When Psoriasis Picks on Your Nails

By

Laura Ramos Hegwer

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Psoriatic Nails

Sometimes psoriasis goes beyond your skin and affects your fingernails and toenails.  For some people, psoriasis attacks only their nails and nothing else.

Fortunately, there are ways you can get your nails back in shape—but it will take a little patience.


What It Looks Like

Many people with psoriasis or psoriatic arthritis have nails that turn yellow or become thick, pitted, or rippled. Sometimes, the nails even crumble and become loose from the skin under the nail.

The skin surrounding the nail also can become red and irritated. In some cases, the skin underneath the nail takes on a reddish-brown color and may develop what look like “splinters” beneath the nail. These are called splinter hemorrhages, caused by damaged blood vessels under the nail.

When to Get Help

If you experience nail changes or suddenly develop splinter hemorrhages, have an expert check your nails. A dermatologist can help determine whether a nail infection, your psoriasis, or another health issue is to blame.

The same types of treatments that can help manage skin psoriasis will aid your nails. Some topical treatments, however, don’t work well because they can’t penetrate nails. Oral medicines or injections may be more helpful. Just remember to be patient. Nails grow very slowly, which means it may take a long time before you notice them looking nicer.

Ways to Cope

You may not like the look of your hands and feet now, but you can improve their appearance while you wait for your medicine to help:

  • Keep your nails neat and trim with manicure scissors. Shorter nails are fashionable and easier to manage.
  • Wear a pretty polish if you like.
  • Try not to bump or scrape your nails, which can make the problem worse.
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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Aug 20, 2015

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Medical References

  1. Ritchlin CT, et al. Treatment Recommendations for Psoriatic Arthritis. Annals of the Rheumatic Diseases. 2009;68(9):1387-94.  
  2. Caring for Nail Infections. American Academy of Dermatology. https://www.aad.org/dermatology-a-to-z/for-kids/about-nails/infections
  3. Psoriasis. American Academy of Dermatology. https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/m---p/psoriasis
  4. Questions and Answers About Psoriasis. National Institutes of Health. National Institute of Arthritis, Musculoskeletal, and Skin Diseases. http://www.niams.nih.gov/Health_Info/psoriasis/default.asp
  5. Hands, Feet, and Nails. National Psoriasis Foundation. https://www.psoriasis.org/about-psoriasis/specific-locations/hands-feet-nails
  6. Nail Psoriasis. The Psoriasis and Psoriatic Alliance. http://www.papaa.org/further-information/nail-psoriasis

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