Most people assume that anything that makes toenails thick and ugly must be a fungal infection. That may not always be the case. Toenails too thick to trim with standard clippers might also be caused by a bacterial infection. Anti-fungal treatment won’t work for such a problem. Some readers report that Neosporin (bacitracin, neomycin, polymyxin) worked against thick toenails caused by a bacterial infection. Another reader may have bumped into green nail syndrome.
Yellow Crumbly Nails:
Q. I have had yellow, crumbly toenails for years and assumed it was nail fungus. Nothing worked, though.
After reading about using Neosporin, I tried my OTC three-antibiotic cream. What amazing results! I had major improvement surprisingly fast. I apply three times a week before bed and put on socks to protect the sheets.
A. Thanks for sharing your story. Some “nail fungus” may actually be bacterial. That could explain why a number of cases respond to antibiotic ointment after failing to respond to antifungal treatments.
Green Nail Syndrome:
Q. My husband has toenail fungus that has made his big toenails green. He doesn’t usually remember to put anything on them. I have him just soaking his sock, while he is wearing it, with Listerine. Will this help or not?
A. It’s possible that your husband might have green nail syndrome. Dermatologists call this condition chloronychia. It is not caused by fungus, although fungus may also be present. Instead, a bacterial infection such as Pseudomonas aeruginosa is usually responsible (Clinical Interventions in Aging, Jan. 14, 2015).
One test you could perform at home involves dropping a clipping of the affected nail into a small amount (1 ml) of distilled water. After a day, the water turns bluish-green if P. aeruginosa is the cause. We recommend that he see a podiatrist or a dermatologist to confirm the diagnosis.
Soaking the nail in dilute vinegar may help. Sometimes, topical antibiotics such as Neosporin or Polysporin can also fight this infection.
Most likely the expert will recommend keeping the nails dry. These bacteria flourish in a damp environment. That’s why soaking his socks in Listerine while he is wearing them might not be the best approach, even though this mouthwash has both antifungal and antibacterial activity.
Mehaz for Toenails Too Thick to Clip:
Q. Not long ago, you wrote about toenails too thick to clip. I’ve had this problem and use a wide-jaw toenail clipper by Mehaz. It does the trick.
Not all hard, thick toenails are caused by fungal infections. I’ve been dealing with this for seven years on both my big and little toes.
My primary physician wasn’t concerned, saying it’s just cosmetic. Nonetheless, I’ve tried lots of prescription and non-prescription medications, to no avail.
Recently, I saw a podiatrist who took specimens of the nails for analysis. The problem wasn’t fungal, but rather bacterial. He recommended an inexpensive antibacterial ointment such as Neosporin.
It’s working wonders. Three of the nails are clear and the fourth, the worst, has but a speck remaining.
A Spelling Bee Brain Buster: Onychauxis:
A. I will bet that unless you are a dermatologist or a podiatrist, you have never heard of the word onychauxis. I’ll double that bet if you think you know how to pronounce onychauxis. That is the medical term for toenails too thick to clip.
Want to know how to pronounce it? Here is a link. Did I win the bet? But wait…here is another way to pronounce onychauxis. But wait, it gets worse: onychauxis. And here is the pronunciation of onychauxis with British, Australian and American English. Why do dermatologists come up with such tongue twisters for something as simple as thickened toenails? By the way, the medical term for a separation of the nail from the skin is onycholysis and the term for nail fungus is onychomycosis. More about these terms in a few seconds.
Although thick, discolored nails are often caused by fungal infections, other conditions, such as psoriasis, can also create this problem. One study found that 32 percent of patients with nail disorders did not have detectable fungi (Journal of Cosmetic Dermatology, July 2021).
The authors conclude:
“Although fungal pathogenic agents are mostly detected among the diseases causing color changes and deformities in the nails, it should be kept in mind that nail findings of systemic or other skin diseases may mimic onychomycosis and the diagnosis should be confirmed by laboratory tests in addition to clinical manifestations for accurate treatment.”
In a different study, researchers used DNA sequencing and found that half of the toenail infections were bacterial (Journal of the American Podiatric Medical Association, March 1, 2021).
The authors provide this background:
“It is well established and accepted that fungi are a major contributing factor in nail dystrophy. It has also been recognized that bacteria play a crucial role in onycholysis. However, the bacteria and fungi that can be grown on culture media in the laboratory are only a small fraction of the total diversity that exists in nature.”
They conclude:
“Toenails tested with DNA sequencing demonstrated the presence of both bacteria and fungi in many samples. Further work is required to fully investigate its relevance to nail pathology and treatment.”
What to Do About Toenails Too Thick to Clip?
A diagnostic workup makes sense, especially if the nail problem has not responded to standard treatments. Toenails grow slowly, so it can take months for them to grow out healthy. You can learn more about various remedies for nail fungus in our *free* eGuide to Hair and Nail Care. This downloadable PDF can be found in the Health eGuides section of this website.
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