5 Tips for Nail Psoriasis

Nail problems are common in people living with psoriasis and psoriatic arthritis. Nail issues may include pitting, splitting, thickening, lifting, crumbling, or even becoming yellow.

What can help with nail psoriasis?

While we might hide other psoriasis patches under our clothes, that’s not possible with nails! Aside from wearing gloves all day, can anything help?

Here are some home remedies and over the counter options recommended by this community. Always check with your dermatologist too!

Trim your nails

Let’s talk about hand hygiene. Keeping your nails trimmed short helps prevent splitting, and will prevent them from getting caught on anything.

If your nails are already lifting away from the nail bed this is extra important! You might find that nail files increase splitting or crumbling, so avoid them if you can.

Nail gels

Those living with psoriasis and psoriatic arthritis we are especially prone to weak and brittle nails. Hardening gels may help nails from crumbling and can lessen the appearance of pitting. Over the counter, options include Nutra Nail and Hard as Nails by Sally Hansen.

Colored polishes can be ideal if psoriasis is turning your nails yellow or brown. If acrylic nails don’t bother you, using acrylic right at the nail bed can help prevent lifting as well (pro tip from a guitar player).

Nail soaks

On a number of nail psoriasis articles, community members have shared at-home soaks that work for them. These three are the most popular:

• One cup original Listerine (the brown kind) with one cup warm water
• Coal tar oil or coal tar soap mixed with warm water
• A few capfuls of hydrogen peroxide (3%) diluted in a small bowl of warm water

People report soaking for 5-30min, so start short and see what works for you. If you’ve been prescribed topical steroids for your nails/nail bed, soaking in warm water first will increase absorption.

Topical remedies

Many of you swear by oils or creams applied to the top of the nail with a cotton ball, or around/under the nail with a Q-tip. We’ve heard from you that Vicks Vaporub and tea tree oil are faves. Soak the tip of a cotton ball with either and press against the nail for a few minutes until absorbed (tape the cotton ball on your finger if it helps).

If using a Q-tip, be very gentle if your nails are lifting away. A note that pure tea tree oil can be very irritating, so make sure to dilute in a carrier oil, and always do spot checks first!

Protect those nails

About 25% of people with psoriasis suffer from the Koebner phenomenon. This means that wherever there is injury or trauma, psoriasis develops. Think of how often we bash our hands around on a daily basis, run them under really hot water, scrape, press or bang our nails.

To better protect your nails, wear rubber gloves when washing the dishes, and thick protective gloves when gardening or doing other manual tasks. Mostly, be more aware of daily trauma to your nails.

Final thoughts

Nail psoriasis can look very similar to nail fungus or other conditions, so make sure to check with your dermatologist if nothing is working. Note too that sudden nail changes indicate for some people that a psoriatic flare is coming.

Pay close attention to your nails, and report any changes to your dermatologist or rheumatologist.