Psoriatic Nails: Nail Deterioration

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Toenails are not “extra” parts—they serve a purpose. They help protect your feet and the sensitive skin at the ends of your toes. Unfortunately, even though they are made of hardened, compacted keratin, toenails are susceptible to injuries and infections. Sometimes skin conditions spread and affect the nails. This is most common for issues like fungus, but skin diseases like psoriasis can give rise to an unpleasant problem as well: psoriatic nails.

Nail DeteriorationPits and Lines

Psoriasis is a chronic condition that causes patches of your skin to become red, scaly, and thickened. It’s an autoimmune problem, so no one is entirely sure what causes the condition to develop. In about half of all people with the disease, the nails show symptoms as well as the skin. The problem is even more common if you have psoriatic arthritis.

The most common symptoms that arise from nail psoriasis include discoloration, pitting, thickening, crumbling, and lines in the hard keratin. You may have yellow or red spots that look like drops of blood or oil under the nail. White patches and vertical black lines may also appear as the skin underneath the nail bleeds slightly. Sometimes the skin there thickens as well, and the hard keratin pulls away from the nail bed.

Managing the Symptoms

These changes are unsightly and can be uncomfortable—they weaken the nail so much that it can crumble and become prone to infections. The disease affects the keratin as it grows, before it is visible on your finger, making the condition particularly challenging to identify and treat. Our podiatrists will examine your limbs and nails carefully and rule out other possible conditions. The skilled doctors are Country Foot Care will also determine the extent of your nail psoriasis and if any secondary infections have developed. Then, we will begin treating the problem.

Rubbing creams and ointments into your psoriatic nails can help strengthen the affected tissue. Steroid cream to address the disease is common, though topical vitamin supplements may help as well. However, topical medications do have a drawback: they are not able to pass easily through the keratin to the nail bed below. Steroid injections directly into the nail matrix or applied to the skin under the nail may be more effective, though the results are mixed.

Oral prescriptions to combat the systemic problem may decrease symptoms over time, too. We can also help with cosmetic repairs so your toes are less embarrassing for you. If these conservative and noninvasive methods don’t work, we may recommend nail surgery. This involves removing the damaged keratin and treating the skin underneath.

Limiting the Flare-Ups

Taking care of your nails can actually help manage the condition and reduce the effects of the disease. Keep your toenails short, so they don’t catch or get damaged easily by your footwear. Damage can trigger or worsen nail psoriasis, so take extra care to wear appropriate shoes to protect your toes. Choose models that aren’t too tight and wear socks that help wick moisture.

Even though there is no “cure” for psoriatic nails, you don’t have to resign yourself to living with unpleasant and embarrassing toes. You can manage the condition and relieve the symptoms. Let Country Foot Care help you take care of your nails. Just request an appointment by calling our offices or by submitting a request online using the MAKE AN APPOINTMENT button at the top of this page.

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