Thickened Nails: Causes and Treatment Options

Nail thickening

The nails are thickened, and the surface of the nails has pitting resembling tiny holes.

Lin, 10~19 year old female. Ask Date: 2016/04/23

Dr. Wu Yuxin reply Dermatology

It is recommended to seek medical attention to determine the cause of the condition.

Reply Date: 2016/04/23

More Info

Thickened nails, often accompanied by pitting or the appearance of small holes on the surface, can be indicative of several underlying conditions. Understanding the causes and treatment options for this condition is essential for effective management.

Causes of Thickened Nails
1. Fungal Infections: One of the most common causes of thickened nails is a fungal infection known as onychomycosis. This condition can lead to discoloration, thickening, and even crumbling of the nail. Fungal infections thrive in warm, moist environments, making the feet particularly susceptible.

2. Psoriasis: Nail psoriasis is a chronic autoimmune condition that can cause the nails to thicken, become pitted, and develop ridges. The pitting occurs due to the rapid turnover of skin cells, which affects the nail matrix.

3. Eczema: Chronic eczema can also affect the nails, leading to thickening and changes in texture. This is often associated with inflammation and irritation of the surrounding skin.

4. Trauma: Repeated trauma or injury to the nails can lead to thickening as the body attempts to protect the area. This can be due to tight footwear, frequent manicures, or other forms of physical stress on the nails.

5. Nutritional Deficiencies: Deficiencies in certain vitamins and minerals, such as biotin, zinc, and protein, can affect nail health and lead to thickening.

6. Systemic Conditions: Conditions such as diabetes, thyroid disorders, and circulatory issues can also manifest as changes in nail thickness and texture.

Treatment Options
1. Antifungal Medications: If a fungal infection is diagnosed, topical or oral antifungal medications may be prescribed. Common topical treatments include ciclopirox and efinaconazole, while oral options include terbinafine and itraconazole.

2. Topical Steroids: For conditions like psoriasis or eczema, topical corticosteroids can help reduce inflammation and improve the appearance of the nails.

3. Nail Care: Regular trimming and filing of the nails can help manage thickness. Keeping the nails clean and dry is crucial to prevent fungal infections.

4. Moisturizers: Applying moisturizers to the nails and surrounding skin can help alleviate dryness and prevent cracking, especially in cases of eczema or psoriasis.

5. Dietary Changes: Ensuring a balanced diet rich in vitamins and minerals can support overall nail health. Supplements may be recommended if deficiencies are identified.

6. Medical Treatments: In severe cases, dermatologists may recommend treatments such as phototherapy or systemic medications for conditions like psoriasis.

7. Surgical Intervention: In cases where the nail is severely damaged or painful, surgical removal of the nail may be considered.

Conclusion
If you are experiencing thickened nails with pitting, it is essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment plan. Early intervention can prevent further complications and improve nail health. Regular follow-ups with a dermatologist may also be necessary to monitor the condition and adjust treatment as needed. Remember, maintaining good nail hygiene and addressing any underlying health issues are key components in managing thickened nails effectively.

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