Nail psoriasis is the term for changes in your fingernails and toenails that occur as a result of having the autoimmune disease psoriasis. According to the National Psoriasis Foundation, up to 55 percent of people with skin psoriasis also have nail psoriasis.
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. It may also be a clue that you're at greater risk of developing psoriatic arthritis. Although it cannot be cured, nail psoriasis can be helped with treatment.
How Psoriasis Affects the Nails
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:
- 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
Nail Psoriasis Treatments
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 with nail psoriasis. Topical, oral, and steroid injections can be options for treating nail psoriasis.
â€œOf the older oral medications, methotrexate was found to be ineffective for nail disease, whereas cyclosporine and leflunomide used for six months showed some efficacy,â€ says Neha Shah, clinical instructor of immunology and rheumatology at Stanford Health Care in Palo Alto, California. â€œFor the most effective and efficient treatment that typically gives most patients results in three months, it's recommended that the newer biologic therapies (anti- TNF, anti-IL17, and anti IL-12/23) be used, based on results seen in clinical studies.â€
Other options for nail psoriasis include:
- Dovonex (calcipotriene), a form of synthetic vitamin D3 that can slow cell growth
- High-potency corticosteroids, anti-inflammatory medication that can be applied to the nails temporarilyCordran (flurandrenolide), a steroid medication that comes in the form of a tape that's applied to the nails
- 5-fluorouracil cream, a topical treatment that often helps with nail pitting
- Tazorac (tazarotene), a topical medication that can slow cell growth
Keeping Nails in Good Shape
In addition to following your doctor's recommendations for treatment of 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.
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