Thick Toenails: 5 Causes and a Bunch of Treatments

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Thick Toenails: 5 Causes and a Bunch of Treatments

Sometimes you just have to live with thick toenails—and some strong clippers.*

Sometimes you just have to live with thick toenails—and get some strong clippers.*

by James Hubbard, MD, MPH

Several of my Facebook fans have asked what to do for their thick toenails. And to tell the truth, it’s not a trivial question. Thick toenails can be the starting point for bad bruises, infections, even gangrene.

In a disaster situation, these problems could become more likely if you have to do a lot of walking or even just standing. If your shoes press on the toenail, the toe can become quite bruised. Then, if your toes swell from the bruising, the shoes will be tighter on them, causing a dangerous cycle, even to the point of killing some of the tissue under the nail.

So it’s best to treat thick toenails before a disaster rather than during.

5 Causes of Thick Toenails

1. Fungi. A fungus is a common cause and hard to get rid of.

Treatment: You can try daily application of:

    • Tea-tree oil, an antifungal
    • Noxema
    • Topical antifungals bought at the drugstore; the label will say they’re for toenail fungus

Other options include daily 15-minute vinegar and water soaks (one part vinegar, two parts water) or prescribed oral medicine.

Whatever method you try, it usually takes a few months before you see improvement. A new (and expensive) way to treat fungus is to go to a laser treatment center. This is quick and the most likely to be effective, but the fungus often comes back no matter the treatment, especially once you stop it.

2. Poor circulation. There are many chronic diseases that affect circulation. One of the most common is diabetes. As anyone with diabetes knows, with or without thick toenails, you have to always pay particular attention to your feet by wearing shoes that fit well and keeping your toenails clipped well. Any little infection, from rubbing or whatever, can lead to a serious infection quickly. The thick toenails that come from poor circulation just add to the risk.

Treatment: This one’s more about prevention. Keep the diabetes as well controlled as possible to prevent the poor circulation. Also, if you have diabetes, please don’t smoke. Of course that’s bad for anyone’s circulation, but it can be the last straw before losing a limb in someone with diabetes.

Remember, people with poor circulation often have decreased feeling in the feet. It’s essential to wear good-fitting shoes and inspect your feet once or twice or more a day for blisters or abrasions you may not be feeling.

To complicate matters, many people with poor circulation have a fungal toenail infection that’s also causing the toenail thickening that needs to be treated.

3. Eczema, a disease causing the skin to be chronically irritated and inflamed.

Treatment: You can try some of the treatments listed in the fungus section, or maybe use some over-the-counter hydrocortisone on the nails to counter the irritation and inflammation, but really, usually nothing works very well.

4. Psoriasis, a disease that causes patches of thick red skin covered with silvery scales.

Treatment: Treat the underlying psoriasis. Nothing special helps the toenails.

5. Genes. Some people are just born with a tendency for thick toenails. There’s no infection or disease, so there’s no cure.

Living With Thick Toenails

No matter your best efforts, the thick toenails may stick around for you to deal with the best you can. The best alternative may be simply to try to prevent damage from them:

  1. Soak your feet regularly with warm water for 15 minutes.
  2. Dry off your feet.
  3. File down the thickness with a nail file or emery board.
  4. Clip the ends with strong toenail clippers.*

Be careful not to be too aggressive and make yourself bleed, especially if you have diabetes.


What about you? Have you tried any of the treatments? Did they work? Do you have one not listed that did?


*The toenail-clippers link is an Amazon affiliate link.


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  • Jill

    I have thick nails that it seems as if the bottom layer is 1/2 embedded into the skin so it hurts to file it down. Hard to explain but its like partial nail partial skin partial nerves. I have tried tea tree oil but then my foot starts itching and rashing with dermatitis. I use to also have athlete’s feet only on this left foot. as a kid into adult hood and I think thats what caused the bad nails. I am using coconut oil now, and it looks pretty clear at the bottom but still have the 2 layered nails. I wish I could simply use my dremel tool but it hurts to bad to do it. I have tried digging it out also. I’m looking for help with this. Been like this since I was a kid.

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  • Mike Ingle

    My father had very thick toe nails from fungus that he had during WW2. His feet stayed wet so much during combat because there was little time to dry them out. A friend told me to buy some Blue Star ointment and put it on his toes each night and wear socks. I could not believe how the fungus was gone in less than 3 months and the nails left looked like a young persons. My father was so pleased after suffering with the thick nails for over 40 years. The fungus never returned. When I was young my father trimmed his toes with wire dykes and I ran for cover because of flying chunks of nail .

    • James Hubbard, MD, MPH

      Thanks for sharing, Mike.

  • ann3199

    I used fluocinonide solution and it completely got rid of my nail fungus. I am a nurse and I have used it on patients that had toenail fungus for years and within a few weeks of regular use, it wa healed.

    • James Hubbard, MD, MPH

      Thanks, Ann. I haven’t tried a steroid solution on a fungus. Wonder why it gets rid of it so well?

  • Dave K.

    I did not see any mention of de-colorized iodine. I have used it and if diligent, it does work. I have also used tea tree oil with good success. Unfortunately, after clearing up I am less diligent, and it does come back.

    • James Hubbard, MD, MPH

      Thanks, Dave.

  • Beckery49

    Vinegar in a spray bottle and spray every day after shower. It will grow in clear from the point the treatment was started. It takes about 6 months to finish treatment but it does work.

    • James Hubbard, MD, MPH

      Thank you.

  • Skip

    First allow me to thank you Doc for your constant flow of GREAT INFORMATION… Love your books too.. Keep up the good work..

    For almost a year I had a toenail fungus on my big toe that nothing would touch.. I tried about everything that anyone suggested. My foot doctor said my circulation was fine and recommended Tea-tree oil, which, after several more months of use, didn’t touch it.. In fact, I began to develop fungus on two other toes on the same foot. I stopped the Tea-tree oil treatment.

    Finally I thinned the overall thickness of the really bad nail almost to the bed flesh with a small grinder on a Dremel tool.. I then applied colloidal silver, approx 10ppm, very liberally every few hours during the day and evening using a spray bottle or drops.. I always made sure to get drops of it under the ends of my nails. I wore socks to bed and soaked the sock area around the toes with colloidal silver immediately before going to bed. After about a month things started to improve and the fungus disappeared on the smaller toes..

    I continued the treatment for about another 4-6 months and it appeared the colloidal silver killed all the fungus on all the toes, even under the nails.. It has been about a year now since the fungus disappeared. The toenail has almost grown back completely healthy.

    I still use colloidal silver sprayed on and between my toes a couple of times a week. Since using the colloidal silver I have not had any other fungal infections nor athletes foot infections between my toes.. I am 70 years old, diabetic with a little neuropathy, but otherwise my feet remain very healthy.. For years I have made my own high-quality colloidal silver for personal use as it is far too expensive to purchase it ready-made several ounces at a time..

    I hope this info might help reduce the suffering of others.. Keep up your great work, Doc..

    • James Hubbard, MD, MPH

      Skip, thanks so much for sharing and for the kind words.

  • Nina Sala-Gault

    I was treated repeatedly for fungal infection, but eventually was diagnosed with “over-keratinazation” of several nails. I stopped taking the antifungal oral meds and have had much better luck with keeping my nails filed down and using Vicks on them each night. I also have an illness that causes neuropathy, so I’m very careful with my feet. This article was very timely for me, so thank you! Helps to know I’m on the right track.

    • James Hubbard, MD, MPH

      You’re welcome. Glad to help.

  • Steve LaFontaine

    he left one out…. overdose of calcium.

    • James Hubbard, MD, MPH

      Steve, Thanks. I know hypercalcemia can cause nail changes (brittle nails, streaks) but I’m familiar with it causing thickening of the nails.

  • jakartah

    I am having good luck with meleleuca essential oil by young oils but I’m sure any quality brand would work

    • James Hubbard, MD, MPH

      Thanks, jarkartah.