You may know that psoriasis is a condition that affects the skin, but what about the nails? Nail psoriasis is the term for the changes in your fingernails and toenails that occur as a result of having psoriasis. Up to half of all people who have psoriasis will have nail psoriasis as well.
While it’s not a life-threatening condition, nail psoriasis can affect your quality of life, since it may cause you discomfort and affect your self-esteem, and it may also put you at greater risk of developing psoriatic arthritis. Although it cannot be cured, nail psoriasis can be helped with treatment.
Nail psoriasis occurs because psoriasis affects the process of nail formation. People who have nail psoriasis usually have psoriasis on other parts of their body, such as the skin and joints. Rarely does someone have only psoriasis of the nails.
Symptoms of nail psoriasis vary but may include:
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• Discoloration of the nail to yellow-brown
• Pitting (holes) in the surface of the nails
• Horizontal lines across the nails
• White patches on the nails
• Thickening of the nails
• Nails that separate from the nail bed
Treatment Options
Your treatment will depend on the type of nail psoriasis you have and how severe it is. If you have psoriasis that affects other parts of your body, the treatments your doctor recommends to alleviate those symptoms may also help your nail psoriasis.
Other options for nail psoriasis include:
• Topical treatments—These medications are applied to the nails:
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o Dovonex (calcipotriene): a form of synthetic vitamin D3 that can slow cell growth
o High-potency corticosteroids: anti-inflammatory medications that can be applied to the nails temporarily
o Cordran (flurandrenolide): a steroid medication that is in the form of a tape that can be applied to the nails
o 5-fluroruracil cream: a topical treatment that often helps with nail pitting
o Tazorac (tazarotene): a topical medication that can slow cell growth
• Corticosteroid injections—In some cases, having steroid medications injected into your nail bed or matrix can temporarily improve nail psoriasis symptoms.
• Phototherapy. A type of phototherapy known as PUVA (psoralen and ultraviolet light A) uses UVA light plus a light-sensitizing medication called psoralen. When your skin or nails are sensitized to UVA rays, excessive cell production can be slowed. PUVA for nail psoriasis may involve taking psoralen orally or painting it onto the nails before UVA treatment.
• Cosmetic nail repair. Sometimes surgery or the application of a urea compound is necessary to remove deformed nails. In cases where nails are excessively thick and long, they can be filed down. If nails are discolored or otherwise cosmetically deformed, the deformity can be covered up with nail polish or artificial nails. And pitted nails can be buffed and polished.
Maintaining Good Nail Shape
In addition to following your doctor’s recommendations involving treatment for nail psoriasis, there are other ways to take care of your nails:
• Keep your nails trimmed as short as possible.
• Wear gloves when you’re working with your hands.
• Wear shoes with plenty of room in them.
• Avoid scrubbing or scraping underneath your nails.
• Use gentle nail-cleaning tools.
• Soak your nails in tar bath oil mixed with water, then apply nail moisturizer.
• If your nails are intact, consider using a nail hardener to improve their appearance.
Taking good care of your nails can minimize the effects of psoriasis-associated nail changes.
