For Best Results From Treatment
Treating nail psoriasis can be a challenge. It often takes time to treat. To get results, you need to treat your nails as directed and for as long as directed. Some patients need to try a few treatments to find one that works.
The right nail care can help you get the best results from treatment. Youll find out what dermatologists recommend at: 7 easy-to-follow nail care tips that can reduce nail psoriasis
ImagesImages used with permission of the Journal of the American Academy of Dermatology. J Am Acad Dermatol 2013 69:249.
ReferencesCrowley JJ, Weinberg JM, et al. Treatment of nail psoriasis: Best practice recommendations from the Medical Board of the National Psoriasis Foundation. JAMA Dermatol. 2015 Jan 151:87-94.Dogra A, Arora AK. Nail psoriasis: The journey so far. Indian J Dermatol. 2014 Jul 59:319-33.Lin YK, Chang YC, et al. A Chinese herb, indigo naturalis, extracted in oil used topically to treat psoriatic nails: A randomized clinical trial. JAMA Dermatol. 2015 Jun 151:672-4.Manhart R, Rich P. Nail psoriasis. Clin Exp Rheumatol. 2015 Sep-Oct 33:7-13.van der Velden HMJ, Klaassen KMG, et al. Fingernail psoriasis reconsidered: A case-control study. J Am Acad Dermatol 2013 Aug 69:245-52.
All content solely developed by the American Academy of Dermatology
The American Academy of Dermatology gratefully acknowledges the support from Bristol Myers Squibb.
When To See A Doctor
If you suspect psoriasis or have a family history of psoriasis, reach out to your healthcare provider. If you have a new, worsening dark discoloration on one nail in particular, though rarer, this can be a sign of melanoma of the nail.
If you suspect mild fungus, you may manage the symptoms with over-the-counter creams. If creams dont improve symptoms in a few weeks, visit your healthcare provider. Nail fungus usually requires an oral prescription antifungal for successful treatment.
Good hygiene cant prevent psoriasis, but it can help ward off fungal infections.
Fight the fungus with these tips:
- Keep your nails trimmed and clean to prevent fungal growth.
- Avoid cleaning under your nails with sharp tools.
- Use nail moisturizers and oils to keep your nails healthy and soft.
- Avoid tight shoes that cram toes together.
- Dont go barefoot in public .
- Keep your feet and hands dry.
- Wear clean, breathable socks.
Treatment Options And Lifestyle Changes
There are several things you can do that can provide relief from skin and nail psoriasis and psoriatic arthritis .
Once nail psoriasis is suspected, the sooner you start treatment, the better. Coordination of care between a dermatologist and a rheumatologist can provide a patient with the best course of treatment.
Siegel says several systemic and biologic treatments that work for psoriasis and PsA can also work for nail psoriasis. Talk to your health care team to find out if this approach might be effective for you.
Topical corticosteroids can be applied to the nail matrix with the goal of absorbing into the still-forming nail. Patients also have the option of having corticosteroids injected into the affected nail. However, the pain of the procedure can be a deterrent to this treatment.
Using nail polish and nail polish remover with harsh chemicals such as parabens, formaldehyde and acetone can dry out the nails and cause further brittleness and possibly pain.
Siegel and Prussick agree that being overweight can contribute to a person with psoriasis developing PsA. When belly fat increases, the amount of harmful inflammatory cytokines in the body also increases. In addition, there is some speculation that repeated stress on the joints can add to the development of PsA.
Going for a 30-minute walk every day, staying away from high glycemic foods and managing stress can help keep psoriasis and PsA symptoms from worsening.
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Both Conditions Have Similar Symptoms But Are Treated Differently
To make this situation more complicated, patients with psoriasis are at a higher risk for nail funguses.2 Both nail fungus and nail psoriasis can have similar symptoms but are treated very differently.
This article will discuss some of the similarities, differences, risk factors and treatments of both nail fungus and nail psoriasis.
Changes In Nail Shape Or Thickness
In addition to pitting, weakness of the structures that support nails can cause your nails to crumble. Nails can also become thicker due to a fungal infection called onychomycosis, which is common in people with psoriasis.
Additionally, your nail may get thicker because it develops a chalky substance underneath. When this happens, its called subungual hyperkeratosis and may be painful or uncomfortable.
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Always Talk To Your Healthcare Team
Both conditions can be treated by removing the nail. While this sounds awful, it is actually a relatively painless procedure.2,3
Always consult your healthcare team about the best treatment for your needs. Since these conditions can happen simultaneously, and your team should help you decide the best way to treat your condition and help you learn how to prevent another outbreak.
What Are Medical Treatments For Nail Psoriasis
A doctor may recommend that a part of the nail be removed, either chemically or surgically. Chemical removal of the nail involves putting an ointment on the nails for seven days. The nail comes off by itself with no bleeding.
Even with effective treatment, an improvement in symptoms may take a long time, since eight to 12 months can be needed to generate a new fingernail.
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What Is Psoriatic Nail Disease
Psoriatic nail disease is a type of psoriasis. It is not caused by infection and you cannot pass it on to anyone else.
Psoriasis is a common skin condition that usually causes patches of red, scaly skin but sometimes only affects the nails. There is also a form of arthritis that is linked to psoriasis, called psoriatic arthritis. Psoriatic nail disease is particularly common if you have psoriatic arthritis. You can read more about these conditions in the separate leaflets called Psoriasis and Psoriatic Arthritis.
Are There Home Remedies For Nail Psoriasis
There are no home remedies to cure nail psoriasis. In areas where the nail has loosened, gently trim the nail back to the skin where it is connected. This will allow medications to work better. All nail care must be very gentle. Vigorous nail care and attempts to remove debris beneath the nails can cause psoriasis to flare and worsen. Attempt to avoid injuring the nails so that the nail doesn’t loosen more and so that the area doesn’t become infected.
Nail polish is safe to use and can hide discoloration. It may also help to reduce the appearance of surface irregularities. Nail polish should be removed before medical examination of the nails.
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Risk Factors For Nail Psoriasis And Nail Fungus
Fungi are microscopic organisms that thrive in damp, warm settings. Showers and swimming pools are two of their favorite locations to hide. Any gap between your nail and the nail bed is an invitation for fungus to invade. They can even get in through small cuts in your skin. With age, you’re more likely to develop nail fungus. Men are more likely than women to get nail fungus, especially if they have a family history of fungal diseases. Additionally, according to the National Psoriasis Foundation, about 50% of people with psoriasis and over 80% of people with psoriatic arthritis have nail-related medical issues. You’re also more likely to get nail fungus if you
- Sweat profusely
- Work in a humid setting where your hands or feet are frequently wet
- Walk barefoot around public pools, gyms, and showers
- Wear socks and shoes with insufficient ventilation
- Live with a person suffering from nail fungus
- Have an immunosuppressive health condition such as HIV
People with circulatory issues or diabetes are also more vulnerable. Any injury to the nail bed can increase your risk of developing nail fungus. With nail psoriasis, it’s unclear why some people with psoriasis have problems with their nails while others dont.
Symptoms For Nail Psoriasis
Fingernail psoriasis is more common than toenail psoriasis. It is characterized by yellowing and pits all over the nail surface.
Psoriasis nail is more likely to detach your nail from the nail bed, leading to nail loss. Fungal infections rarely lead to nail detachment.
The nail may break or entirely pull apart, leaving a gap between your fingertip and the nail.
Pits become deeper with time and sometimes even holes are formed. Nails become very dry and many ridges are formed, altering the appearance of your nails.
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Everything You Need To Know About Toenail Psoriasis
The skin disease known as psoriasis affects an estimated 10 million Americansabout 4 percent of the population. About half of these affected people have psoriasis symptoms in their nails, and 15 percent experience symptoms only in their nails.
Toenail psoriasisalso known as psoriatic nail diseaseis not merely a cosmetic condition. It can interfere with the ability of a nail to protect the toe or to perceive touch.
Toenail psoriasis can also be quite painful, and the pain can restrict movement, making it difficult for the affected person to walk normally.
This can cause an antalgic gait. In addition, a damaged psoriatic nail can make the nail plate more susceptible to fungal infections.
Psoriatic nail disease is also associated with a serious condition known as psoriatic arthritis80 percent of people who suffer from psoriatic arthritis have had nail psoriatic nail disease.
What Nail Psoriasis Looks Like
Nail psoriasis causes changes to your fingernails and toenails
This fingernail shows 3 signs of nail psoriasis: Crumbling, roughness, and blood under the nail .
Common signs of nail psoriasis
This nail also has 3 signs of nail psoriasis: Tiny dents in the nail , white discoloration, and lifting .
Most people who have plaque psoriasis develop nail psoriasis
Discoloration , nail lifting from the finger, and a thin line of blood are common signs of nail psoriasis.
Nail psoriasis usually begins years after psoriasis first appears on the skin
This patients nail has 3 common signs of nail psoriasis: Grooves, blood beneath the nail , and lifting of the nail from the finger.
Nail psoriasis can be mild
If you have psoriasis, ridges and a thin line of blood beneath the nail can be signs of nail psoriasis.
Improvement from treatment happens slowly
Nails grow slowly, so it will take 6 months or longer to clear debris, a common sign of nail psoriasis, beneath the nail.
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When Should You See A Doctor
See a doctor if you notice discoloration, pitting, or cracking in your nails. If you have psoriasis or diabetes, this is extremely crucial because, as per research, theres a good chance that you could be suffering from both conditions.
Are you suffering from nail psoriasis or nail fungus? Schedule an appointment with MI Express Care. Our doctors can develop a recovery plan to diagnose and treat nail psoriasis and nail fungus accurately.
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Nail Psoriasis Vs Nail Fungus: How Are They Different
May 16, 2022
Urgent Care
Psoriasis is an autoimmune disease that results in skin plaques and lesions. When symptoms appear on the toes and fingers, they can look like nail fungus. Nails fungus is a type of infection that is commonly contracted in wet environments such as pool decks and locker rooms but can also come from a variety of other places. In contrast, nail psoriasis can occur due to the same set of reasons that cause skin psoriasis. This article will go over the differences between nail psoriasis and fungus symptoms.
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What Are The Causes Of Nail Psoriasis
The root cause of nail psoriasis is in the nail root which is the skin tissue of the nail bed from where the nail grows. Changes in the growth pattern of the cells in the nail root results in the development of the disease.
Family aggregation studies have linked psoriasis of the nails to genetic factors along with interactions with environmental influences.
Another cause for nail psoriasis is fungal infections like onychomycosis that cause thickening of the nails. This nail fungus produces the symptoms shown in psoriasis.
How Can You Treat Nail Psoriasis
Depending on the severity, nail psoriasis can be treated topically, with localized injections, or with systemic medications that treat the whole body. People with nail psoriasis can also try some simple treatments at home for mild cases, which can reduce the recurrence of the symptoms. No matter the treatment you choose, it will take time for the nails to grow out and to see any measurable improvement.
Watch dermatologist Dr. Raja Sivamani talk about treatments for nail psoriasis.
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Home Remedies To Treat Nail Psoriasis
Some MyPsoriasisTeam members use home remedies to manage their nail psoriasis, including incorporating moisturizers that help their nails and skin look and feel healthier. One member swears by an unscented, raw shea butter. I use it on my cuticles and on psoriasis spots on my body. It helps a lot!
Another said their skin and nails dont respond well to any single treatment. I use a variety of lotions and potions on my hands to ease it, they wrote.
A third member recommended Aspercreme with aloe to simultaneously help with pain and moisturizing.
Or Maybe Athletes Foot Has Taken Your Little Piggies Hostage
Athletes foot occurs when a fungal infection affects the skin on your feet.
Signs of athletes foot include:
- itchy blisters
- dry skin on the soles and sides of the feet
- burning and itching between the toes or on the soles
- cracking, peeling skin on the feet
Toenail fungus infections can often arise from athletes foot.
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Whats The Difference: Nail Psoriasis Vs Fungus
Did you know that psoriasis can also affect your nails? As an autoimmune disease that causes the rapid overgrowth of skin cells, nail psoriasis can resemble nail fungus. This makes it difficult for people to tell them apart and get proper treatment.
Understanding the difference between nail psoriasis vs. fungus is highly important. It can help symptoms from worsening or infection from spreading. Read on to learn how to tell nail psoriasis vs. fungus apart.
Nail Psoriasis Care Tips
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What Is The Outlook For Psoriatic Nail Disease
Psoriatic nail disease can be difficult to treat and there is no cure. It doesn’t usually grow out without treatment, so can continue to cause problems. The appearance of the affected nails can also sometimes cause distress.
The treatment of severe psoriatic nail disease is now improving with modern medicines.
Psoriatic nail disease can also be mild, not needing any treatment, and able to be hidden with nail varnish.
Nail Psoriasis: Symptoms Causes And Treatments
- Up to 80 percent of people with plaque psoriasis and psoriatic arthritis experience nail symptoms.
- Nail psoriasis can be treated with topical treatments, systemic medications, and treatments provided in a dermatologists office, such as steroid injections.
Psoriasis affects more than just your skin. It can also develop on your fingernails and toenails, leading to symptoms that can resemble a nail fungus or other nail infection. Between 50 percent and 79 percent of people with plaque psoriasis, and 80 percent of those with psoriatic arthritis , have symptoms that affect their nails.
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How Is Psoriatic Nail Disease Diagnosed
The diagnosis of psoriatic nail disease is usually made by the appearance of the affected nails. Sometimes scrapings from under the nail, and nail clippings, are sent to the laboratory to be tested for fungal infection of the nail, which can sometimes look like psoriatic nail disease.
Occasionally, a sample of nail is needed to confirm the diagnosis.
What Are The Similarities
Both can occur in the fingers and toes. Both nail psoriasis and fungal infections can happen in the toenails and fingernails. Nail fungus is more likely to happen in the toenails, while nail psoriasis is more likely to affect the fingernails.1,2
Other similarities include:
- Discoloration of the nail: Both psoriasis and fungal infections can cause discoloration of the nail. Patients with psoriasis often notice their nails change to a yellowish-brown color, while patients with fungal infections see yellow, brown and green colors.3,4
- Nail lifting or falling off: Both conditions can have a symptom where their nails separate from the nail bed or even fall off.3,4 This is known as Onycholysis.
- Nail thickening: Both conditions can cause the nails to thicken.1,2
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How Is Nail Psoriasis Diagnosed
Your healthcare provider can typically diagnose nail psoriasis after a physical exam. Theyll examine your affected areas to look for common signs of nail psoriasis. Theyll also ask about your symptoms and your family history.
Once your healthcare provider has diagnosed nail psoriasis, they may use the nail psoriasis severity index to grade its severity. The NAPSI uses imaginary lines to divide your nail into four even sections . Your nails receive a 0-4 score based on the presence of any nail psoriasis symptoms in each of the quadrants. Your healthcare provider will then add the scores together. A low number means your nail psoriasis is mild, and a high number means your nail psoriasis is more severe.
People with nail psoriasis may develop a number of symptoms. Providers use NAPSI to determine the severity of the condition.
If theres any doubt about your symptoms, your healthcare provider may order a potassium hydroxide preparation or fungal culture to rule out a fungus as the cause of your symptoms. If those test results arent clear, a fungus test known as a periodic acid-Schiff stain can also determine the presence of a fungus.
