Understanding Thickening of Nail Plates and Beds in Older Women

I have noticed that older ladies, say 60+, have a lot thicker nails that are sometimes challenging to cut even with professional equipment! Also, sometimes this is accompanied by a thickening of the nail bed underneath which attaches itself to the nail plate as it grows. I never cut the nail bed as this can cause all manner of problems, least of which is bleeding.

Causes of Thick Nails in Older Women

What causes thickening of the nail plate and bed in this age group? For both healthy toes and fingers, the thickness of the nail plate is determined solely by the length of the nail matrix where the nail plate cells are created. The matrix does not suddenly grow longer, so the nail plate under most circumstances won’t suddenly begin to grow thicker. Several things can cause the plate to appear thickened.

Understanding the Factors Behind Nail Plate and Bed Thickening

For example, if the layers of the nail plate begin to separate, the plate will appear to thicken. An example is a roll of toilet paper. The roll will appear to thicken when it becomes wet, not because there is more paper on the roll, but because the layers are slightly farther apart. Thickening can happen when the nail plate is infected by fungal organisms. Fungi eat keratin, which causes the plate to loosen and come apart.

Separation of Nail Layers: An Illusion of Thickening

Minor damage or constant irritation to the nail bed itself can cause it to produce some nail cells. Under normal circumstances, all nail cells in the plate come from the matrix area at the base of the nail plate. However, this can change if the nail is injured. Under some circumstances, the nail bed can contribute additional nail cells to the bottom of the nail plate, likely as a protective measure.

Fungal Infections: Culprits of Nail Plate Thickening

One more thing that should be understood. It is unlikely that the nail bed would remain attached to the plate, but the hyponychium can be firmly attached and be dragged outward with the nail plate as it grows. This can happen on both toes and fingers. The hyponychium is a seal that protects the nail bed from infection. When the nail is injured, sometimes this tissue remains attached to the bottom of the nail plate, it stretches as it grows, which can become painful. You are correct, this would bleed if cut.

Hyponychium: The Tissue Connection to Nail Plate Growth

In medical terms, when living skin is abnormally stretched like this, it is called “pterygium”. This word is sometimes misused by nail professionals when applied to normal tissue. Pterygium is an abnormal growth of living skin and can occur on several parts of the body, including the nails. What causes this abnormal growth? When it occurs under the free edge, it is often caused by injury, which is another reason why it is unwise to cut this tissue. Doing so will only worsen the condition and can lead to infections.

Pterygium: Abnormal Skin Growth and Nail Injuries

Even though the plate can appear to thicken due to fungal infections, infected nail plates are being broken down and are coming apart to create an illusion that the nail plate has grown thicker. These infections often cause the plate to crumble or come apart more easily. Infection, disease, injury, irritation, or allergic reactions can cause the fingernails to form pterygium.

Unraveling the Truth About Nail Plate Thickening

On the toes, the growth of pterygium is often a result of injury or diseases.  The injury doesn’t have to be severe, but it won’t be caused by minor injury. Some believe injury can also contribute to nail plate thickening, e.g., constant or repeated injury or irritation to the toes, but that is questionable based on how the nail plate grows. It would be best to refer them to a podiatrist or their own medical doctor.

Pterygium on Toes: Causes Beyond Injuries

Even so, I’d also recommend talking to these clients about their footwear so they can identify any irritation or injury to that area since this can also lead to onycholysis. If the condition becomes painful or infected, they should be referred to a medical professional.

Seeking Professional Help: When to Consult a Podiatrist

In conclusion, understanding the reasons behind the thickening of nail plates and beds in older women is crucial for proper care. Whether it’s the separation of nail layers, fungal infections, or abnormal skin growth like pterygium, taking precautions and seeking professional help when needed can help maintain healthy nails and prevent complications. Stay informed and prioritize nail health as a part of overall well-being.

Preventing Nail Troubles: Footwear and Onycholysis Awareness

Remember, thickened nails in older women can pose challenges when it comes to cutting them. It’s important to be cautious and avoid cutting the nail bed, which can lead to various problems, including bleeding. Instead, let’s delve into the factors that contribute to nail plate and bed thickening.

When the layers of the nail plate start to separate, it creates an illusion of thickening, similar to a wet roll of toilet paper appearing thicker due to increased separation between layers. Additionally, fungal infections can cause the nail plate to loosen and come apart, leading to thickened appearance.

Furthermore, minor damage or constant irritation to the nail bed can prompt it to produce additional nail cells, potentially contributing to thickening. While nail cells typically originate from the matrix area at the base of the nail plate, injury can alter this process, with the nail bed producing more cells as a protective mechanism.

It’s worth noting that although the nail bed doesn’t usually remain attached to the nail plate, the hyponychium, a protective seal for the nail bed can be dragged outward as the nail plate grows, especially in cases of injury. It’s crucial to avoid cutting this tissue to prevent further complications and bleeding.

“Pterygium” refers to abnormal growth of living skin, which can occur on various body parts, including the nails. Nail professionals sometimes misapply this term to normal tissue. When pterygium occurs under the free edge of the nail, it’s often a result of injury. Cutting this tissue can worsen the condition and lead to infections, making it important to exercise caution.

While fungal infections may give the illusion of thickening, they actually break down and separate infected nail plates, rather than causing true thickness. Pterygium formation can be attributed to various factors such as infection, disease, injury, irritation, or allergic reactions.

On the toes, pterygium growth often stems from injuries or underlying conditions, but it’s important to note that minor injuries are unlikely to contribute significantly to nail plate thickening. In such cases, it is advisable to refer individuals to a podiatrist or a medical doctor for proper evaluation and guidance.

Encourage clients to evaluate their footwear for any potential sources of irritation or injury to the toes, as this can also lead to a condition called onycholysis. If the thickened nails become painful or infected, it is crucial to seek professional medical assistance promptly.

By understanding the causes and taking appropriate precautions, individuals can maintain healthy nails and mitigate potential complications. Prioritizing nail health and seeking professional help when necessary are essential steps toward overall well-being.