Thick Toenails

Toenails are not just a decorative component of our anatomy; they serve an essential role in protecting the delicate tissues at the end of our toes. The toenails often provide early indications of more serious problems such as toenail fungus, psoriasis, and hypothyroidism. As we grow older, our toenails tend to become thick, sometimes causing discomfort or tenderness. This article will explore the causes of thick toenails, their symptoms, and potential treatments.

What Causes Thick Toenails?

Thick toenails may occur due to many factors. One of the causes of thick toenails is aging. As we age, our toenails become less flexible, drier, and less supple, leading to thickening. Often, thickening will also occur as a response to trauma to the toenail. Injuries such as repeatedly hitting the toenail at the end of a shoe that is too short, or when something is dropped on the toenail, can result in the nail falling off. When the nail grows back, it can often be thicker than before it was lost.

Toenails that are thick or have other unusual characteristics can be a sign of underlying health problems. Several conditions can lead to the thickening of toenails. Fungal infections, also known as onychomycosis, can cause thick, discolored toenails. Other visible signs of toenail fungal infections may include brittleness, a foul odor, and separation of the nail from the nail bed.

Psoriasis is another possible explanation for thick toenails. This condition causes the skin to redden, become itchy, and to develop flaky patches. In the nails, psoriasis can cause depressions or craters, yellow-brown spots under the nail, and thickening.

Hypothyroidism is a condition where the thyroid gland does not produce enough hormone. It can cause hair loss, dry skin, fatigue, and weight gain. In addition, it can cause toenails to become thick and brittle.

Symptoms of Thick Toenails

The thickening of toenails can make the nail difficult to cut, and the nail may become curved, causing discomfort or tenderness. Thick toenails may be more difficult to treat, as creams and topical solutions may be unable to penetrate the nail effectively. Fungal toenail infections can cause the nail to thicken and change color. The infected nail may appear dark, yellow, or green, and may develop an unpleasant smell.

Treatment for Thick Toenails

If you have thick toenails, it is essential to seek proper medical treatment. A foot and ankle surgeon can diagnose the underlying cause and provide the best treatment options. The treatment for thick toenails will depend on the cause of the thickening.

For toenails that have thickened as a result of aging, a foot and ankle surgeon may recommend using emollients to hydrate the skin and soften the nails. As an alternative, devices known as nail drills can be used to thin the toenails, removing some of the thickness and making them easier to cut.

If the thickening in the toenails is due to a fungal infection, the foot and ankle surgeon may prescribe oral antifungal medication or suggest topical treatments such as nail gels or ointments. Often, prescription medications are combined with laser treatment to eradicate the fungus. Over-the-counter fungal nail treatments are generally ineffective in treating more severe cases of the infection.


Thick toenails are a common problem that can be caused by aging, trauma, fungal infections, psoriasis, and hypothyroidism. If you experience a change in toenail thickness or appearance, it is important to seek medical advice to diagnose and treat the underlying cause. A foot and ankle surgeon may prescribe oral or topical medication, laser treatment, or emollients to treat thick toenails. Dr Gilbert Huang DPM, a certified foot and ankle surgeon, specializes in the diagnosis and treatment of thick toenails. Contact his office to schedule an appointment for an evaluation.

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