Nail Psoriasis

If you have psoriasis and you notice some changes in your nails, there are many treatments you can turn to for help.

Nail psoriasis alters the way your toenails and fingernails look. They may get thick, develop pinprick holes and change color or shape. They also can feel tender and hurt.

You can treat these problems with medicine. Cosmetic repairs can make your nails look better.

Symptoms of Nail Psoriasis

You'll know you're getting nail psoriasis when you see these changes in your fingernails or toenails:

  • Color. Your nails may turn green, yellow, or brown. They may also have small red or white spots underneath.
  • nail psoriasisSurface appearance. You may get ridges or grooves in your nails, or pitting (small pinprick holes) on the nail surface.
  • Debris buildup. Chalky white material can gather under your nail, causing it to lift away from the skin. This can be painful.
  • Thickening. About a third of people with nail psoriasis can also get a fungal infection that can cause your nails to get thick. They may also get brittle and break.
  • Separation. Your nail may loosen or separate from the nail bed.

Some of these nail changes can make it hard to move your fingers and toes. You may also get tenderness and pain in your nails. This can make it hard to do things with your hands.

Prevention of Nail Psoriasis

Good nail care is the best way to treat nail psoriasis. Try these prevention tips:

  • Keep your nails trimmed short.
  • Use a nail file to keep nail edges smooth.
  • Wear gloves to clean and do other work with your hands.
  • Moisturize your nails and cuticles every day and after they've been in contact with water.
  • Wear comfortable shoes with enough room for your toes.

If you're unhappy with the way your nails look, try nail varnish or artificial nails. They can also protect your nails from more damage. Some people are sensitive to the chemicals in varnish and nail adhesive. Talk to your doctor about whether these are right for you.

Treatments for Nail Psoriasis

The same treatments you get for skin psoriasis can also treat your nail psoriasis. Because your nails grow slowly, it can take time before you see any improvements in the newly grown parts of your nail.

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The treatments for nail psoriasis include:

If your nails are thick, the medicine you apply may have a hard time getting inside. Gels or ointments that contain urea can help thin them.

Your doctor may also prescribe a nail lacquer that hydrates and strengthens your nails. You apply it every day in the same way you put on nail polish.

  • Corticosteroid injections. These are put under your nail surface every 2-9 months. Your doctor will numb the area or use a nerve block to reduce pain.
WebMD Medical Reference Reviewed by Stephanie S. Gardner, MD on November 02, 2018

Sources

SOURCES:

The Psoriasis and Psoriatic Alliance: "Nail Psoriasis."

National Psoriasis Foundation: "Hands, Feet, and Nails," "Moderate to Severe Psoriasis: Biologic Drugs."

The Psoriasis Association: "Psoriasis Treatments."

Radtke, M. Patient Related Outcome Measures, Dec. 22, 2010.

de Vries, A.C. Cochrane Database of Systemic Reviews, Jan. 31, 2013.

Dogra, A. Indian Journal of Dermatology, July-August 2014.

Oram, Y. Dermatology Research and Practice, 2013.

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