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Nail Psoriasis : Understanding Symptoms, Causes, and Treatment

Psoriasis is a chronic autoimmune skin condition that affects millions of people worldwide. While most commonly known for its effects on the skin, psoriasis can also impact other parts of the body, including the nails. Nail psoriasis can be a distressing symptom for those who experience it, causing discomfort and embarrassment. In this blog post, we will explore the symptoms, causes, and treatment options for nail psoriasis, providing you with a better understanding of this condition and how to manage it.

Symptoms of Nail Psoriasis

Nail psoriasis can present in various ways, and the severity of the symptoms can vary from person to person. Some common symptoms of nail psoriasis include:

  1. Pitting: Pitting refers to the presence of small depressions or dents on the surface of the nails. These indentations can give the nails a rough or uneven appearance, and they are one of the hallmark signs of nail psoriasis.
  2. Discoloration: Nail Psoriasis may also appear discolored, with white or yellowish spots or patches on the nails. In some cases, the nails may even turn brown or green.
  3. Separation: Psoriasis can cause the nails to separate from the nail bed, a condition known as onycholysis. This can result in the nails becoming loose or detached from the nail bed, which can be painful and uncomfortable.
  4. Thickening: Psoriasis can cause the nails to thicken, becoming thicker than normal. This can make the nails appear bulky and misshapen.
  5. Ridging: Another common symptom of nail psoriasis is the presence of ridges on the surface of the nails. These ridges can be vertical or horizontal and can give the nails a rough or bumpy texture.
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Causes of Nail Psoriasis

The exact cause of nail psoriasis is not fully understood, but it is believed to be related to an overactive immune response. In psoriasis, the immune system mistakenly attacks healthy skin cells, leading to the rapid growth of skin cells and the formation of plaques on the skin. This immune response can also affect the nails, leading to the characteristic symptoms of nail psoriasis.

In addition to the immune system’s role, there are several risk factors that can increase the likelihood of developing nail psoriasis. These include a family history of psoriasis, certain genetic factors, and other triggers such as trauma to the nails, infections, or hormonal changes.

Treatment Options for Nail Psoriasis

As mentioned previously, nail psoriasis can be challenging to treat, and management usually requires a multi-faceted approach.

  • Topical treatments: Topical corticosteroids, vitamin D analogues, and other topical medications can be applied directly to the nails to help reduce inflammation and manage symptoms. These treatments are typically prescribed by a dermatologist and may need to be used consistently over a period of time for best results.
  • Systemic medications: In some cases, oral or injectable medications may be prescribed to help control the immune response and reduce inflammation throughout the body, including the nails. These medications are typically reserved for more severe cases of nail psoriasis and are closely monitored by a healthcare professional.
  • Nail care: Proper nail care can also play a role in managing Nail psoriasis. This may include keeping the nails short and well-groomed, avoiding trauma to the nails, and moisturizing the cuticles and nails regularly to keep them hydrated.
  • Phototherapy: Phototherapy, which involves exposing the nails to ultraviolet light, can also be used as a treatment option for psoriasis nails. This can help reduce inflammation and slow down the rapid growth of skin cells in the nails.

How can you tell the difference between nail psoriasis and toenail fungus?

Nail psoriasis and toenail fungus can both affect the nails and can have similar symptoms, making it challenging to distinguish between the two conditions. However, there are a few key differences that can help you determine whether you are dealing with nail psoriasis or toenail fungus.

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Symptoms:

Nail Psoriasis: Psoriasis nails typically have pitting, ridges, or discoloration, with small depressions or dents on the surface of the nails. The nails may also appear thickened or crumbly and may separate from the nail bed.

Toenail Fungus: Toenail fungus typically causes the nails to become thickened, yellow, or brown in color. The nails may also appear brittle or crumbly, and there may be a foul odor or debris under the nail.

Location:

Nail Psoriasis: Psoriasis can affect the nails on both the hands and feet.

Toenail Fungus: Toenail fungus typically only affects the nails on the feet.

Risk Factors:

Nail Psoriasis: Psoriasis is an autoimmune condition and may have a genetic component. It may also be triggered by stress, infections, or injury to the nails.

Toenail Fungus: Toenail fungus is caused by a fungal infection and can be spread through contact with infected surfaces or objects. It is more common in people with weakened immune systems, diabetes, or a history of athlete’s foot.

Diagnosis:

If you suspect that you may have nail psoriasis or toenail fungus, it is essential to seek medical attention for an accurate diagnosis. Your doctor or dermatologist will examine the nails and may take a sample of the nail to send for laboratory testing to determine the cause of the symptoms.

Treatment:

Treatment for nail psoriasis and toenail fungus may vary depending on the severity of the condition. In general, nail psoriasis is treated with topical or systemic medications, phototherapy, and proper nail care. Toenail fungus is treated with antifungal medications, either topical or oral, as well as proper nail care to prevent reinfection.

In summary, while nail psoriasis and toenail fungus may have similar symptoms, there are key differences in the location, risk factors, and diagnosis that can help distinguish between the two conditions. It is important to seek medical attention for an accurate diagnosis and appropriate treatment.

About the Author: Jeff Strauss received his pre-med/biology degree from Villanova University and has become an industry expert in the field of dermatology, with 20 plus years of experience. He is also the CEO and Co-Founder of Distinct Dermatology Inc.