Thickening toe nails?

Maybe fungus?: When patients (and many non-dermatologist physicians) see this problem they automatically assume it's a fungal infection but this is only true about 50% of the time. There are several other non-infectious causes of thickened nails including psoriasis, chronic friction/trauma, and hereditary causes. See a dermatologist who may want to take a sample of the nails for a fungal culture and/or biopsy.

See podiatrist: Could be fungus, dystrophy which is thickness without fungus - a scrapping of the toenail can be sent to a pathology lab to find out if there is fungus present.

Nail biopsy first: When patient have thick dystrophy nails they should get a nail biopsy before any treatment. As we wait for the biopsy the patient should begin a topical treatment of urea to soften the nail and an antifungal that cover yeast and dermatophytes. When the biopsy result arrive the nail should be treated as properly. Oral treatment for nail fungal should be add if the nail biopsy comes by positive.