Thickened Toenails: Everything You Need to Know

close up of thickened toenails.

A thickened toenail is a condition where one or more toenails grow thicker than they should be. The affected toenails may also appear yellowish and deformed, which can also impact the  overall look of your feet.

But, it’s not just the appearance of your toes that it affects, it also makes foot care like nail cutting incredibly difficult. Not to mention, it may also cause pain and discomfort, especially when wearing shoes.

Do you think you have a thickened toenail? Read on and learn what causes it, and what you can do about it!

Key Takeaways

  • Thickened toenails exhibit various symptoms, including an increase in the thickness of the nail plate, discolouration (yellow, brown, or white), brittleness, deformation, foul odour, and pain or discomfort.
  • The most common causes of thickened toenails are fungal and yeast infections, trauma to the nail, psoriasis of the nails, yellow nail syndrome, and aging.
  • Treatment options for thickened toenails depend on the underlying cause. Topical medications, such as antifungal creams or ointments, can be used for fungal infections. Oral antifungal medications may be prescribed for severe infections. Debridement or trimming by a healthcare professional can improve appearance and reduce discomfort. Laser therapy and surgery may be considered for severe cases.
  • Prevention of thickened toenails includes practising good foot hygiene, wearing comfortable and properly fitting shoes, protecting the toenails from injury, avoiding exposure to fungal infections, and maintaining a healthy diet and lifestyle.
  • Seeking help from a podiatrist, such as Watsonia Podiatry, is recommended for proper diagnosis, personalized treatment plans, preventative care, and the use of custom orthotics if necessary.

Here’s what thickened toenails may look like

What are the symptoms of thickened toenails?

It’s relatively easy to tell whether you have a thickened toenail or not just by looking at your toenails, however, aside from the thickening of the nail plate, there are other symptoms to look that you may need to watch out for:

Discolouration – the toenail may turn yellow, brown, or white.

Brittleness – you may notice that the nail plate breaks or cracks easily, which can make it difficult to trim the nail or wear shoes comfortably

Deformation – having a misshapen or unusual appearance of the toenail is also visible

Foul odour – we’re not gonna lie, thickened toenails may stink, particularly if there is an underlying fungal infection

Pain – when wearing shoes or engaging in certain activities, thickened toenails may cause pain or discomfort

What causes thickened toenails?

There are many reasons why thick toenails happen. Below are some of the most common causes of this condition:

Fungal and yeast infections

Thickened toenails are often caused by nail fungal infections, also called onychomycosis, that targets the toenails and fingernails. The infection, typically starts at the end of the nail plate and can spread to the nail bed and surrounding skin if left untreated.

Onychomycosis is caused by a group of fungi called dermatophytes, but other types of nail fungus and yeasts can also cause the infection. The condition is also more common in toenails than in fingernails and is more prevalent in older adults.

If you have thickened, discoloured, and distorted nails, as well as nails that become brittle and prone to breaking, there’s a high chance that you have onychomycosis. If yours is a severe case, the affected nail plate may detach from its bed, causing pain and discomfort. You can learn more about onychomycosis here.

Trauma to the nail

Aside from toenail fungus, another culprit of thick toenails is trauma.

When the toenail is traumatised, for example, by repeatedly hitting the nail against the front of a shoe or stubbing the toe, the nail matrix can be injured, leading to irregular and thickened nail growth. The nail matrix, by the way, is a delicate and sensitive tissue that is responsible for the growth and development of the nail.

The trauma can also cause a blood clot or hematoma to form under the nail, which can push the nail plate upward and cause it to thicken and lift from the nail bed. In some cases, the thickened nail may become deformed or develop ridges or lines, which can further impact the appearance and function of the nail.

Psoriasis of the nails

In psoriasis, the immune system attacks healthy skin and nails, causing inflammation and abnormal growth of skin cells. The inflammation and abnormal cell growth can disrupt the normal structure and function of the nail matrix, leading to thickening and changes in the nail’s appearance.

Aside from a thickened toenail, psoriasis can also cause several nail changes. These changes include:

  • Pitting
  • Discolouration
  • Crumbling
  • Slight separation of the nail from the nail bed

Yellow nail syndrome

This condition can cause thickened toenails by disrupting the normal growth and development of the nail plate, the hard protective covering on top of the nail bed. What happens is that the excess keratin, a protein that makes up the nail plate, and lymphatic fluid accumulate under the nail.

In yellow nail syndrome, a thickened toenail can also become discoloured. In most cases, the nails may appear yellowish-green in colour.


Thickened toenails are a common condition in older adults and can be caused by a variety of factors.

As we age, the circulation of blood in our body becomes less efficient, and this can lead to a decrease in the blood flow to the nail bed. This can cause the nail to grow more slowly and become thicker and more brittle.

Another reason for a thickened toenail in old age is a loss of moisture in the nail. As people age, their nails tend to lose moisture, making them more brittle and prone to cracking and breaking. This can cause the nail to thicken as it tries to compensate for the loss of moisture.

Fungal infections, which are a lot more common in older adults, can also cause thick toenails. Fungal infections can lead to the accumulation of debris and damaged nail cells, which can cause the nail to thicken and become discoloured.

Poor foot hygiene and improper trimming of the nails can also contribute to the development of thickened toenails in older adults.

Are thick toenails permanent?

Thick toenails are not necessarily permanent, and their treatability depends on the underlying cause. In some cases, thick toenails can be treated and eventually return to normal thickness and appearance, while in other cases, the thickening may be permanent.

If the thickening is due to an infection, such as a fungal nail infection, treatment with antifungal medications can help to eliminate the infection and allow for the nail to grow normally. However, it can take many months for the nail to grow out and for the thickened portion of the nail to be replaced with healthy nail tissue.

If the thickening is due to an underlying medical condition, such as psoriasis or yellow nail syndrome, treating the underlying condition may help to improve the appearance and thickness of the nail. In these cases, however, the thickening may not completely resolve, and the nail may never return to its normal thickness and appearance.

Thick toenails can also be treated with laser or surgical procedures to remove the thickened portion of the nail. This will allow for new and healthy nail tissue to grow and replace the damaged nail.

How to treat thickened toenails

Topical Medications

If the thickening is due to a fungal infection, antifungal medications can be applied topically to the affected toenail. These may include over-the-counter options such as creams, ointments, or sprays, or prescription medications like medicated nail polish or oral antifungal medications.

Oral Medications

If the fungal infection is severe or if topical medications have not been effective, oral antifungal medications may be prescribed. These medications are taken for several weeks or months and can have side effects, so it is important to follow the prescribed dosage and discuss any concerns with your doctor.


Healthcare professionals like us here in Watsonia Podiatry may remove the thickened portion of the toenail by debridement or trimming. This can improve the appearance of the toenail and reduce discomfort.

Laser Treatment

Laser therapy may be used to treat thickened toenails caused by fungal infections or trauma. Laser treatment can penetrate the toenail and kill the fungus or promote healthy nail growth.


In severe cases, the affected toenail may need to be removed surgically. This is typically a last resort and is only considered when other treatment options have been unsuccessful.

How do you prevent thick toenails from developing?

Prevention, as cliché as it may sound, is always better than cure. That is why we always recommend practicing good foot care all the time. The following steps will help you prevent foot conditions like thickened toenails:

Practice good foot hygiene

Keep your feet clean and dry and avoid wearing damp or sweaty socks and shoes for long periods. Regularly trim your toenails and use a file to smooth the edges.

Wear comfortable, properly fitting shoes

Choose shoes that fit well and provide ample support for your feet. Avoid wearing shoes that are too tight or cause your feet to sweat excessively.

Protect your toenails from injury

Wear protective shoes when engaging in activities that may result in nail trauma, such as sports or heavy manual labour. Also, be careful when trimming your nails and avoid cutting them too short or too close to the skin.

Avoid exposure to fungal infections

Fungal infections can lead to thickened toenails, as we’ve already discussed in this piece. So it is important to avoid exposure to these types of infections. This includes not sharing shoes or socks, wearing shower shoes in public locker rooms or showers, and keeping your feet dry and clean.

Maintain a healthy diet and lifestyle

A healthy diet and lifestyle can promote overall health and help prevent a variety of health conditions, including those that can lead to toenail thickening.

How Can Watsonia Podiatry Help

One of the first things that you should do if you think you have thickened toenails is to call the experts for help. Especially if the thick toenails have already become uncomfortable or bothersome for you.

Here at Watsonia Podiatry, we can help you throughout the whole process of managing or getting rid of those thick toenails:

Diagnosis – we will examine your toenails and determine the underlying cause of the thickening.

Treatment – our podiatrists can develop a treatment plan that is tailored to your specific needs and based on the underlying cause of the thickened toenails. This may include the use of topical or oral medications, laser therapy, debridement or trimming of the toenail, or surgical removal of the toenail.

Preventative care – as part of our holistic approach, we always guide how to prevent the recurrence of thickened toenails, including proper foot hygiene, the use of appropriate footwear, and regular nail trimming.

Custom orthotics – if needed, we may prescribe custom-made orthotics, which are specialized shoe inserts designed to help relieve pressure and discomfort on the feet and toes. This can help to prevent or reduce the development of thickened toenails.

Call us or visit Watsonia Podiatry clinic for further assessment!

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