Psoriatic arthritis is a distinct form of arthritis that affects certain individuals living with psoriasis, an autoimmune skin disorder. While it’s common knowledge that psoriasis can trigger red, scaly patches on the skin, many aren’t aware that it can also bring about changes to the nails, a condition often referred to as nail psoriasis. This occurrence is particularly common among those who develop psoriatic arthritis.
Before we delve into how this condition might affect your nails, let’s quickly unpack what nail psoriasis is. Nail psoriasis manifests when psoriatic disease affects the nails, leading to symptoms like pitting (small dents in the nail surface), separation, and thickening underneath the nail. It can potentially affect all or just one of your nails.
While not synonymous with psoriatic arthritis, nail psoriasis often accompanies it. In fact, around 80% of individuals diagnosed with psoriatic arthritis present signs of nail involvement.
Here, we’ve rounded up the five most common ways psoriatic arthritis might alter your nails and tips on how to handle it.
- Pitting is one of the most frequent indicators of nail psoriasis. These are small depressions that form on the nail surface, appearing as dents, grooves, or ridges. While nail pitting could be attributed to other causes such as vitamin deficiencies, it’s a major symptom of psoriatic arthritis.
- Discoloration Psoriatic arthritis can lead to discoloration of your nail bed, causing it to appear yellow, red, pink, brown, or even white.
- Separation Onycholysis or nail separation is another symptom where the nail plate detaches from the nail bed, creating a space where bacteria could potentially grow, thereby increasing the risk of infection.
- Subungual Hyperkeratosis This term refers to the thickening of the nail bed due to an accumulation of keratin layers. This build-up of a white, chalky substance under the nails can be particularly uncomfortable, especially when wearing shoes.
- Fungal Infections While nail psoriasis isn’t a fungus, it can coexist with a fungal infection called onychomycosis, which causes the nails to thicken and crumble. This condition affects roughly 35% of individuals with nail psoriasis.
As for managing nail psoriasis, it’s crucial to note that there’s no outright cure for psoriatic arthritis. The focus remains on managing and controlling symptoms as effectively as possible. Treatments often encompass oral anti-inflammatory medications, corticosteroids (administered topically, orally, or through injections), vitamin A and D derivatives, light therapy, laser therapy, and topical creams.
Treatment response can vary between individuals, and it might take several months to observe improvements due to the slow growth of nails. Consequently, healthcare providers often recommend a personalized approach and might combine two or more therapies for optimal results.
In addition to professional treatment, you can implement the following nail care tips at home:
- Keep your nails short, clean, and dry.
- Regularly moisturize your hands, especially after washing and bathing.
- Wear gloves when undertaking manual tasks.
- Avoid artificial nails and aggressive manicures.
- Refrain from biting your nails or picking at cuticles.
- Allow nail build-up to clear naturally, without attempting to scrape it off.
Remember, if you suspect your nail-related changes might be due to psoriatic arthritis, don’t delay seeking treatment. This condition can progressively damage the joints if left untreated. However, with the right care, it’s entirely possible to manage the symptoms effectively and continue enjoying your everyday activities.
