Fingernail abnormalities like loosening, crumbling, discoloration or pitting may be signs that you have nail psoriasis. Affected nails may also become thickened and show horizontal lines. If you have skin psoriasis, you may likely have the condition in your nails, as well.
Treatment Options for Psoriatic Nails
The treatment for nail psoriasis depends on the area that is affected. Any nail pitting comes from the nail matrix, which is the base of growth for fingernails. Thickening nails come from the skin beneath each nail.
If you only have mild symptoms, your physician may use steroid injections or topical treatments to fight the psoriasis. There are cosmetic treatments that can be done, as well. These include keeping your nails trimmed short and smooth. They may be painted with a clear polish, as well. If you have skin psoriasis or psoriatic arthritis as well, your doctor may prescribe biologic or systemic treatments to help in symptom reduction.
Psoriasis plaque usually responds faster than improvement of the fingernails. It may take months to show positive reactions to medications. If you’re worried about the appearance of your nails, you can seek out a nail technician who knows how to deal with nail psoriasis. The affected nails need to be treated gently, without any pushing back or clipping of the cuticles. If you have nails that are lifted up, don’t clean aggressively underneath them, or the lifting may become worse. Buff those nails gently to smooth out the surface, and then paint with clear polishes.
Psoriatic Nail Appearance and Medications
You have probably always taken your fingernails for granted. But when they become unsightly, you’ll do almost anything to get the natural look back. You may have covered weak nails with false tips or nails for some time, but when the nails peel back and pain is present, you’ll want to seek help from your physician.
Some of the medications used for psoriatic nails have side effects which will make you pause before you take them. Ointments and creams may be somewhat effective, but methotrexate, which is an immunosuppressive drug available only by prescription, may have long term side effects. They include respiratory and nervous system impairments.
There may be months of taking medications, when you’re not sure whether they are working or not. The fingernails are exposed to so many things that it makes it hard to fully protect them, to allow ointments to work properly.
From the initial pitting and into cases where people have nails that simply crumble away, you may reach a point where you don’t go out as much, because you’re embarrassed about the look of your hands.
Topical steroids are often used for people with psoriatic nails. Stronger treatments may be needed, including treatments with UVB light and a light sensitizing drug in conjunction. Cortisone injections done around fingernails have shown some promise. Like other treatments, though, it takes a long time to see any marked improvement. Newer biologic agents being developed may lead to a brighter prognosis for people with nail psoriasis.