There’s no way around it: Thick toenails are not pretty. If you notice that your toenails have become thick and discolored over time, it may make you self-conscious to go barefoot or rock your flip-flops. Besides that, they may also be painful. If you’ve tried to remedy them on your own to no avail, you may need to see a podiatrist. We asked Dr. Patrick McEneaney, DPM, podiatrist and owner of Northern Illinois Foot & Ankle Specialists, to answer all your questions about thick toenails. Here are three causes of thick toenails, and what to do if you suspect it’s the cause.
Causes of thick toenails
Nail fungus
“The most common issue is nail fungus (onychomycosis),” says Dr. McEneaney. “This is typically the same fungus that causes athlete’s foot. It’s very transmittable and very easy to pick up walking around barefoot, where other people who have either a nail fungus or an athlete’s foot infection.” Because of this, the most common places to pick it up are pools, locker rooms, beaches, showers and even hotel rooms. Basically, anywhere anybody is walking around barefoot. According to Dr. McEneaney, the best types of treatments for this are prescription topical medications, oral medications, and laser therapy. “Laser therapy is a cold laser which actually penetrates through the nail and kills the fungus from within the nail and the fungus that lives within the nail bed itself,” says Dr. McEneaney. He adds that typically, over-the-counter treatments don’t tend to be very effective for this.“There are a lot of old wives tales about this, soaking in apple cider vinegar, using Vicks Vapor Rub, and tea tree oil,” says Dr. McEneaney. “Medical studies show that those things just don’t take care of the problem.”
Dystrophic nails
Dystrophic nails are a condition where the nails can thicken and become discolored due to repetitive microtrauma to an area. “One of the things I compare it to is when people are doing activities and they get a lot of rubbing in their shoe, they can get a blister. The nail itself doesn’t blister,” says Dr. McEneaney. “What actually happens is the nail will thicken and become a darker color. It can be yellowy, it can be brownish, and sometimes it can be speckled with little flecks of blood underneath.” Things that cause this include repetitive microtrauma, sports (like skiing, windsurfing, soccer, basketball and tennis), wearing shoes that are too tight, and wearing shoes that are too big. The treatment for this is identifying what’s causing it “If it’s something as simple as shoe gear, then that’s an easy fix,” says Dr. McEneaney. You can also do some nail maintenance. “When these nails become thick, you can actually take an emory board and file them top to bottom to thin out the nail so that it doesn’t rub as much. The thicker it is, the more it rubs, and the thicker it becomes,” says Dr. McEneaney. “Otherwise, there are medications that can be utilized to eat away at the nail and can thin out the nail.” If you’re not sure if your nail issues are fungal or dystrophic, you can have a nail biopsy done. “This is where a nail clipping is taken and sent to the lab and the lab, which will determine if the cause is fungus, yeast, or molds,” says Dr. McEneaney.
Cancer
There are also types of cancer that can develop in and around the nail unit, specifically melanoma. “If someone has melanoma in the base of the nail, the root where the nail grows out, causing streaking of (a brown streak) that runs longitudinally along with the nail,” says Dr. McEneaney. “It actually grabs some of the pigment from cancer and drags it through the nail. So if you have any streaking of the nails or of odd blotches underneath the nail, that definitely should be biopsied. It’s not that common, but it does happen.” Next up: A Podiatrist Explains Why Your Feet Might Be Hurting
Sources
Dr. Patrick McEneaney, DPM, podiatrist and owner of Northern Illinois Foot & Ankle Specialists
