Toenail thickening, medically termed onychauxis or onychogryphosis, is a condition where the nails, most commonly the toenails, become abnormally thick. They may appear discolored (often yellow or brown), or have an altered shape or texture. Onychauxis refers to a general thickening, while onychogryphosis describes a more severe form where the nail may become excessively overgrown and curved, sometimes resembling a ram’s horn. While this phenomenon can occur at any age, it is frequently observed as people get older.
Normal Age-Related Changes
As individuals age, several physiological changes contribute to the natural thickening of toenails. The rate at which toenails grow typically slows down with age. This reduced growth can lead to a buildup of nail cells, making the nail plate denser and consequently thicker.
Blood circulation to the extremities, including the toes, can also decrease over time. Less efficient blood flow means that the nail bed receives fewer nutrients, which can impact healthy nail formation and contribute to slower growth and increased thickness. Nails may also lose moisture with age, potentially becoming more brittle and thicker.
Common Causes of Thickening
Beyond aging, other factors can contribute to or worsen toenail thickening. Fungal infections (onychomycosis) are a common cause, leading to discoloration, brittleness, and thicker nails. They often thrive in warm, moist environments and are more prevalent in older adults.
Repeated trauma to the toenails is another frequent culprit. This can stem from ill-fitting footwear or activities involving repetitive impact, such as certain sports. Even minor, repeated injuries can damage the nail bed, causing the nail to grow back thicker.
Underlying medical conditions can also cause thickened toenails. Psoriasis, a chronic skin condition, often affects the nails, causing them to thicken, become brittle, or change color. Diabetes can lead to thickened nails due to reduced circulation and nerve damage. Peripheral artery disease (PAD), characterized by reduced blood flow to the legs and feet, can also result in abnormal nail growth and thickening.
When to Seek Professional Advice
While some toenail thickening is normal with aging, certain symptoms indicate medical attention is beneficial. If the thickened toenail causes pain or discomfort, especially when wearing shoes or walking, seek professional help. Discoloration beyond typical yellow or brown (e.g., red or black), or a foul odor, could signal an underlying infection or other issue.
Changes in nail shape, such as excessive curling, deformation, or separation from the nail bed, also warrant evaluation. If thickening is sudden or severe, or if you have difficulty trimming nails due to their thickness, a medical assessment can determine the cause and appropriate management. A professional diagnosis is important to rule out or address underlying medical conditions.
Managing and Caring for Toenails
Proper care can manage thickened toenails and improve comfort. Regular nail trimming is important, ideally cutting toenails straight across to prevent ingrown nails. Using heavy-duty clippers designed for thick nails makes this task easier and safer. Maintaining good foot hygiene, including daily washing and thorough drying (especially between toes), helps prevent infections.
Moisturizing the nails and surrounding skin can help maintain nail flexibility and reduce brittleness. Wearing appropriate footwear that provides ample toe space and avoids pressure on nails can prevent further trauma and discomfort. For minor thickening, over-the-counter softening creams may offer relief. If thickening is significant or persistent, a podiatrist can professionally thin the nail (debridement) and offer specific treatments if an underlying condition is diagnosed.