Onychauxis

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What Is Onychauxis?

Onychauxis is a condition characterized by the abnormal thickening of the nails, usually affecting the toenails more than the fingernails. This thickening can make the nails difficult to trim and may lead to discomfort or pain when wearing shoes.

Symptoms

  • Thickened Nails: The primary symptom is the noticeable thickening of the nails, often more pronounced in the toenails.
  • Discoloration: The nails may appear yellowish or brown.
  • Brittleness: Thickened nails can become brittle and prone to splitting or crumbling.
  • Discomfort or Pain: Thick nails can press against shoes, causing discomfort or pain, especially when walking.
  • Difficult to Trim: The nails may become tough to cut with regular nail clippers.

Causes

Several factors can contribute to the development of onychauxis, including:

  • Aging: As people age, nails can naturally thicken.
  • Repeated Trauma: Continuous pressure or injury to the nails, such as from tight-fitting shoes, can cause thickening.
  • Fungal Infections: Fungal infections can lead to nail thickening and discoloration.
  • Psoriasis: This skin condition can affect the nails, causing them to thicken.
  • Peripheral Vascular Disease: Poor blood circulation to the extremities can contribute to nail thickening.
  • Genetic Factors: Some individuals may be genetically predisposed to developing thick nails.

Diagnosis

Diagnosis of onychauxis involves:

  • Physical Examination: A healthcare provider will examine the thickened nails and assess the extent of thickening and any associated symptoms.
  • Medical History: Discussing the patient’s medical history, including any underlying conditions or previous nail injuries.
  • Nail Clipping Analysis: A sample of the thickened nail may be taken to check for fungal infections or other abnormalities.
  • Imaging Tests: In some cases, X-rays may be used to assess underlying bone or tissue changes.

Treatment

Treatment for onychauxis focuses on managing symptoms and addressing underlying causes:

  1. Proper Nail Care:
    • Regularly trim and file thickened nails to manage their growth and reduce discomfort. Using specialized nail clippers for thick nails can help.
    • Soak nails in warm water before trimming to soften them.
  2. Fungal Infection Treatment:
    • Topical Antifungals: Apply antifungal creams or lacquers to the affected nails.
    • Oral Antifungals: For severe infections, oral antifungal medications may be necessary.
  3. Footwear Adjustments:
    • Wear properly fitting shoes with enough room to avoid pressure on thickened nails.
    • Use cushioned insoles or pads to reduce pressure on the toes.
  4. Managing Underlying Conditions:
    • Treat any contributing medical conditions, such as psoriasis or peripheral vascular disease, with appropriate medications and therapies.
  5. Professional Care:
    • Regular visits to a podiatrist can help manage thickened nails effectively. A podiatrist can trim and file nails professionally and provide additional treatments if necessary.

Summary

By addressing the root causes and following proper nail care routines, onychauxis can be effectively managed.

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