The Burden of Nail Psoriasis

Psoriasis anywhere on the body can be a nightmare. Whether it’s in your scalp, covering your body or on the bottom of your feet, it can prove really burdensome.

But what about psoriasis on your nails? I absolutely hate it when my psoriasis flares up on my fingernails or toenails for a few reasons.

How do I treat psoriasis on my nails?

Firstly, it can be embarrassing, especially if its on your fingernails as you can’t really hide it. The discolouration, pitting, thickening and the separating of nails from the nail bed can cause people to stare or look at your nails when speaking to them. It may start in one nail and then move to the others. At least with toenails you can hide it, but why should you? If it’s a warm day you should be able to show off your feet with pride, not worry about being stared at or having strange looks from passers by.

Then there is the issue of treatment. Nail psoriasis for me has been difficult to treat even on a biologic treatment. It’s one of the issues that the biologic treatment has been unable to really treat, and oils and creams don’t really do the trick either. I’ve had to learn to just live with mine as I choose not have a myriad of treatments. Phototherapy was the only treatment which really sorted out my nail psoriasis but as soon as I stopped it came back. It was great while I was on it, but came back worse than before when I came off it.

Nail changes could also mean psoriatic arthritis

It can also be rather tricky to cut your nails with nail psoriasis. I find sometimes I cut too much into the nail bed taking off either more nail or skin because it’s not always easy to know where the psoriasis is and what the nail is. I try and clean my nails as much as I can and keep them short, but it’s not always simple. I bring this up with my medical team and have been helped, so would advise doing that as well if you are affected by problematic psoriasis on your nails.

You also have the risk of psoriatic arthritis. Nail changes can be the first signs of this illness so it’s worth keeping an eye on your nail changes and notifying your medical treatment of any changes as you may need to see a specialist. I have had nail psoriasis for years and do not have psoriatic arthritis but is at the back of my mind as a possibility in the future, so I just keep an eye on it.

What you need to remember about psoriasis is that it is a fleeting condition. It will come and go, affect one area of you and not the others, come about in small ways and large ways and then you may have a period in your life where you’re not affected at all. Nail psoriasis is part of psoriasis, but not everyone gets it. In the early days, my psoriasis was mainly confined to my scalp but later it flared up all over my body, including in my nails. I continue to have the challenge of keeping it at bay as best I can.