If the nail is affected in the distal 2/3 of the nail plate or on the surface of the nail plate, the brittle nail can be carefully scraped or the thickened nail thinned with a knife and applied with 30% glacial acetic acid or antifungal medication such as ciclopirox, amorolfine cream or rub until a new normal nail grows out. However, care should be taken to avoid injury to the perinail tissues and thus infection, especially in diabetic patients or those with impaired circulation to the extremities.