What is nail psoriasis?

Nail psoriasis is an autoimmune disorder that can be identified as changes to the fingernails and the toenails. This disease causes discolouration, pitting and changes in the nail structure. The disorder is not contagious and with the correct treatment, the conditions can improve. 

Nail psoriasis can affect anyone, irrespective of any pre-conditions. However, you are more likely to develop this disorder if:

• You are more than 40 years of age.
• You are genetically inclined to develop psoriasis due to a family history.
• You have psoriatic arthritis.

Click here to Book Arthritis Screening Check-Up!

Symptoms of nail psoriasis

It is important to be able to identify nail psoriasis symptoms, so you can start the treatment as early as possible. Some of these symptoms are:

• Pitting: If you observe any dents or pits on your nail, it could be nail psoriasis. The pits can be extremely small (0.4 mm) or larger (2 mm). You can also have any number of pits on the nails.

• Discolouration: In cases of nail psoriasis, the nail bed changes colour. The patches, also called oil drop spots or salmon patches, appear red, pink, yellow or brown. 

• Nail structure: A nail psoriasis symptom can be changed in the nail structure. The nails might become extremely thin and crumble. Grooves might develop horizontally across the nails. In some cases of nail psoriasis, nail fungus might develop.

In some cases, the discomfort and tenderness might affect the ability to walk or stand and/or use the hands. 

Tiny dents in the nail (pits), white discoloration, and lifting (the nail is separating from the finger) are all common signs of nail psoriasis. It is often treatable with medications or laser. Consulting your dermatologist early helps.

Dr. M.G. Kartheeka, MBBS, MD

Prevention of nail psoriasis

Maintaining personal hygiene is a good way to prevent the occurrence of nail psoriasis.

• Always keep the nails short.
• Use a nail file to smoothen the edges of the nail.
• Wear gloves while handling chemicals like washing dishes and washing clothes.
• Moisturise the hands, cuticles and nails every day.
• Wear comfortable and roomy shoes. 

Causes of nail psoriasis

There are no specific nail psoriasis causes as this is an autoimmune disorder. For healthy people, new skin cells grow every 28 to 30 days. For people with nail psoriasis, new cells grow every 3 to 4 days and when it moves to the skin surface, it creates a skin rash. 

If someone has skin psoriasis, they may also have nail psoriasis. 

Also Read: What Causes Hangnails: Insights from Dermatological Research

Without treatment, nail psoriasis may worsen. Nails may become uncomfortable or even painful. You may have trouble performing your daily activities, it is not a fungal infection but an autoimmune condition. Nail changes can also be a sign of a type of arthritis called psoriatic arthritis.

Dr. Ashish Bajaj – M.B.B.S, M.D.

Nail psoriasis treatment

If you suspect you have nail psoriasis, contact your healthcare provider. This disorder might not be curable by most treatment plans. Some nail psoriasis treatment options are:

• Corticosteroids: Corticosteroids are an effective nail psoriasis treatment and they can be in the form of an ointment, cream or nail polish. The medication must reach the nail bed and the area of the finger from where the nail starts to grow.

The medication has to be applied twice a day and it will take about 4 to 6 months to see any noticeable improvements.

• Oral medicines: A nail psoriasis treatment for more serious cases, there are some liquid medicines and tablets. These medicines are methotrexate, apremilast and cyclosporine.

• Injections: Another treatment plan is the use of injections. A thin needle is used to inject medicines like adalimumab, ustekinumab and etanercept into the skin around the nails.

• Phototherapy: This treatment for nail psoriasis uses ultraviolet light from special lamps. These rays are used in combination with a drug called psoralen.

• Laser therapy: Laser therapy treatment involves the use of a pulsed dye laser that targets the blood vessels under the nails, reducing the severity of the disorder. This nail psoriasis treatment occurs once every 6 months. 

If you have nail psoriasis, you might feel self-conscious about your nails. In this case, you can apply nail polish or lightly buff the nails. But avoid fake nails, as they can make the situation worse and further damage the nail bed.

Also Read: Brittle Nails: Causes, Symptoms, and Proven Solutions

Pay attention to your nails. In case you notice any changes, contact the healthcare provider immediately.

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

Links and product recommendations in the information provided here are advertisements of third-party products available on the website. PharmEasy does not make any representation on the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.