Thickened Nails: Causes and Treatment Options - Dermatology

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Thickened nails, medically known as onychomycosis or nail dystrophy, can arise from various causes, including trauma, fungal infections, and underlying health conditions. In the case of your friend, the initial trauma from being pinched by a door likely triggered a cascade of changes in the nail matrix, leading to abnormal nail growth. When the nail is injured, it can sometimes heal improperly, resulting in thickened or deformed nails.


Causes of Thickened Nails
1. Trauma: As in your friend's case, physical injury to the nail can disrupt normal growth. The nail matrix, which is responsible for nail growth, may be damaged, leading to thickening as the nail tries to heal.

2. Fungal Infections: Fungal infections are one of the most common causes of thickened nails. These infections can cause the nail to become discolored, brittle, and thickened. They often require antifungal treatment for resolution.

3. Psoriasis: This chronic skin condition can also affect the nails, leading to pitting, discoloration, and thickening. Nail psoriasis can be challenging to treat and may require systemic therapies.

4. Other Medical Conditions: Conditions such as diabetes, peripheral vascular disease, and thyroid disorders can also lead to changes in nail thickness and appearance.


Treatment Options
1. Avoiding Further Trauma: It's crucial for your friend to avoid further injury to the nail. This includes being cautious with activities that could lead to additional trauma.

2. Proper Nail Care: Instead of using a file or grinder, which can cause more harm than good, your friend should consider trimming the nail carefully and keeping it clean. If the nail is too thick, a podiatrist or dermatologist can safely reduce the thickness using specialized tools.

3. Topical Treatments: If a fungal infection is suspected, topical antifungal treatments may be prescribed. These treatments can help if the thickening is due to a fungal infection, but they may take several months to show results.

4. Oral Antifungal Medications: In cases of severe fungal infections, oral antifungal medications may be necessary. These are more effective for deeper infections but come with potential side effects, so they should be used under medical supervision.

5. Medical Evaluation: Given the persistence of the thickened nail, it would be wise for your friend to consult a healthcare professional, such as a dermatologist or podiatrist. They can perform a thorough examination, possibly including a nail biopsy or fungal culture, to determine the underlying cause of the thickening and recommend appropriate treatment.

6. Managing Underlying Conditions: If the thickened nails are related to an underlying health issue, addressing that condition may also help improve nail health.


Prevention
To prevent further issues, your friend should maintain good foot hygiene, keep nails trimmed and clean, and wear well-fitting shoes. If they have a history of nail problems or other health conditions, regular check-ups with a healthcare provider can help manage and monitor their condition.

In summary, thickened nails can result from various factors, and the best course of action is to seek professional advice for an accurate diagnosis and tailored treatment plan. Avoiding self-treatment methods that can cause injury is crucial, and a healthcare provider can offer safe and effective solutions.