Condition Basics

What is nail psoriasis?

Many people who have psoriasis have nail changes. This can involve:

• Pitting on the surface of the nail.
• Defects in the nail, such as ridges or crumbling nails.
• Yellowish colour to the toenails (and sometimes fingernails).
• Thickening of the fingernails or toenails.
• Spots under the fingernails, such as yellow-red patches.
• Separation of the nail from the nail bed.
• Total loss of the nail bed.

Nail changes rarely happen without other signs of psoriasis. And sometimes changes in the nails can confirm a diagnosis of psoriasis. Nail problems happen most often in people with psoriatic arthritis.

How is it diagnosed?

Your doctor can often recognize psoriasis by looking at your skin, scalp, and nails. Special tests usually aren't needed.

How is nail psoriasis treated?

Psoriasis of the nail can be very hard to treat, and treatment is not always successful.

Treatments include some of the same topical and systemic therapies that are used to treat psoriasis that affects the skin. In some cases, medicines can be injected into the nail bed.

Treatments take time to work, and you may not see improvement for months. New, healthy nails may need up to a year to grow.

How can you care for your nails?

Here are some tips you can try to protect your nails.

• Soak them before trimming.
• Trim them short and file the edges smooth to avoid injuring them or scratching yourself.

  Avoid excessive cleaning under the nail, because it may promote psoriasis scale buildup.

• Do not cut, tear, or bite the skin around your nails (cuticles).
• Use colourless nail polish to protect your nails.
• Wear gloves when working with your hands.
• Follow instructions for prescribed medicines.