Psoriasis of the nails can be very distressing. Not only can it be immensely irritating, but it can also cause immense embarrassment.
About 1 in 50 people have psoriasis at some time in their lives. It can develop at any age but it most often starts between the ages of 15 and 30 years. Nail changes occur in about half of all people with psoriasis, so about 1 in a 100 people. About 4 in 5 people with psoriatic arthritis have psoriatic nail disease, and only a few people have psoriatic nail disease without it affecting either the skin or the joints.
Other than the face, the nails and hands are areas which, when affected, cannot be hidden easily. So, when the nails are affected by Psoriasis, many sufferers will resort to any treatments – even harsh chemical treatments and corticosteroids – no matter how serious the side effects may be. Most conventional topical treatments are simply not designed to treat psoriasis of the nails as the skin under the nail is very difficult to get to, and chemical treatments taken orally have a plethora of known adverse side-effects.
What Are The Symptoms of Nail Psoriasis
Pitting and Beau’s Lines
The hard surface that forms the top of your nails is made of keratin cells. Nail psoriasis causes this surface to lose cells which results in small pits forming. Sometimes only a single pit while others have dozens. This is called Pitting. Beau’s lines are lines that form across the nail from the changes in texture.
Nail bed separation
Sometimes your nail can separate from the nail bed. This separation is called onycholysist and it leaves an empty space under your nail. Bacteria can get into this space under the nail and cause infection, turning the whole nail a dark colour
Fungal Infection
Weakness of the structures that support nails can cause your nails to crumble. Nails can also become thicker due to a common fungal infection called onychomycosis. Crumbling nails will often turn white or you may see a yellow-red patch in the nail bed. This is called an Oil Drop Spot.
Nail Psoriasis Treatments
Nail psoriasis can be hard to treat because psoriasis affects the nail as it grows. Treatment options include topical corticosteroids which are common for nail psoriasis treatment. Sometimes these corticosteroids are administered as an injection.
Phototherapy or PUVA has been shown to be helpful in alleviating nail separation and discolouration.
Laser Treatment used in nail psoriasis is called the pulsed dye laser (PDL). It works by targeting blood vessels under the skin with a beam of light, and it appears to reduce the severity of nail psoriasis symptoms.
For those of you that want to steer clear of oral steroid medications or stronger, Turmeric, Capsaicin, Dead Sea Salt and Aloe Vera are natural remedies that may relieve many psoriasis symptoms but, for nail psoriasis, alternative treatment options are fairly limited.
Natural Remedies
One herbal remedy that has shown benefit for nail psoriasis is indigo naturalis, a Chinese herbal medicine that comes from the same plant used to make blue dye. In one small study, an indigo naturalis extract in oil (Lindioil) improved nail thickening and onycholysis.
Mahonia Aquifolium Herbal Extract
This extract has been effective for many people in alleviating and treating the symptoms of nail psoriasis at home. It is a pure extract also known as Oregon Grape Root and has anti-proliferative and anti-fungal properties that have been proven to help with psoriasis symptoms. We recommend using it in the following way:
- Take M-Folia Herbal Extract internally – 10 drops daily in a little freshly boiled water. This starts working from the inside of your body. However, it can take time to start to make an impact on the nails, especially if your circulation is poor. For this reason, and for faster effects, we then recommend:
- Bathe the nails for three minutes in a bowl of hot water with 10 drops M-Folia Herbal Extract. Then immediately put the nails into a small bowl of very cold water for one minute. Repeat this three times consecutively. Pat dry and apply M-Folia Psoriasis Cream or Psoriasis Ointment on and around the nail. If possible, cover the tips of the fingers and nails with air-tight plasters.
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Tips for prevention
In addition to medication, try these tips for preventing flares:
- Keep your nails short to avoid injury or lifting the nail from its bed. Trimming your nails regularly will also prevent build up from collecting underneath them.
- Don’t bite or pick at your nails or push back your cuticles. Injuries to the skin can set off psoriasis flares. This is called the Koebner phenomenon.
- Wear protective gloves when you garden or play sports and when you wash dishes or work with your hands in water.
- Keep your nails clean to prevent infection.
- Use a moisturising cream on your nails and cuticles. This can help prevent cracked or brittle nails.
Avoid cleaning your nails with a nail brush or a sharp object. This will help prevent nail separation. - Take Mineral supplements – this should be in liquid form for maximum absorbency and contain at least 70 minerals and trace elements including Calcium, Magnesium, Zinc & Selenium. Milk Thistle is also very good for liver function
- Drink plenty of water and try to balance your pH foods – avoid acid-forming foods and eat plenty of alkaline foods. Maintaining a healthy pH Acid-Alkaline balance is vital.
How To Hide Nail Psoriasis
If you feel self-conscious about your nail psoriasis, there are some things you can do to make it less noticeable.
Cosmetic treatments such as nail filing, buffing, and polish can improve the appearance of your nails while they heal. Just avoid fake nails, as this may increase the risk of your nail separating from its bed
IMPORTANT NOTE: It is advisable to consult your health practitioner, Dermatologist or GP before changing your current treatment regime.
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