Nail Psoriasis

According to the statistics, approximately 7% of patients who suffer from psoriasis have nail psoriasis. It means that along with inflammatory skin rash they have nail pitting. Very often nail plates become dark with transversal and longitudinal grooves. Nails are also affected in half of the cases when people have psoriatic arthritis.

Nail Psoriasis

Nail psoriasis symptoms

Nail psoriasis is a disease with long history. It was described back in the XIX century, and the difficulty of its diagnosing was also mentioned. Scientists assumed that the disease has an isolated form. Nowadays this hypothesis was confirmed. Psoriasis of the nails can develop independently. But very often when patients have any form of psoriasis nails also may become affected. There are many nail psoriasis symptoms.

Clinical presentations of the disease are very diverse. The most common are the following types of nail plate deformation: little pits on the nails (called “thimble symptom”), subungual hemorrhage, onycholysis, trachyonychia. Let us have a look on them in more detail.

Thimble symptom

This is the most well-known form of nail psoriasis. It manifests itself in the form of small pits of various diameters (0.5-2 mm) on the nail plate. The cause of psoriasis in nails lies in the nail plate formation malfunction. The pits are different in shape, size and depth and are located chaotically, resembling the surface of a thimble. Normally, a healthy person may have isolated pits on nails, but this is not considered to be psoriatic nails. Such nail plate changes can also accompany other chronic dermatoses.


This is the second common symptom of psoriasis on nails. Nail plate separates from its bed gradually and without any pain. It is not accompanied with inflammatory processes. Loosening usually starts on top of the nail plate and spreads towards the root. There are two degrees of manifestation of psoriasis under nails: full and partial.

When nails loosen an empty space is formed underneath the nail plate. Dust, dirt and air bubbles easily get into this hollowness. In it there is also exfoliated epidermis, which makes the nail look grayish-white. Sometimes the colour can vary from yellow to brown. In some cases, onycholysis may be accompanied by an unpleasant odor. A distinctive feature of this form is the presence of a narrow pinkish stripe, which eventually becomes yellowish.

Subungual hemorrhage

There are two types of subungual hemorrhage that have different characteristics. The first is characterized by the appearance of spots under the nail plate. The spots can vary in size and are pink or bright red. The disease is also known as the “syndrome of oil spots”. The second type of subungual hemorrhage appears as strip bleeding of red, brown and sometimes black colour. This type is a result of rupture of blood capillaries.


Sometimes it accompanies psoriasis vulgaris. Trachyonychia is characterized by dull and rough surface of the nail. As a rule, there is no lunula. In some cases, this pathology is accompanied by the indentation in the center of the nail plate. At the early stages of psoriatic nail disease can be observed flattening of the nail, which later becomes concave. Subungual tissue is not prone to changes.

Nail psoriasis pictures

Nail psoriasis pictures

Psoriasis nails pictures

Nail psoriasis photos

What causes of nail psoriasis

What causes nail psoriasis? There are several nail psoriasis causes. They may include:

  • Infectious diseases;
  • Immune system disorders;
  • Hormonal disorders;
  • Dysbolism;
  • Nervous shock or stress;
  • Genetic predisposition.

Nail psoriasis treatment

How to treat nail psoriasis? It is worth to mention that psoriasis nails treatment is a long and fairly complicated process which requires big efforts from both the physician and the patient.

In all forms of psoriasis of fingernails and toenails you need to understand that the disease is chronic, relapsing, and undulatory. Therefore, the main condition for therapy is daily proper nail care. In fact nail psoriasis treatment can be reduced to a few simple tips. They can be summarized as follows:

  • Nails should be cut short;
  • You should reduce to a minimum the possibility of microtraumae;
  • Manicure, pedicure and other beauty treatment is strictly forbidden;
  • You should wear gloves while doing housework.

In order to cure nail psoriasis you should take vitamin complexes rich in minerals. This is relevant for any of the form of psoriatic nail dystrophy. For normal nail formation you need zinc, calcium, potassium and silicon. However, you should stop taking these drugs during acute stage of the disease, or if you are intolerant to any of the components.

Medical treatment of nail psoriasis is not required if you have mild form of nail psoriasis. As one of the treatment options you can use healing coatings that hide nail defects. They slow down the processes of destruction of the nail and prevent relapses. In more severe cases dermatologists recommend to use local treating medications such as solutions, creams and ointments. Such therapy should last at least 3 months. If you have nail psoriasis on your toes, the treatment is identical.

How to treat nail psoriasis at home

  • Begin the treatment with the drugs of general action containing calcium. They provide anti-inflammatory effect and reduce sensitivity;
  • If you have itching, use antihistamines. They will help you to get rid of the itching;
  • Carefully follow the hygiene rules for your hands and feet. Do not allow the complete destruction of the nail plate;
  • It is recommended to do the herbs decoction bath for nails. You may use calendula, chamomile or sage for making the healing decoction;
  • Before going to bed, apply different oils on the nail plate on daily basis. You may simply use olive, sunflower or corn oil;
  • Take vitamins that affect directly your metabolic functions and provide regulation of metabolism at the cellular level (group B, A, E, C, P vitamins);
  • Use ointments, creams and lotions only if they are prescribed by your doctor;
  • Don’t forget about special nail psoriasis diet. Avoid unhealthy food.

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