Do I Have Nail Psoriasis?- Symptoms, Causes, and Treatment

An autoimmune disorder, psoriasis does not discriminate when it comes to which skin portion to effect. While the skin and the scalp psoriasis are pretty common and the most prevalent, nail psoriasis is especially painful. Psoriasis is a condition where a hyperactive immune system loses the ability to distinguish between healthy cells and unhealthy ones. As a consequence, it ends up attacking the healthy cells of the body. This factor triggers an effect where the skin cells start to produce rapidly. When these new cells come to the surface, the old cells are still alive. This issue causes the skin cells to be stacked unevenly. Consequently, the affected region takes on an appearance of scaly, and reddish patches. Now as to what triggers the immune system to go haywire,there are multiple reasons for that. When it comes to the symptoms of Nail psoriasis, it can create issues for the skin beneath, and around the nails, and the nails themselves as well. Its symptoms can take on a similar appearance to nail fungus, but this is where the similarities end.

Symptoms of Nail Psoriasis

The symptoms of Nail psoriasis are as follows:

1. Skin around the nails become patchy and scaly:

As we said in the introduction, nail psoriasis affects the skin around the nails and the nail bed first. However, it is not localised within this region. While it can be the most common scenario where the nails are the only regions that are affected, other regions can be affected all the same. These regions can be the back of your neck, the crevices of your folded skin (if you are obese), the scalp and even the face. The patchiness of the skin as a result of psoriasis can be different based on the severity of the condition:

The patches are not only unseemly to look at, but they also itch a lot.

They appear to be smooth and almost glossy.

Silvery patches are also a bit prevalent. They represent the skin cells that are dead, but you haven’t exfoliated them yet.

Red patches around nails are also common.

2. Loss of Nails:

Not only the skin around the nails but psoriasis can also affect the skin at the nail bed. The severity of this condition can mess with the integrity of the nail and the skin, and as a result, the nails can start to fall off. It is a especially painful symptom where either a sudden trauma or time can make you lose your nails. This issue is called nail lifting or onycholysis.

3. Yellowing of the nails:

As psoriasis starts to affect the skin on the nail bed gradually, it will start to form pits, and the nail would appear yellow coloured The intensity of yellowing of the skin would indicate how deep these pits have gotten. The more skin deformation takes place in the background, the more yellow your nail would appear in the foreground. If you press upon this region, you would feel a painful sensation. We recommend you don’t do that.

4. Further colour changes:

Nail yellowing is just one of the colours that you might see. Depending upon the skin deformation and the type of psoriasis, small red and white spots underneath the nails can appear as green, yellow or brown.

5. Changes to the nail surface:

With time, psoriasis reaches the hard structure of the nails as well. This causes pitting on nail’s surface in addition to some rigid jaggedness and some grooves.

6. Thickening:

If you have nail psoriasis, then your immune system is in a compromised state. To that end, your body is not fully capable of handling infections such as nail fungus. If you get a fungal infection of the nails, it will thicken the nails and with time, can also cause them to break.

7. Build up of chalky debris:

Keratin, a protein that is responsible for creating skin cells, can overproduce as a result of psoriasis. To the patient, this overproduction would appear as a chalky substance beneath the nails. Pressing upon the nails in this situation can be painful.

8. Tiny black lines in the nails:

This particular condition is called splinter haemorrhages. As the skin is affected beneath the nails, the tiny capillaries that are present on the skin are affected as well. They haemorrhage as the result of psoriasis. When that happens, there is blood accumulation between the nail and the nail bed.

9. High risk of psoriatic arthritis:

According to researches, there is 53% to 86% chance that a person with psoriasis can also have psoriatic arthritis.

10. Furrows going across the sides of the nails:

The patient of nail Psoriasis can also observe some lines going across the nails. This condition is called Beau’s Lines. They appear to look like indentations or ridges.

What Causes Nail Psoriasis?

Psoriasis is an autoimmune disease that can be triggered by some different factors. We differentiate each form of psoriasis based on the parts of the skin they spread into. Furthermore, you can know about their cause from the region that was affected. In the case of Nail psoriasis, it is the nails that are affected. Therefore, the following might be the cause of this disorder:

  1. Recent trauma: if your nails have recently been hit by something, it can cause some trauma and can trigger Nail psoriasis.
  2. Inherited Condition: There has been a plethora of research to find out if the condition is hereditary. While the evidence pointing to that is not fully conclusive, researches show that there is about 50% chance for you to have psoriasis if both your parents have it too.
  3. Smoking: When you are inhaling toxins, your body reacts to it. Smoking is one of the major trigger factors associated with Nail Psoriasis.
  4. Alcohol consumption: Another one of the major triggers to nail psoriasis is alcohol consumption.
  5. Heavy stress: Your mind rules the body is a statement that you can take in a positive, as well as a negative way and you would be right with either of them. Stress is a major trigger factor because it can severely affect the immune system of your body.
  6. Infections: Nail Psoriasis is not an infectious disease. It is borne out of the reaction to infections. Infections like fungal infections etc. can trigger nail psoriasis.
  7. Lack of vitamin D: While vitamin D deficiency does not directly trigger Psoriasis, and it can surely cause the body to lose the ability to make healthy skin cells. Researchers like Dr Olbricht have stated the same. Furthermore, it has also been found that one common denominator in the people with Plaque psoriasis is lack of Vitamin D.
  8. Reaction to certain medications: It has been found that medications like lithium, beta blockers, iodides and antimalarial drugs can trigger psoriasis as well.

Treatment of Nail Psoriasis

Following are the prescribed treatments for Nail Psoriasis:

  1. Topical treatments: if the skin around the nails is the only region affected, then topical ointments with ingredients like coal tar or salicylic acid are also recommended.
    1. Lazotene: Vitamin A in topical form
    2. Calcipotriene: Vitamin D in topical form
  2. Medications: Dermatologists prescribe medications such as Vitamin A derivatives, antimetabolite drugs, vitamin D supplements.
  3. Steroids: Steroids are considered to be the best course of action when dealing with almost any kind of inflammation. In this particular case, cortisone injections can be given directly under the nail.
  4. Chemical or surgical removal: To deal with the painful symptoms, a part of the nail can be removed as per the doctor’s This can either be done surgically or chemically. Chemical removal is highly recommended because there is no bleeding involved.
  5. Systemic Therapy: If the psoriatic symptoms are spread across both the nails and the skin, then systemic therapy is also applied. In this therapy, the entire body is medicated with either injection of oral medications. These medications might include:
    1. Cyclosporin
    2. Methotrexate
    3. Biologics

Home Remedies to Treat Nail Psoriais

There are no home remedies to cure this condition. However, there are some aesthetic things that you can do to promote the positive effects of the medication:

  1. If the nail is loosened, trim it back gently to its original place.
  2. Make sure that you are gentle on your nails at all times.
  3. Don’t be vigorous in your attempts to scratch the itch.
  4. Avoid any nail injury.
  5. Use nail polish to hide any irregularities.
  6. Make sure to remove the nail polish before it is time to medical examination.

Nail Psoriasis is a quite and an appalling condition. However, with constant vigilance from your part and the treatments from the doctor’s, you can eventually treat the symptoms of this autoimmune disorder.

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Sagar Papneja

For me, health is about sustainable living and consuming environmentally conscious food; I am a vegan.

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