Sophia Delgado
Thick nails can be unsightly and are often a sign of underlying health conditions. Thickened nails can be caused by fungal infections, autoimmune conditions, trauma, injury, or the aging process. Nails thicken over time as a result of fungal infections, with symptoms including discolouration, curling, and separation from the nail bed. Onychauxis is a condition where nails thicken abnormally, although it is rarely dangerous and typically harmless if left untreated. Treatment for thick nails includes antifungal medication, nail filing, and debridement.
| Characteristics | Values |
|---|---|
| Cause | Fungal infection, injury, underlying conditions (e.g. psoriasis, onychomycosis, cancer, immune disorders), aging, genetics, trauma |
| Symptoms | Nails become thicker, yellowed, curved, painful, difficult to trim |
| Treatment | Prompt treatment is key; antifungal medication, trimming and cleaning nails, foot soaks, debridement, buffing, removal of the affected nail, nail hardeners |
| Prevention | Wear well-fitting shoes, practice good foot hygiene, keep nails trimmed, avoid nail polish during healing |
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Fungal infections
A fungal nail infection, or onychomycosis, occurs when fungi overgrow in, under, or on the nail. This causes the nail to become discoloured, thick, and/or brittle. While fungal nail infections are not serious, they can take a long time to treat and may cause significant pain and embarrassment, nail loss, and ingrown nails.
Fungal nail infections usually affect toenails, but they can also occur in fingernails. Toenails are more susceptible to fungal infections because fungi thrive in dark, warm, and moist environments. Additionally, the toes have less blood flow than the fingers, making it harder for the body to detect and prevent an infection.
Fungal nail infections typically start at the edge of the nail and gradually spread to the rest of the nail. The nail may turn white, yellow, green, or black. It may also become thick, fragile, and hard to trim. In some cases, the nail may curl up or down or loosen from the nail bed.
Fungal nail infections can be caused by various organisms, including dermatophytes, nondermatophyte moulds, yeast, and certain types of microorganisms. These organisms can enter the nail through small cracks in the keratin or the surrounding skin.
To prevent fungal nail infections, it is important to maintain good nail hygiene and avoid walking barefoot in places like communal showers, gyms, swimming pools, and locker rooms, where fungi can easily spread. If you suspect a fungal nail infection, it is recommended to seek medical advice from a healthcare provider or pharmacist. Treatment options may include topical or oral antifungal medications, and in severe cases, nail removal or laser treatment may be necessary.
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Underlying conditions
Thick nails can be indicative of underlying conditions, which can be acute or chronic. In some cases, thick nails are harmless and may not require treatment, but they can sometimes be a sign of a condition that needs medical attention.
Fungal Infections
Thick nails are often caused by fungal infections, also known as onychomycosis. Toenails are particularly susceptible to these infections due to exposure to wet areas, which provide a favourable environment for fungi and yeast to grow under the nail bed. While doctors do not usually consider fungal nail infections to be serious, they can cause discomfort and affect the appearance of the nail. Prompt treatment is crucial, as fungal infections can be challenging to cure and may require months of therapy.
Trauma or Injury
Sudden or repeated trauma or injury to the nail bed can lead to thick nail growth. This is commonly observed in individuals involved in sports, exercise, or dancing, as they are at a higher risk of experiencing trauma to their nails. Wearing ill-fitting shoes can also contribute to nail thickening. In such cases, seeking medical treatment can help the nail grow back more normally.
Ageing
Advanced age is another factor that can lead to nail thickening. As individuals age, their nails may thicken, and buffing or smoothing the rough surfaces may be recommended to improve their appearance.
Autoimmune Conditions
Thick nails can sometimes be a symptom of autoimmune conditions, such as psoriasis or yellow nail syndrome. Psoriasis often causes red, scaly patches on the skin and can affect both the fingernails and toenails. Yellow nail syndrome is associated with respiratory problems and swelling in the arms and legs due to fluid buildup. While there is currently no cure for yellow nail syndrome, treatment can help manage the condition and improve nail health over time.
Congenital Disorders and Chronic Illnesses
Underlying congenital disorders or chronic illnesses can also result in thickened nails. In such cases, it is important to consult a healthcare professional to identify and address the specific underlying condition.
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Trauma or injury
Minor injuries can cause noticeable changes to the nail, such as stubbing your toe, catching your finger in a door, or hitting your nail on a hard surface. These injuries can lead to temporary alterations, such as bruising, ridges, or a rough surface, which typically resolve over time as the nail heals and new, healthy cells replace the affected area.
More severe trauma, such as crushing injuries or deep cuts, may result in long-term or permanent effects if the nail matrix is significantly damaged. This can include chronic thickening, uneven or irregular growth, or even complete and permanent nail loss. In some cases, the nail may grow more slowly or stop growing temporarily as it recovers from the injury.
If the nail is torn or jagged after an injury, it is recommended to trim it to avoid further injury. If the nail lifts off the nail bed, it can be bandaged back into place, but it will not reattach and new nail growth will be slow. If there is bleeding under the nail, it is important to seek medical attention, especially if it covers more than half of the nail, as it could indicate a fracture or tissue tear.
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Ageing
With age, the rate at which our nails grow tends to slow down, and this can result in thicker nails. The nail matrix, the area under the cuticle responsible for nail growth, can become less active over time, leading to slower growth. As a result, the nails may appear thicker as the cells take longer to regenerate and replace old nail tissue. Ageing also brings about changes in the structure and composition of nails. The nail plate, the hard, visible part of the nail, can become more brittle and prone to cracking or splitting. This is because the nail plate loses moisture and natural oils over time, making it drier and less flexible. In addition, the blood vessels that supply nutrients to the nail matrix may function less efficiently as we age, resulting in reduced nutrient delivery and potential deficiencies that can affect nail health and thickness.
The nails themselves also undergo changes in texture and appearance. They may become rougher in texture and develop vertical ridges, which can make the nail surface uneven and cause the nail to appear thicker in certain areas. Additionally, age spots or pigmentation changes can occur on the nails, further altering their appearance. Ageing is also often associated with reduced blood circulation, which can impact nail health. Poor circulation may result in decreased oxygen and nutrient delivery to the nail bed, potentially affecting nail thickness and overall health. This reduced blood flow can also contribute to slower nail growth and recovery from damage or infection.
Hormonal changes that occur with ageing, especially during menopause, can also influence nail thickness. Fluctuations in hormone levels can impact the moisture content and oil production in the nail bed, potentially leading to drier, more brittle nails that are more prone to thickening. Additionally, certain medical conditions that become more prevalent with age, such as thyroid disorders or diabetes, can also affect nail growth and thickness. These conditions can influence metabolism and circulation, both of which play a role in nail health and regeneration.
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Genetic predisposition
While nail thickening is often associated with fungal infections, ageing, or other medical conditions, there is also a genetic component to consider. In some cases, individuals may be genetically predisposed to developing thick nails, a condition known as onychauxis. Onychauxis causes fingernails or toenails to grow abnormally thick, and it can run in families. If one's parents have this nail condition, there is an increased likelihood of inheriting it.
Mycotic nails, also referred to as onychomycosis, are another type of nail thickening that can have a genetic predisposition. About 10% of the general population will experience mycotic nails at some point, and the likelihood increases with age. If family members have a history of mycotic nails, one is more likely to develop them as well. This condition is caused by fungal organisms that infect the toenails or fingernails, leading to thick and fragile nails that separate from the nail bed.
Additionally, a rare condition known as yellow nail syndrome can result in thickened nails, and it is believed to have a possible genetic connection. People with yellow nail syndrome experience respiratory problems and swelling in the arms and legs due to a buildup of fluid. While there is currently no cure for this syndrome, it is worth noting that it may also be associated with certain cancers and immune disorders.
It is important to consult a healthcare professional if one notices nail thickening, as prompt treatment can help resolve the issue and prevent potential complications. In some cases, underlying conditions may be identified and treated, leading to improved nail health. Additionally, maintaining proper nail care practices, such as keeping nails trimmed and clean, can help manage the appearance and comfort of thickened nails.
While genetic predispositions play a role in nail thickening, it is not the only factor. Environmental factors, lifestyle choices, and other health conditions can also contribute to nail thickening. By understanding the various causes, individuals can take preventive measures, seek appropriate treatment, and maintain proper nail care to manage the condition effectively.
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Frequently asked questions
Thick nails are often a symptom of a fungal infection, such as onychomycosis, or an underlying condition such as psoriasis or onychauxis.
Nails may become painful, yellow, and curved. They may also force the nail plate to separate from the nail bed.
Treatment depends on the cause. If it is due to a fungal infection, your doctor may prescribe medication or recommend home remedies such as foot soaks. If it is due to an underlying condition, your doctor may address that issue first. In some cases, a doctor may recommend procedures such as debridement to reduce nail thickness.
To prevent thick nails, it is important to practice good foot hygiene, wear well-fitting shoes, and minimize injury to the toenails. Keeping your nails trimmed and clean can also help prevent complications from thick nails.
