Nail psoriasis causes changes to the fingernails and toenails, ranging from discoloration to alterations in the nail bed. There are various treatment options, such as hydrocortisone cream and corticosteroid injections.
The condition can have a physical and emotional impact on a person and affect their quality of life. It can take time for symptoms to improve, but treatment is available.
A study published in 2016 noted that 80–90% of people with psoriasis may also have nail psoriasis. It is even more prevalent in people with psoriatic arthritis.
This article will discuss nail psoriasis in more detail, including its causes, symptoms, and treatments.
Usually, skin cells reproduce every
Nails are part of the skin. They grow from the nail root just under the cuticle, where psoriasis affects them. Nail psoriasis is a chronic condition of the immune system. It is an autoimmune condition, meaning the immune system mistakenly attacks the healthy nail tissue.
A person with nail psoriasis may have the following problems with their nails:
- dents or holes
- white spots
- grooves
- changes in shape or size
- thickening
- onycholysis, separation of the nail from the nail bed
- crumbling
- discoloration
- blood streaks
If the nail becomes detached from the nail bed, an infection can develop in the gap. When this happens, a yellowish patch may form on the tip of the nail and extend to the cuticle.
A chalky substance may develop under the nail, also creating a gap. This condition is known as
The nail may feel uncomfortable or painful when a person applies pressure, and an affected toenail may hurt when wearing shoes. The condition can make it difficult to perform specific tasks, such as sewing.
Certain nail care measures may help relieve symptoms and prevent the area from becoming infected.
For example, while working with the hands, it is a good idea to wear rubber or cotton gloves. This can protect the hands from injury and the fingers from harmful bacteria. It can also help protect the nails from corrosive materials such as cleaning agents. However, a person should avoid latex gloves, which can irritate sensitive skin.
The American Academy of Dermatology Association (AAD) recommends that a person with nail psoriasis keep their toe- and fingernails trimmed and clean to prevent bacteria from building up and refrain from cleaning the nails with a sharp object. If having a manicure, a person should request the manicurist not to push back or touch the cuticles.
As much as possible, a person should avoid biting or picking their nails or the surrounding skin.
Rubbing moisturizers into the nail and cuticle helps to keep the nails soft. A pharmacist or healthcare professional can advise about suitable products that prevent the hands, feet, and nails from becoming too dry. A thick, fragrance-free product is best.
Nail psoriasis is not contagious. Treatment can reduce or help control the symptoms.
If the nails show symptoms of psoriasis or fungal infection, a person should contact their doctor. This is especially important for people who already have a type of psoriasis.
A person may have to try several treatments before finding one that works. Symptoms can take time to improve and may take up to a year to clear. One reason for this is that the nail plate grows very slowly. The symptoms may also return at a later date.
With new drugs appearing on the market, more effective treatments for nail psoriasis may be on the horizon.
There is currently no cure for psoriasis. Anything that irritates the skin can cause the condition to flare up. The AAD offers the following advice to avoid flare-ups whenever possible:
- protect the skin from sunburn
- use a cold compress
- moisturize regularly
- avoid scratching
- avoid stress
- avoid skin injuries such as cuts and bug bites
Below are answers to some commonly asked questions about nail psoriasis.
Can I hide nail psoriasis?
If a person wants to hide the effects of nail psoriasis, they should talk with their dermatologist about the best options. Sometimes using nail polish or having a professional manicure might help, though a person should take care not to touch the cuticles and tell their nail technician about their condition. Certain types of nail polish and nail polish remover for people with sensitive skin do not contain the harsh chemicals that regular products do.
Does nail psoriasis spread?
Unlike a fungal infection, nail psoriasis does not spread through contact. Without treatment, nail psoriasis may get worse. In severe cases, it may become difficult for a person to use their hands or feet because of the discomfort of nail damage. Untreated, it can also lead to joint problems.
Is there a cure for nail psoriasis?
There is currently no cure for nail psoriasis. However, many treatment options may make the condition more comfortable. Even if a person’s nail psoriasis is severe, there are many ways to avoid or manage flare-ups. Symptoms may take up to a year to clear.
How does nail psoriasis look on skin of color?
People of Color with nail psoriasis may develop what looks like small pinpricks on the nail. The nails may also become thicker, crumble, and develop discoloration. Nail psoriasis can mimic other conditions. Often, a doctor
Nail psoriasis does not always cause physical pain but may cause embarrassment. Doctors often use a scoring system to help determine the severity of symptoms. Treatment can prevent the condition from worsening.
Nail psoriasis can resemble a fungal infection, making diagnosis difficult. Getting a correct diagnosis is vital because the treatment for a fungal infection is different from nail psoriasis treatment. Anyone with psoriasis who experiences changes in their nails should make sure their doctor is aware of their psoriasis.