Thick and brittle toenails — Buffalo Grove

I care for thick toenails at the studio in Buffalo Grove, in the suburbs of Chicago, also for seniors and people with diabetes without wounds.

Who it is for

• The nail is thick and hard and cannot be cut with ordinary clippers.
• The nail crumbles, turns yellow or lifts from the nail bed.
• The shoe presses on the nail, and the toe hurts when you walk.
• Seniors and people who find it hard to reach their feet.

Where it comes from

The nail is made by the matrix, the tissue under the skin at the base of the nail. When it makes the nail unevenly, the nail gets thicker. Sometimes it thickens evenly and becomes hard and tall. Sometimes it grows irregularly, twists to the side and looks like a horn — this most often affects the big toe.

According to the nail literature, the most common causes are repeated pressure in shoes, an old injury, age, foot deformities (such as a bunion) and weaker circulation. Similar changes appear with other skin and nail conditions, so the look of the nail alone is not enough to judge the cause.

Before

After

What the visit looks like

1. Assessment. I look at the nail, the skin around it and your shoes, and check whether this is a case for foot care.
2. Thinning. I reduce the thickness of the nail with a rotary tool, using a dry technique. Less thickness means less pressure in the shoe.
3. Cleaning and shape. I clean the space under the free edge and trim the nail straight across.
4. Plan. We agree on the time to the next visit — a thick nail grows back and needs regular care.

Thinning does not change how the matrix works. That is why the thickening usually comes back, and the goal is comfort and safety for the foot, not a one-time result.

What you can do yourself

• Trim nails straight across after a bath, when the nail is softer.
• Wear shoes with a tall, wide toe box.
• Do not lift the nail with sharp tools — it is easy to cause a wound under the nail.
• With diabetes, check your feet every day, including between the toes.

When to see a physician first

• there is a wound, pus or a black discoloration under the nail;
• the toe is red, warm and swollen;
• you have diabetes with wounds, poor circulation or reduced feeling — then I work only together with your physician;
• you want testing or medication for a nail change — a physician orders that.

Questions

Why does a toenail get thick?

Most often from repeated pressure in the shoe, an old injury, age or weaker circulation in the feet. According to the nail literature, part of the nail matrix then makes the nail unevenly, so thinning alone does not stop it for good.

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See also: foot care pedicure · first visit · all services

Source: R. Baran, R.P.R. Dawber, “Diseases of the Nails and their Management”, 3rd ed., ch. 2, 4 and 10.