Thick Toenails - Causes, Treatment & Home Remedies | Pain Care

Thick Toenails – Causes, Treatment & Home Remedies

Thick toenails usually give an embarrassing appearance to the feet and may present with other symptoms such as pain and swelling.  This is a cause for concern because any texture, appearance, and colour of nails away from normal indicates an aberration to health.

The nails are a physical barrier to infectious agents, protecting the nail bed and tissues around if from foreign bodies the hands and feet are exposed to on a daily basis. Our boots, hand gloves, stockings, and even bare floors contain a lot of infective agents that may damage the toes if exposed to them.

Thick toenails may result from a wide range of causes including aging, however detecting the cause of one’s thick toenails would help determine the best line of action for treatment and prevention of its recurrence.

Causes of Thick Toenails

The following factors would make an individual’s toenails thicken.


As individuals advance in age, their nails lose the ability to regenerate new cells to replace dead ones in addition to losing their ability to retain water, so the nails thicken. This is a physiological occurrence associated with ageing and is untreatable.

Although age-related nail thickness affects both fingernails and toenails, it more commonly affects the toenails.

Fungal Infection

A fungal infection of the nails called Onychomycosis & is one of the commonest cause of thick toenails.

The fungus infects the nail bed when it gains entry into it through the point where the nail bed meets with the nail, through a cut in the skin near the nail, or through a crack in the nail. Over time, the fungus infects the nail causing it to become thickened.

Fungi multiply and spread quickly in moist skin areas making the feet a suitable environment for the infection since it is often exposed to moisture from heat in footwear, wet floors, and bathtubs.

However, there are some risk factors which predispose people to onychomycosis including jobs which lead to constant exposure of feet and hands to moisture, smoking, alcohol abuse & wearing tight footwear.

Other factors includes ‘tinea pedis’ another fungal infection of the web spaces in between the toes and the sole of the feet, diseases which suppress one’s immunity such as HIV and cancer, use of drugs that weaken one’s immunity such as cancer drugs and steroids, medical conditions that affect blood supply to the feet, diabetes, and skin diseases such as psoriasis.

Toe Injury

 Repeated injury to the toes as occurs in athletes, dancers, choreographers, soccer players, would trigger a chronic inflammation that causes the toenails to thicken.

Constant wearing of ill-fitting shoes may also cause repeated toenail injury resulting subsequently in thickness of the toenails.

Yellow nail syndrome

This is a rare cause of thickened toenails.

It also affects the fingernails. This syndrome is characterized by nail abnormalities such as thickening, the curvature of the nails, yellow discolouration of the nails, as well as pulmonary symptoms such as a cough and chest tightness from emphysema, and leg swelling caused by lymphatic obstruction.

Although the cause of yellow nail syndrome is not certain, studies have shown that it is associated with cancer, autoimmune diseases, and genetic abnormalities.


Paronychia is an infection (usually bacterial although may also be caused by yeast) of the nail bed and skin around the nail.

The bacteria which cause paronychia usually gains entry into the nail bed via small cuts or cracks in the skin where it joins the nail.

Frequent exposure to moisture also predisposes to paronychia and people at risk include dishwashers, bartenders, laundry workers, nurses, cooks, cleaners.

Poorly-done pedicure and manicure and cutting the nails or cuticles too much or too close to the adjoining skin are other common risk factors of paronychia.

When paronychia occurs, it causes acute inflammatory changes on the affected nail and skin around it, causing severe pain, swelling, tenderness, and warmth of the skin around the nail.

In severe cases, it may cause severe accumulation of pus in the nail bed. Recurrent episodes of paronychia causes a chronic inflammation that causes the nail to become thickened.


Psoriasis is a chronic inflammatory disorder caused by immune cells attacking the skin and nails.

The nail changes in psoriasis affects both toenails and fingernails. Psoriasis, in addition to making the toenails thickened, causes development of ridges on the nails and separation of the nails from the nail bed, a phenomenon called onycholysis.

Symptoms associated with Thick Toenails

The symptoms associated with thick toenails depend on the cause and include the following;

  • Nail fungus: Fungal nail infection also presents with yellow, brown, or green discoloration of the nail, foul smelling skin around the nails, separation of the nail from its nail bed, scaly appearance of the nails, itching around the nails, and presence of cracks on the nails.
  • Paronychia: Paronychia presents with severe pain, swelling, redness, and warmth over the skin around the nail and on the nail bed. There is also release of purulent discharge from the angle of the nails in paronychia.
  • Psoriasis: Psoriasis presents also with separation of the affected nail from its nail bed and presence of ridges on the nail.

Treatment of Thick Toenails

The treatment of thick toenails depends on what is causing it. After a doctor has correctly diagnosed the cause of your thick toenails, then appropriate treatment may be commenced.

Medical Treatment of Thick Toenails

Onychomycosis: For thick toenails caused by toenail fungus, there are different treatment methods.

Your doctor may prescribe topical medications such as clotrimazole cream or nystatin lotion, oral antifungal medications such as ketoconazole tablets, or laser treatment or any combination of these methods.

These treatment options must be maintained for several months before the toenail reverts to its normal thickness.

This is because it often takes 12 to 18 months for new toenails to fully grow out and replace the old thick ones.

Aging: For thick toenails that result from the ageing process, a cure is not possible. However, the symptomatic treatment which involves buffing the smooth surfaces of the nails to smoothen them may be recommended.

Psoriasis: Psoriasis-induced toenail thickness is often treated with anti-inflammatory drugs including topical steroids, injectable steroids, and other drugs such as methotrexate.

The thick toenails may be treated surgically by removing the nail and treating the nail bed underneath.

Paronychia: The chronic inflammation caused by paronychia may be treated with antibiotics and surgical drainage of abscesses.

Home Remedies for Thick Toenails

The following home remedies have been shown to be very effective in resolving abnormal thickening of toenails. These include;

Apple Cider Vinegar

 Apple cider vinegar is mildly acidic, creating an acidic environment that is unfavourable for the growth of fungus.

Apple Cider Vinegar

Additionally, apple cider vinegar has antibacterial and antifungal properties, preventing infection of the nails and nail bed.

To enjoy this health benefit of apple cider vinegar, mix it with water in equal amounts and soak your toenail in the mixture for about 30 minutes once every day.

Ensure you dry your toenails thoroughly after soaking your feet in it. This yields improvement in the thickness of the toenails after a couple of weeks.

Tea Tree Oil

 Tea tree oil has strong antiseptic and antifungal properties. Tea tree oil has been used several times in the past to treat skin infections.

Tea Tree Oil

To use this oil, you should mix it with any essential oil such as olive oil and lavender oil and apply the mixture with a cotton ball on the affected toenail and leave for 10 to 15 minutes.

Afterwards, gently scrub off the paste with a toothbrush and leave the toenail to dry.

This process should be repeated twice or thrice daily to get quick and satisfactory results.


Garlic contains certain compounds including allicin and ajoene which have strong antioxidant and antifungal properties.


You can apply garlic oil mixed with an equal amount of white vinegar on and around the affected toenail and leave covered for 2 to 3 hours.

Alternatively, you may also eat one or two garlic cloves daily to enjoy this benefit.

Baking Soda

Baking soda is a common kitchen staple which is commonly used in the treatment of toenail fungus.

Baking Soda

To provide resolution of abnormal thickening of toenails, soak the affected toenail in a mixture of one-half cup of baking soda, 3% hydrogen peroxide and one-half cup of Epsom salt in four cups of warm water for about 10 minutes, then clean and dry the toe.

This process should be repeated twice daily for 3 to 4 weeks to see improvement in the toenail thickness.

Lavender Oil

Lavender oil contains several compounds with strong antiseptic properties to fight off skin infections.

Lavender Essential Oil Bottle

Mix five drops of lavender oil and olive oil and apply the mixture on the affected toenail and over the skin around it using a cotton ball.

Leave on the toenail for about 10 minutes, then rinse off and dry the toe thoroughly. This should be repeated twice to thrice daily to see significant resolution of the symptoms.

Orange Oil

Orange oil has strong antifungal properties and is very effective for the treatment of toenail fungus.

However, it is recommended that you test its use on a small spot of skin first before using it to treat your thick toenail because orange oil causes allergic reactions.

To use orange oil to treat thick toenails, apply a drop between your toes, on each toenail, and on the skin around the toenails.

Leave the oil on for about 30 minutes, then wash off and dry your feet. This process should be done two to three times daily to see significant relief.

Oregano Oil

Oregano Oil is a very effective home remedy for thick toenails because of its strong antiparasitic, antiviral, antifungal, and antiseptic properties keeping the nails infection-free.

You can use oregano oil by applying a few drops mixed with a teaspoon of olive oil on the affected toenail. Allow the mixture on the toenail for about 30 minutes, then rinse off and dry the toes.

Repeating this process thrice daily for three weeks yields significant relief of nail symptoms.

These home remedies should be applied consistently and patiently to see results and significant improvement of the toenail symptoms.

How to prevent Thick Toenails

Although thick toenails rarely cause complications, they may get worse and the associated symptoms may degenerate if left untreated.

Prevention of thick toenails involves preventing the risk factors of toenail fungal and bacterial infections and include the following;

  • Keep your feet properly washed with soap and water regularly, and thoroughly dried afterwards.
  • Ensure your feet is kept as dry as possible.
  • Change your socks twice or thrice daily.
  • Wear cotton socks that take off moisture from your feet.
  • Avoid tight-fitting shoes and wear shoes that breathe
  • Use a foot powder to keep your feet dry if you sweat a lot.
  • When in the locker room or pool, wear flip flops or other shower shoes that would keep your feet moisture-free.
  • Ensure proper toenail grooming by keeping the toenails well-trimmed.
  • Ensure your pedicurist uses sterile instruments and no disposable equipment should be reused.
  • Ensure your footwear is kept dry after each use
  • If you recently treated toenail fungus, discard your old footwear and get new ones to prevent re-infection.
Bottom Line: A thick toenail is always a symptom to be concerned about as the appearance of the nails are clues to one’s health status.

While thick toenails may be a result of the normal aging process, it may also be caused by fungal infections, bacterial infections, psoriasis, diabetes, immunosuppression, and yellow nail syndrome.

Treatment is very essential for thick toenails and the kind of treatment depends on the cause of an individual’s thick toenails.

Antifungals, antibiotics, and topical steroids may be used in treating toenail thickness caused by fungi, bacteria, and psoriasis respectively.

Additionally, home remedies which have been proven effective in the treatment of thick toenails include oregano oil, orange oil, lemon juice, and baking soda.

Although psoriasis rarely causes any major complication, persistence and recurrence may cause progression of the symptom as well as other associated symptom.

Thick toenails can be prevented by avoiding exposure of the feet to moisture, drying footwear after use, and ensuring proper feet and nail grooming.

Dr. Sachin

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