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4 Causes of Toenail Thickening

toenail thickening

Thick toenails or toenail thickening can be a source of concern, and can also make someone self-conscious or embarrassed of how their toenails look. Toenails can tell a lot about what is going on inside of your body, and your health. There can be several reasons for toenail thickening. As a foot doctor, many of my patients see me due to different concerns about their toenails, but this is one of them. Here are the top causes of toenail thickening.

4 Causes of Toenail Thickening Are:

1. Trauma or an injury to your toenail

toenail thickening

Trauma or an injury to your toenail is probably the most common cause of toenail thickening that I see in my patients. The root of your nail is very delicate, and any pressure over a long period of time on this root, or your nail bed can cause your toenail to thicken.

Runners, dancers, and other athletes are at risk of having toenail thickening due to the nature of their activities. Toenails pounding into shoes, into the ground, or balls can cause your nail root or nail bed to be damaged, and make your toenail grow out much thicker than it previously was.

A direct hit to your toenail can also cause toenail thickening as well. Take a moment to think back over the years. Have you ever dropped something heavy on your toe? Was there ever a time that your nail lifted and fell off, or was ripped out? All of these things can cause your toenails to thicken due to damage to the nail root and possibly even the nail bed.

2. Toenail Fungus

toenail thickening

Toenail fungus is also a common cause of toenail thickening. The fungus that can infect your nails is commonly found in all of our environments but is more commonly found in dark, wet, damp places like the inside of your shoe for example. Being barefoot in spaces that are shared like locker rooms, saunas, and spas also can increase your risk of catching a toenail fungus.

Most people are able to fight off a toenail fungus infection before it causes a problem with how your nail will grow out. For people who have a lower immune system response like diabetics for example, or people with autoimmune disease, the risk of getting toenail fungus increases.

Going to a nail salon that does not autoclave or sterilize their instruments also increases your risk of catching toenail fungus as well.

3. Psoriasis or Psoriatic Arthritis

toenail thickening

Yes, psoriasis can affect your toenails as well. For many people with psoriasis, one of the issues is that they will experience toenail thickening. The toenail on someone with psoriasis also can look white, and very crumbly. They usually won't get too long due to them being softer than a healthy nail and will break constantly.

4. Aging

toenail thickening

Even without a history of a toenail injury or toenail fungus, a toenail can still start to thicken. Unfortunately, sometimes toenail thickening is a part of the aging process. As many of us get older, things our bodies will begin to change, and the toenails can be one of them. How fast your toenails grow can slow down over time, and this is why thicker toenails are more common in seniors or the elderly.

Treatment Options For Toenail Thickening:

nail thickening
A before and after with Keryflex Temporary Nail Restoration

Treatment options for toenail thickening will depend on its root cause.

Toenail thickening caused by trauma

  • Unfortunately, when the nail root is damaged in this way, the toenail thickening is permanent.

  • Toenails that have thickened due to trauma can be very painful and put pressure on the rest of your toe.

  • To give a more healthy look to the nail, Keryflex is a temporary and cosmetic nail restoration system. The Keryflex is applied in the office, and will have to be re-applied as the nail grows out.

  • Surgical removal of the thickened toenail is an option. An acid will be used during the procedure to kill the root so that the toenail ever comes back. This procedure can be done in the office.

Toenail thickening caused by nail fungus

  • Toenails infected with the fungus can return to normal with treatment of the fungus.

  • There are several options for the treatment of toenail fungus including topical and oral medications.

  • Keryflex can also be used to give a normal, healthy, look to nails temporarily damaged by fungus, as your new, normal nail is growing out.

Toenail thickening caused by aging

  • Having the thickened toenails trimmed by a foot doctor or podiatrist can help temporarily relieve pain. This usually is done every 1-2 months and depends on how fast your nails or growing

  • Another option is having the nail surgically removed. This is done in the office, and an acid is used to burn the nail root so that it doesn't;t grow back again.

  • Keryflex can be used on certain nails that are thickening due to aging to give the nail a healthy appearance temporarily. Keryflex will be applied in the office and has to be reapplied as the nail grows out.

Toenail thickening caused by psoriasis

toenail thickening
Another before and after of Keryflex

  • Usually managing the disease of psoriasis itself with medication can make the nails grow normally again, but unfortunately is not a guarantee.

  • Work with your PCP and rheumatologist to find treatment options that work best for you.

  • Keryflex is safe to use on nails damaged by psoriasis for a temporary cosmetic enhancement.


Toenail thickening can be a very complex issue and has many causes from an old injury, infection, autoimmune disease, or aging. If you are concerned about the changes or the state of a thickened toenail, it's a good idea to see a foot doctor in your area.

Schedule Your Appointment At Direct Podiatry Arizona

Looking for a foot doctor in the Phoenix area? My name is Dr. Tarr, and I am the owner of Direct Podiatry Arizona in Tempe. To view my available appointment times, click here.

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