Psoriaticnail diseasecan also lead to progressive damage to the nails.
It also shows photos of nail psoriasis so you could see what it looks like.
What Causes Nail Psoriasis?
Illustration by Ellen Lindner for Verywell Health
Nail psoriasis is an autoimmune disease like skin psoriasis.
Autoimmune means that the body’s immune system sees normal tissues as harmful and attacks them.
Although the skin is the main target of psoriasis, other tissues are affected, too.
NEJM.org
When it happens in the skin, psoriasis plaques develop.
Nail psoriasis cannot be spread to another person since its an autoimmune disease, not an infection.
It’s also possible to have nail psoriasis and nail fungus.
Trevor Knowles / Getty Images
In general, there are some key signs of nail psoriasis that affect how the nail looks.
The condition usually affects a few digits, rather than just one.
This photo contains content that some people may find graphic or disturbing.
How Is Nail Psoriasis Diagnosed?
There are no blood tests or imaging studies to diagnose psoriasis.
Under a microscope, psoriatic tissues will typically have cells that are dense and tightly compacted (acanthotic).
This process is called adifferential diagnosis.
Using certain substances or taking certain medications can also cause nail changes.
Treatments for nail psoriasis can be topical, oral, or injected.
Your provider might want you to use more than one treatment.
Topical Steroids
Topical steroidsare sometimes used to reduce localized inflammation.
While helpful in treating skin psoriasis, they can be hard to apply to the nails.
Overusing topical steroids can lead to permanent skin thinning (atrophy) in the treated area.
Calcipotriol
Calcipotriolcomes from vitamin D. It is applied topically twice daily to the affected nail.
It is available in a 50-micrograms-per-gram (mcg/g) formulation.
Tazarotene
Tazaroteneis a topical retinoid product used to treat acne and plaque psoriasis.
Several studies have shown it to be safe and effective at treating nail psoriasis as well.
Triamcinolone acetonideis the most commonly used steroid that is put directly into the affected area (intralesional).
Its usually prescribed in a single 0.1-milliliter (mL) injection given in four places around the nail.
Pain is the most common side effect of the treatment.
Systemic therapies to treat nail psoriasis usemedicationsthat quiet the immune response that triggers nail changes.
One example isphototherapyusing ultraviolet (UV) lamps.
While oral retinoids like acitretin can treat nail psoriasis, their benefits depend on the dose.
Summary
Nail psoriasis is resulting from the same immune system response as skin psoriasis.
Many treatments, like prescription medications, are used to treat nail psoriasis.
Other options like phototherapy might help, but they are not always as effective for nail psoriasis.
Nails on the hand regrow in about three months.
Nail psoriasis in toenails can take six months to look better because of they grow more slowly.
it’s possible for you to use nail polish to cover up nail psoriasis.
However, you should not wear artificial nails.
Fake nails or tips can damage your nails and trigger a flare-up of nail psoriasis.
Stress does not cause nail psoriasis, but it can trigger a flare-up.
Psoriasis of the nails is an autoimmune condition, and stress is a common trigger for autoimmune disease symptoms.
2017;7:51-63. doi:10.2147/PTT.S126281
American Academy of Dermatology Association.What is nail psoriasis?
National Psoriasis Foundation.Nail psoriasis.
American Academy of Dermatology Association.Nail fungus: Signs and symptoms.
Centers for Disease Control and Prevention.Fungal nail infections.
The Psoriasis and Psoriatic Arthritis Alliance.Psoriasis in the nails.
National Psoriasis Foundation.Hands, feet & nails.
Nemours Kids Health.Your nails.
2019;99(6):516-523. doi:10.2340/00015555-3098
Pasch MC.Nail psoriasis: A review of treatment options.Drugs.
American Academy of Psoriasis.7 Nail care tips that can reduce nail psoriasis.
American Academy of Dermatology.Are triggers causing your psoriasis flare-ups?.
2022;5(1):32-39. doi:10.1097/jd9.0000000000000187
