When Psoriasis Picks on Your Nails


Laura Ramos Hegwer

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11 Tips for Living Well With Psoriasis

These 11 healthy lifestyle tips will help you feel your best and minimize flares.
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 break through 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.
Medical Reviewers: L. Marcellin, MD, MPH Last Review Date: Nov 11, 2012

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Medical References

  1. “Treatment Recommendations for Psoriatic Arthritis.” C.T. Ritchlin et al. Annals of the Rheumatic Diseases. September 2009, vol. 68, no. 9, pp. 1387-94 (http://ard.bmj.com/content/68/9/1387.long);
  2. “Nail Fungus & Nail Health.” American Academy of Dermatology, 2010. Accessed August 22, 2010 (http://www.aad.org/public/publications/pamphlets/common_nail.html);
  3. “Psoriasis & Psoriatic Arthritis.” American Academy of Dermatology, 2010. Accessed August 22, 2010 (http://www.aad.org/public/publications/pamphlets/common_psoriasis.html);
  4. “Questions and Answers About Psoriasis.” National Institute of Arthritis, Musculoskeletal, and Skin Diseases, National Institutes of Health, April 2009. Accessed August 22, 2010 (http://www.niams.nih.gov/Health_Info/Psoriasis/default.asp);
  5. “Treating Psoriasis. Specific Locations: Hands and Feet.” National Psoriasis Foundation, 2010. Accessed August 22, 2010 (http://www.psoriasis.org/netcommunity/sublearn03_loc_hands);
  6. “Psoriatic Nails.” American Academy of Dermatology, 2010. Accessed August 22, 2010 (http://www.skincarephysicians.com/psoriasisnet/psoriatic_nails.html);

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