Why Do Nails Get Thicker With Age?

Nail: – Nail is the hard part of the body, which is made up of a tough protective protein called alpha-keratin. The nail has a plate-like, translucent structure with three main parts, i.e., root, plate, and free margin. Nails present at the fingers and toe’s tip, thus protecting the fingertip and surrounding soft tissues from injuries. Except for growth rate, toenails and fingernails are the same. Toenails grow four times slowly as compare to fingernails. Nails never stop growing and do not hurt when people cut their nails because they are not innervated.[1]   

Nails are not only for decoration purposes. Nails are a barometer of our overall health and give us an idea about our health if it is proper or not. With advancing age, changes in the growth rate and morphology of the nail plate appear. The mechanism behind these changes is not entirely understood, but it might be due to ultraviolet radiation effects or dysfunctional blood circulation at the distal extremities.[2] 

In this document, Section-1 will discuss the method for measurement and the general range of nail thickness. Section-2 will discuss the process behind nail thickness changes due to aging and other changes in nails due to age while Section-3 will emphasize symptoms, treatment, and minimization ways of nail thickness. Section-4 will discuss other reasons for thick nails.

Section-1: -Thicken Nails

Method: Nail thickness, nail volume, and matrix volume in a healthy person and nail disease can be easily calculated using a non-invasive method, i.e., 20 MHz ultrasound. 

Nail thickness range: – Normal average thickness of fingernails is 0.6 mm in males and 0.5 mm in females. Toenails are thicker and have a range of 1.65 ±0.43 mm in males and 1.38±0.2 mm in females. The nail plate thickness may increase, decrease, or may remain unchanged in older people. Male and females both are prone to age-specific thickness differences. Matrix volume increased significantly with age. Right-hand shows the trend of the higher nail and matrix volumes in left-right comparison.[3,4]

Section-2: – Why Do Nails Get Thicker With Age?

Section-2.1: Nail Thickness With Age: – If you’ve ever noticed that older people tend to have thicker toenails and, thus, are more challenging to become trim. Fingernails and toenails both get thicken with age. Fingernails are filed and buffed often; therefore, they are less thick than fingernails. Unfortunately, in most cases, thickening toenails are a by-product of aging; as people get older the growth rate of nails decreases, which causes nail cells to pile up. The process of nail cells piling up is called as Onychocytes, and due to this process, nails become thicker. 

Thicken nails result in pain and interfere with daily activities. The condition will also affect social and intra-family interactions because the aesthetic aspect also plays a role in older adults.[5,6,7]

Section-2.2: Other Changes In Nails Due To Age: – 

  1. Alteration in chemical composition
  2. Alteration in histology
  3. Alteration in nail growth
  4. Alteration in nail color
  5. Alteration in contour
  6. Alteration in surface texture[4] 

Section-3: Symptoms & Treatment of Thick Nails

Section-3.1: Symptoms Of Thicker Nails: – In the early stages, thick nails go unnoticed, but as the nails get thicker, symptoms should be noticed like: 

  1. Bad odor from the nail, brittle, and easy to break nails.
  2. Cutting and trimming are difficult, and nails lift easily from the nail bed.
  3. Splitting or cracking of the nail occurs easily
  4. Pain and discomfort can be felt

Toenails may appear Gnarly with some scaling on the surface as they gradually thicken over time, and often, the nails take on a yellow, green, and brown hue.[8] 

Section-3.2: Treatment for Thick Nails: – In instances where aging is causing a person’s toenails to thicken, the treatment will likely be as simple as buffing the rough surfaces to smooth them. 

Section3.3: Minimization of Nail Thickening: – We can’t avoid the aging process, but enhancement in the appearance of thickening nails and reduction of pain can be done by using the following ways: – 

  1. Regular filing nails at home will help reduce nail thickness and assist with the appearance by removing a discolored outer layer.
  2. Groom the feet properly, and toenails shouldn’t grow beyond the toe’s end because this will help prevent toenails thickening.[9] 

Section-4: Other Causes Of Thickening Nails: – 

  1. Fungal and Yeast Infections: – Fungal and Yeast are the most common cause of nail thickening. Primarily they affect a person’s toenails. Fungal infections develop in warm and moist conditions; thus, toenails provide the most favorable environment. Onychomycosis (a type of fungal infection) is the most common cause of thick nails. Fungal infection can be prevented by keeping footwear dry and avoiding walking around barefoot in public places, especially locker rooms and showers.[10] 
  2. Injury: – Sudden or repeated trauma or injury can also result in thick nails. The people more prone to damage are involved in sport or exercise, such as soccer players, dancers, and runners. Other than these, ill-fitting shoes also cause nail injury.[10] 
  3. Yellow Nail Syndrome: – This condition affects both fingernails and toenails and causes the nails to become yellow, curved, and thickened. Yellow nail syndrome is the less common cause. In this condition, a person also experiences respiratory problems and swelling in the arms and legs due to a build-up of fluid around the lungs and limbs.[10] 
  4. Psoriasis: – Psoriasis is an autoimmune disorder that affects both skin and nails. Psoriasis affects both fingernails and toenails. A condition when psoriasis is the direct cause of thickened nails, ridges develop on the nails, and the nails may loosen and separate from the nail bed.[10] 
  5. Paronychia: – It is a skin condition that causes swelling and redness around the nails. Fingernails and toenails both become thick on multiple infections. Paronychia will be noticed when the layers of the nail start to peel off. People frequently sucking on their fingers, dishwashing, and trimming the nails and cuticles too much are more likely to develop paronychia infection. People with a job like bartenders, laundry workers, cleaners, cooks, etc. are more prone to infection.[10]

Conclusion:

Nails are the barometer of the overall health and thus; show whether the health is proper or not. Nails show changes in thickness, growth rate, texture, color, and shape with age. Toenails become thicker as compared to fingernails with age. Nail thickness can be measured via using a non-invasive method, i.e., 20 MHz ultrasound.        

The reason behind nails thickening due to age is a process called Oncocytes. Other reasons for nails thickening are fungal infection, injury, yellow nail syndrome, psoriasis, and paronychia. Thick nails are an unsightly condition, and if left untreated, can cause pain.

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