There are several different causes of thickened toenails. Fungal nail infections and repeated trauma to the nail are among the most common causes we see.
Age is another common trigger — metabolic changes and reduced circulation to the nail can contribute to gradual thickening over time.
Fungal Nail Infection
One of the most common causes — the nail becomes discoloured, brittle and progressively thicker as the infection develops.
Trauma
Repeated impact or injury to the nail — from sport, ill-fitting footwear or a single significant knock — can cause permanent thickening.
Age-Related Changes
Metabolic changes and reduced circulation to the nail bed as we age are a common and often overlooked contributor to nail thickening.
Psoriasis
A long-term condition that often affects the nails alongside red, flaky patches of skin elsewhere on the body.
Footwear Pressure
Long-term pressure from shoes that are too small or too narrow over the toes places repeated stress on the nail bed.
Reactive Arthritis
A condition where the immune system responds to an infection elsewhere in the body — nail changes can be one of the presenting signs.
It's recommended that you have your nails checked by an HCPC-registered podiatrist or chiropodist to establish how and why the nail has become thickened. Your podiatrist can examine the nail, confirm the underlying cause, and provide the treatment needed to ease your symptoms and improve the condition.
Get an accurate diagnosis before treating. Thickened nails can have several different underlying causes — fungal infection, trauma, psoriasis or reactive arthritis among them — and the right treatment depends on identifying which one applies. Self-treating without an accurate diagnosis can delay effective care.
Your feet will be thoroughly evaluated by our podiatry team. Our experienced podiatrists can reshape the nail, reduce the thickened mass, cut the nail properly, or remove it where necessary. We'll then discuss your aftercare and arrange review appointments as needed.
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Assessment & Diagnosis
We examine the nail to establish the underlying cause — fungal infection, trauma, age-related changes or another contributing factor — before deciding on treatment.
02
Nail Reduction & Reshaping
Using specialist podiatry instruments, the thickened nail is safely reduced and reshaped to relieve pressure and discomfort in footwear.
03
Discussing Your Treatment Options
The different treatment options available for your specific presentation will be discussed with you, and a treatment plan outlined so you understand what to expect.
04
Aftercare & Review
We'll talk through aftercare and arrange review appointments as required, so your nails stay comfortable and manageable between visits.
05
Education & Self-Care
We aim to educate every patient and give you the tools to stay injury-free, with practical guidance on footwear and nail care to reduce recurrence.
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Accurate diagnosis firstWe identify the underlying cause before recommending treatment — not a one-size approach.
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HCPC-registered podiatristsExperienced, regulated practitioners providing safe, professional nail care.
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Safe nail reductionReshaping, reduction or removal carried out with specialist sterile instruments.
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Clear aftercare guidanceWe explain your treatment plan and review arrangements so you know what to expect.
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Five-star patient reviewsConsistently rated 5.0 on Google by patients across Richmond and Kensington.
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No referral neededBook directly online or by phone — no GP referral required.
Is a thick nail always caused by fungal infection?
No. Fungal infection is a common cause, but thickened nails can also result from trauma, age-related changes, psoriasis, reactive arthritis or long-term pressure from footwear. An accurate assessment is needed to confirm the cause before treatment.
Does treatment hurt?
No — reducing and reshaping a thickened nail is a straightforward, comfortable procedure using specialist instruments. Most patients feel immediate relief in their footwear afterwards.
Will the nail go back to normal?
This depends on the underlying cause. Where the cause can be resolved — such as a treated fungal infection or removing a source of footwear pressure — the nail can improve over time as it grows out. Where the change is age-related or due to a chronic condition, ongoing reduction and maintenance is often the most effective long-term approach.
How often will I need to come back?
This varies depending on the cause and how quickly your nail grows. We'll agree a review schedule with you at your first appointment, tailored to your specific presentation.
Do I need a referral?
No — you can book directly online or by phone without a GP referral.
Book your thick nail assessment
Richmond and Kensington clinics available. No referral needed.
