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If you have been diagnosed with nail psoriasis, you may be seeking an effective way to manage your condition. There is no cure for psoriasis, but with the proper treatment, you can improve the appearance and function of your nails.

What is Nail Psoriasis?

Psoriasis is a common chronic skin condition. While it often only affects the skin, 10 to 55 percent of patients also have psoriasis of the nails. This causes the fingernails and toenails to exhibit the following symptoms:

  • Discoloration
  • Thickening of the skin under the nail
  • Pits, ridges, and irregular contours of the nail surface
  • Separation of the nail from the nail bed
  • Brittle, crumbling nails

Nail Psoriasis Treatment Options

Psoriasis is primarily a genetic condition. It cannot be cured or prevented. However, treatments for nail psoriasis are available to help your nails look and feel better. Always take gentle care of your nails if you have psoriasis. Vigorous attempts to remove debris from beneath your nails could cause a flare-up. If you feel self-conscious, nail polish is safe to use and can reduce the appearance of surface irregularities.

Here are the recommended treatment options for nail psoriasis.

Topical Treatments

Your dermatologist may recommend one or more of the following:

  • Apply steroid cream or ointment to the skin under your nail to fight most symptoms of nail psoriasis.
  • Rub calcipotriol or other vitamin D-derived creams and ointments on and around the nail to help prevent debris buildup.
  • Use a topical vitamin A cream such as tazarotene to treat pitting, separation from the nail bed, and discoloration.

Corticosteroid Injections

If topical treatment isn’t strong enough, corticosteroid injections under the nail may be more effective. This treatment helps prevent nail thickening, ridging, nail separation, and buildup under the nail.

PUVA Light Therapy

This involves combining two treatments: taking (or soaking your nails in) a prescription medication called psoralen, followed by exposure to ultraviolet A (UVA) light. PUVA treats nail discoloration and separation. It does little to address nail pitting.

Systemic Therapy

This describes a treatment that spreads throughout your body and targets the areas affected by psoriasis. Systemic therapies often come in a pill or injectable form. Your options may include taking a biologic agent, antimetabolite, retinoid, immunosuppressant, or anti-inflammatory. Your dermatologist is most likely to recommend systemic therapy if you have both skin and nail psoriasis.

Nail Removal

If none of the above treatments prove successful, you may choose to pursue nail removal. This may be done in part or in full using either surgical or chemical techniques. Chemical removal involves applying an ointment to encourage the nail to fall off within seven days without bleeding. With surgical removal, the area is numbed with a local anesthetic, and the nail is removed.

If you struggle to control your nail psoriasis, the dermatologists at Arlington Dermatology can help. Call our Rolling Meadows, IL office at (847) 725-0824 to discuss which treatment options may work best for you.

 

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