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Psoriasis thumb nail. Nail Psoriasis: Causes, Symptoms, and Effective Treatments

by alexxlab

What is nail psoriasis, and how can it be treated? Discover the causes, symptoms, and effective treatments for this common skin condition.

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Understanding Nail Psoriasis

Nail psoriasis is a type of psoriasis that affects the nails, causing a variety of changes and complications. It is a common condition, affecting up to 50% of people with psoriasis. Psoriasis is an autoimmune disorder that causes the rapid buildup of skin cells, leading to the formation of scaly, red patches on the skin. When this condition affects the nails, it can lead to a range of symptoms and challenges for those living with it.

Causes and Risk Factors of Nail Psoriasis

The primary cause of nail psoriasis is the same as that of other types of psoriasis – an overactive immune system. In people with psoriasis, the immune system mistakenly attacks healthy skin cells, causing them to grow and build up rapidly. This rapid cell turnover leads to the characteristic psoriatic plaques on the skin, and when it affects the nails, it can result in a variety of nail changes.

Certain factors can increase the risk of developing nail psoriasis, including:

  • Genetics: If a close family member has psoriasis, you are more likely to develop the condition.
  • Stress: High levels of stress can trigger or worsen psoriasis flare-ups.
  • Certain medications: Some medications, such as lithium and antimalarial drugs, have been linked to increased risk of nail psoriasis.
  • Injury or trauma to the nails: Physical damage to the nails can sometimes lead to the development of nail psoriasis.

Symptoms of Nail Psoriasis

Nail psoriasis can manifest in a variety of ways, and the specific symptoms can vary from person to person. Some of the most common symptoms include:

  • Yellowish-red discoloration of the nails
  • Thickening and crumbling of the nail
  • Pitting or denting of the nail surface
  • Separation of the nail from the nail bed (onycholysis)
  • White or yellow streaks on the nail
  • Nail loss (onychomadesis)

Diagnosing Nail Psoriasis

Diagnosing nail psoriasis typically involves a visual examination by a healthcare professional, such as a dermatologist. They may also perform a skin or nail biopsy to confirm the diagnosis and rule out other potential causes. It’s important to get a proper diagnosis, as nail changes can be associated with a variety of other conditions, such as fungal infections or lichen planus.

Treating Nail Psoriasis

Treating nail psoriasis can be challenging, as the nails are slower to respond to treatment compared to the skin. However, there are several effective treatment options available, including:

  1. Topical Treatments: Topical medications, such as corticosteroids, vitamin D analogues, and calcineurin inhibitors, can be applied directly to the affected nails to help reduce inflammation and promote nail growth.
  2. Systemic Treatments: Oral or injectable medications, such as methotrexate, cyclosporine, or biologics, may be prescribed for more severe cases of nail psoriasis or when the condition is affecting multiple nails.
  3. Nail Procedures: In some cases, healthcare providers may recommend more invasive treatments, such as laser therapy, injections, or surgery, to help improve the appearance and function of the affected nails.
  4. Lifestyle Changes: Maintaining good nail hygiene, avoiding trauma to the nails, and managing stress can also help in managing nail psoriasis.

Coping with Nail Psoriasis

Living with nail psoriasis can be challenging, both physically and emotionally. The changes to the nails can be unsightly and may cause discomfort or difficulty with daily activities. It’s important for those with nail psoriasis to seek support and work closely with their healthcare team to find the most effective treatment plan. Additionally, practicing self-care, such as using nail polish or wearing comfortable shoes, can help improve quality of life and boost confidence.

Preventing Nail Psoriasis Flare-ups

While it’s not always possible to prevent nail psoriasis flare-ups, there are some steps you can take to help manage the condition and reduce the frequency of outbreaks:

  • Maintain good nail hygiene by keeping nails trimmed and clean
  • Avoid trauma or injury to the nails, such as from vigorous nail trimming or manicures
  • Manage stress through relaxation techniques, exercise, or therapy
  • Stick to your prescribed treatment plan and follow your healthcare provider’s recommendations
  • Monitor for signs of flare-ups and address them promptly

Nail psoriasis can be a challenging condition to manage, but with the right treatment and self-care strategies, many people are able to effectively control their symptoms and maintain healthy nails. If you are experiencing any changes or concerns with your nails, it’s important to consult with a healthcare professional for proper diagnosis and treatment.

What is nail psoriasis, and how can I treat it?

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Nail Psoriasis: Picture, Symptoms, Treatment, Prevention

Written by Paula Ford-Martin

  • Symptoms of Nail Psoriasis
  • Prevention of Nail Psoriasis
  • Treatments for 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.

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

  • Color. Your nails may turn white, yellow, or brown. They may also have small red or white spots underneath.
  • Surface 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.

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.

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.

The treatments for nail psoriasis include:

Phototherapy. Ultraviolet light is used to treat skin psoriasis and may also be useful in nail psoriasis. The treatments usually take place in a doctor’s office or a clinic.

Medicines that work throughout your body. Your doctor may call these “systemic medications.” Some examples are:

  • Acitretin (Soriatane)
  • Apremilast (Otezla)
  • Cyclosporine (Sandimmune)
  • Methotrexate

Drugs that target specific parts of your immune system. You may hear your doctor call these “biologics.” They are given by injection under the skin, in a pill, or through an IV. Some examples are:

  • TNF-alpha inhibitors:
    • Adalimumab (Humira)
    • Certolizumab pegol (Cimzia)
    • Etanercept (Enbrel)
    • Etanercept-szzs (Erelzi)
    • Infliximab (Remicade)
  • Interleukin 17 inhibitors:
    • Brodalumab (Siliq)
    • Ixekizumab (Taltz)
    • Secukinumab (Cosentyx)
  • Interleukin 23 inhibitors:
    • Risankinumab (Skyrizi)
    • Guselkumab (Tremfya)
    • TIldrakizumab (Ilumya)
  • Interleukin 12 and 23 inhibitor:
    • Ustekinumab (Stelara)

Medicine you apply directly to your nails. Your doctor may call these “topical” drugs. For nail psoriasis, they may suggest a corticosteroid (such as clobetasol), vitamin D, or retinoid creams that you rub into your nail and cuticle every day.

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.

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