Nail psoriasis is a common condition for those with skin psoriasis, affecting from 10 to 50% of all patients. It can occur on both fingers and toes – but since toes can be hidden in socks and shoes for a large proportion of the day, fingernails are the real worry for many.
So what are the characteristics of nail psoriasis?
The most obvious textural difference is referred to as pitting. These are tiny, punched-in depressions (basically little craters on the skin). They look as although the nail has ‘sunk in’ around those areas and are affected by psoriasis affecting the nail matrix, and fluctuating the plate growth as a result.
Another usual feature of nail psoriasis is when the nail grows heavier and crumbles at the ends. This is caused by the matrix splitting away from the nail plate, and is known as onycholysis. As the ends are whitish, the appearance of this can be particularly unpleasant, as it looks similar to nail fungus.
The more visual appearances can be seen in the yellow discoloration of the nail in general, as well as “oil spots”, which are more localized spots of a dark brown colour.
As the nail plate is so thick and slow-growing, not only is it hard to penetrate, but it can also take months to replace a damaged nail. In fact, the average nail growth rate of 3mm per month can mean that it would take 7 months for a new one to appear!
6 Psoriasis Nail Care Tips
1) Trim the nails regularly to keep them smooth and reduce the chance of an infection!
2) Avoid wash your hands with insensitive soaps (especially anti-bacterial soaps) as they irritate the skin underneath the nail. When you do, make sure to dry the areas around the nail appropriately and try to massage some handcream into and around the nail cuticle.
3) Wear gloves whenever you’re exposing your hands and nails to harsh treatment – this contains gardening, housework (watch out for those detergents), and other activities. Get vinyl gloves for wet work and cotton gloves for dry work.
4) Consider picking up some water shoes if you go swimming regularly, specially for public pools with loads of chlorine.
5) Prevent biting your nails, scratching your nails, or routinely manicuring your nails. This can reason some irreversible damage to the nail matrix.
6) If you are really anxious about your nail psoriasis, and this is perfectly understandable in a professional workplace where your appearance is key, then you can get artificial nails. However, only do this if you have to because they can worsen nail psoriasis through the Köbner phenomenon.