How does psoriatic arthritis affect your nails?

According to rheumatologist M. Elaine Hosny, MD, people are often bothered by these nail changes. They may also be bothered by the cosmetic aspects of nail symptoms. In addition, these changes can sometimes cause discomfort.

But like other symptoms of psoriasis and psoriatic arthritis, nail symptoms can be controlled.

How common is psoriatic arthritis, fingernails and toenails?

Psoriasis and psoriatic arthritis are autoimmune diseases that cause inflammation.

Psoriasis occurs when the body’s immune system attacks your skin, causing red, scaly, inflamed patches.

Psoriatic arthritis occurs when the immune system attacks the joints and connective tissues (ligaments and tendons). The disease causes pain and swelling in the joints, as well as fatigue.

Nail symptoms are common in people with psoriasis and even more common in psoriatic arthritis. Up to 80% of people with psoriatic arthritis notice changes in their nails. In fact, fingernail symptoms can be a warning sign of this type of arthritis.

Turns out nail symptoms go deeper than the skin.

Where each of your nails consists of three components:

The nail plate – which is the nail itself.

Nail bed – the skin under the nail plate.

Nail matrix – the area where your nails begin to grow.

Psoriasis and psoriatic arthritis can affect all three parts of the nail, and depending on where it occurs, you can experience many different nail symptoms.”

What do nails with psoriatic arthritis look like?

With psoriatic arthritis, some people may experience changes in just a few fingernails while others may notice changes in all of their fingernails and toenails.

Nail changes caused by psoriasis and psoriatic arthritis come in several different forms:

Nail pitting These small depressions in the nail plate are the most common symptom of nail pitting.

Onycholysis, the nail separates from the nail bed.

Subungual hyperkeratosis, thickening of the nail bed.

Bo lines, showing the bumps and grooves of the nails.

– Bleeding splinters Small bruises or clots appear under the nail and look like small splinters.

Discolored nails may be yellow or brown.

– Fungal infections Nails with psoriasis are also more susceptible to secondary fungal infections.

Treatment options for psoriasis

To treat nail changes caused by psoriatic arthritis, your doctor may prescribe topical creams or ointments to rub on your nails. Systemic (which affects the whole body) medications for psoriasis or psoriatic arthritis can also be very helpful. These medications may include:

Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation.

Disease-modifying antirheumatic drugs (DMARDs) to prevent inflammation.

Biologics, a special class of modulating anti-rheumatic drugs (DMARDs), which target specific parts of your immune system that cause inflammation in psoriatic arthritis.

Nail care tips for psoriatic arthritis

Treating psoriasis and psoriatic arthritis can help reduce the uncomfortable symptoms of nail psoriasis. The following tips can also help keep your nails healthy and pain free.

Avoid using nail polish or nail polish remover that contains harsh chemicals, as they can make your nails more brittle.

– Do not press on your fingernails or toenails.

Keep your fingernails trimmed.

Protect your hands, wear gloves when washing dishes or gardening to keep them dry and prevent damage.