.
- Yellow Nail Syndrome: Yellow nail syndrome is characterised by thickened, yellow nails that seem to stop growing. It can be associated with underlying conditions such as lung disease and rheumatoid arthritis.
- Subungual Melanoma: Subungual melanoma, or nail matrix melanoma, is a type of skin cancer affecting the nail matrix. It typically presents as brown or black discolouration on the nail.
Medications
Certain medications can also impact nail growth and lead to nail thickening.
- Chemotherapy: Chemotherapy drugs can cause Beau's lines and slow nail growth.
- Medications Causing Light Sensitivity: Medications that increase light sensitivity, such as tetracycline, nonsteroidal anti-inflammatory drugs (NSAIDs), psoralens, and oral retinoids (vitamin A derivatives), may contribute to onycholysis (nail separation).
- Antifungal Medications: Oral and topical antifungal medications are used to treat fungal nail infections. Oral options include terbinafine, itraconazole, and fluconazole, while topical treatments come in the form of creams, ointments, or gels applied directly to the nails.
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Nail infections
A fungal infection is a common cause of nail thickening. Onychomycosis, or mycotic nails, is a fungal infection that affects the toenails or fingernails, causing them to thicken and become fragile. It may also change colour, appearing yellow, brown, or black. While mycotic nails may thicken, they usually do not affect movement. Treatment for mycotic nails involves oral or topical antifungal medications, and in severe cases, surgical removal of the nail may be necessary. Even with treatment, mycotic nails can recur, so it is important to take preventive measures.
Another condition that can cause nail thickening is onycholysis, which is when the nail separates from its nail bed. This can be caused by injuries, such as bumping or hitting the nails, wearing tight shoes, or prolonged exposure to water. Fungal infections can also lead to onycholysis. Treatment for onycholysis includes cutting away the affected nail, antifungal medications, and discontinuing certain nail products.
Additionally, severe eczema and psoriasis can affect the nail matrix, leading to temporary nail thickening and other changes such as pitting and colour alterations. In the case of nail psoriasis, up to 80% of people with psoriasis may develop it.
Furthermore, certain illnesses, such as lung disease and rheumatoid arthritis, can cause yellow nail syndrome, resulting in thickened nails. Serious health events like a heart attack, COVID-19, or pneumonia can also cause Beau's lines, which are deep horizontal ridges in the nails indicating slowed or stopped nail growth.
In rare cases, nail thickening and other nail changes, such as brown or black discolouration, can be a sign of subungual melanoma, a type of skin cancer affecting the nail matrix. Therefore, it is important to consult a dermatologist or healthcare provider for an accurate diagnosis and appropriate treatment.
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Skin conditions
The hyponychium is the skin just under the free edge of your nail, located near your fingertip. It acts as a barrier to protect your nail from harmful substances and germs. However, it can become problematic if it overgrows, causing pain and increasing the risk of infection. This overgrowth is more likely if you get gel manicures, wear acrylic nails, bite your nails, or have nail psoriasis and fungal infections.
Psoriasis is a skin condition where skin cells multiply rapidly, causing a buildup of dead skin cells. It can affect the nails, leading to rapid cuticle growth and overgrowth. Eczema, another inflammatory skin condition, can also trigger overgrown cuticles and nail changes. Proper cuticle care is essential to treat and avoid cuticle overgrowth.
Cuticles are thin layers of dead skin that grow around the edge of your toenails and fingernails, providing protection against infection. While cuticles themselves do not grow thicker, the living skin at the base of the fingernail, known as the proximal nail fold, may appear thicker due to cold weather or damage. Trimming this skin can stimulate faster regrowth, so it is recommended to treat it with high-quality nail oil instead.
Fungal infections can also affect your nails, causing them to thicken, become yellow, cracked, or cloudy. These infections can thicken both the nail and the underlying skin. Additionally, certain injuries and illnesses can damage your nail matrix, interrupting nail growth and causing changes in appearance. However, with proper treatment, healthy nails can often grow back.
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Nail care habits
Maintaining good nail care habits is essential for keeping your nails healthy and strong and can even reflect your overall health and well-being. Here are some tips for nail care habits:
Keep Nails Clean and Dry
Bacteria and fungi thrive in a moist environment, so it's important to keep your nails clean and dry. Wash your hands and nails regularly with mild soap and warm water, using a soft nail brush to clean under the nails, and dry them thoroughly. This helps prevent the buildup of dirt, bacteria, and fungi that can lead to infections and other nail problems.
Trim and File Nails Regularly
Trimming and filing your nails help maintain their shape and strength. Cut your nails straight across with sharp nail scissors or clippers, and then slightly round the tips. Avoid cutting or damaging the proximal nail fold, as it may grow thicker to protect itself, similar to how the foot develops calluses when subjected to increased pressure or rubbing. Filing your nails with an emery board helps keep them smooth and free of snags.
Moisturize and Nourish
Regularly moisturizing your nails and cuticles is essential for maintaining nail health. Using high-quality nail oil daily and performing weekly hot oil treatments can help nourish and protect your nails and the surrounding skin. Maintaining a balanced diet rich in vitamins, minerals, and proteins is also crucial for promoting nail strength and growth. Include leafy greens, lean proteins, and nuts in your diet to support nail health.
Break Unhealthy Habits
Unhealthy habits such as biting nails or picking at cuticles can damage your nails and interfere with their growth. If you have grooves and ridges in the center of your thumbnails, you may have developed a habit of pushing back your cuticles without realizing it. A dermatologist can help you break these habits and guide you on growing healthy nails.
Recognize Nail Changes
Be mindful of any changes in your nails, such as swelling, pain, or discoloration. These could indicate serious nail problems or underlying health conditions. For example, a new or changing dark streak on your nail may indicate melanoma, the most serious type of skin cancer. If you notice any concerning changes, consult a dermatologist for a proper examination and guidance.
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Frequently asked questions
Nails can thicken as a result of a number of factors, including fungal infections, skin conditions such as psoriasis, and certain medications. In some cases, thickening of the nail can be a sign of a more serious underlying condition, such as lung disease or rheumatoid arthritis.
If your nail has grown back thicker, it is important to determine the underlying cause. This may involve consulting a healthcare professional or dermatologist, who can provide advice and treatment options. In some cases, antifungal medications or changes to your nail care routine may be recommended.
The time it takes for a nail to grow back can vary depending on whether it is a fingernail or toenail. Fingernails typically take about six months or longer to grow back, while toenails can take up to 18 months. During this time, it is important to keep the area clean and dry, and to watch for any signs of infection.
