Symptoms of psoriasis in nails

The vast majority of people who have nail psoriasis also have classic psoriasis symptoms on other parts of the body, usually silvery, scaly patches of built-up skin that sometimes turn red and become itchy. Conversely, about half of all people with psoriasis have symptoms in the nails. In rare cases, nail psoriasis occurs without any signs of a skin condition. Nail psoriasis can affect both the toenails and fingernails. The severity of the symptoms of psoriasis in the nails varies from person to person and does not necessarily follow the severity of the skin psoriasis. It is possible to have severe symptoms in the nails even if the problems elsewhere on your body are mild. 

The symptoms of psoriasis in the nails can be very similar to the symptoms of nail fungus, or onoychomycosis, and sometimes a fungal infection occurs simultaneously with psoriasis in the nail. Nail psoriasis can also occur together with paronychia, in inflammation of the skin that surrounds the nail. The condition is chronic and even though it is not life-threatening it can cause pain, functional problems and embarrassment. If you experience any of these symptoms it may be time to seek treatment for nail psoriasis:

  • Pits. Nail pitting is a classic symptom of nail psoriasis. The pits can be shallow or deep and form when the surface of the nail plate loses cells. Each affected nail could have just one pit or several dozen.
  • Discolouration. The affected nails often develop a clear yellow-red patch underneath the nail plate. The spot usually looks like a drop of blood or oil and is called an oil drop spot or salmon patch. Crumbling can cause the nail to turn white, and in other cases the nail may become yellow or brown. The pale area at the bottom of your nail could also become red if the capillaries under the nail are congested. White spots could be a sign of leukonychia or midmatrix disease. 
  • Thickening of the skin underneath the nail. When material builds up under the nail it becomes raised and tender. In medical terms this is called subungual hyperkeratosis and could lead to the nail becoming loose, so called onycholysis.
  • Onycholysis. This is the medical term for the loosening of the nail that occurs when the nail separates from the skin underneath. It usually starts with a white or yellow patch at the tip of the nail and works its way back toward the nail base. Onycholysis can cause the nail bed to become infected with bacteria or fungi and the nail may turn a dark color.
  • Lines. So called Beau lines go from side to side of the nail and could be a sign of nail psoriasis. Psoriatic nails may also develop tiny black lines that run from tip to cuticle. These are called splinter hemorrhages and result from bleeding between the nail and the skin under the nail.
  • Crumbling. If the underlying structures of the nail are not healthy, it will weaken and begin to crumble. This is usually a sign of severe nail psoriasis.
  • Thickening. If the psoriatic nail is infected by fungus it will likely start to thicken and may become difficult to trim.

Resources


Nail psoriasis treatment

Nail psoriasis is challenging to treat but you can improve the appearance and function of the nails with treatment.


Nail psoriasis causes

Psoriasis makes your body overproduce skin cells. Who gets nail psoriasis and why?

Naloc – Triple acting fungal nail treatment

Naloc is antifungal, reduces discolouration and strengthens and smoothens the outer layers of the nail.

Read about Naloc