Five tips for patients: Managing nail psoriasis


The American Academy of Dermatology (AAD) has released a list of five tips for at-home self care of nail psoriasis which can help patients reduce pain, allow them to perform their daily activities, and make their nails look more normal.

“There are many treatment options available for nail psoriasis, including topical and oral medications, corticosteroid injections and biologics,” said board-certified dermatologist Dr. Richard K. Scher, in a press release from the AAD.

He noted that nail psoriasis can be challenging to treat, and that to achieve good results it is important that patients know they need to treat their nails in the manner and for as long as directed to by their dermatologist. Dr. Scher said that the right self-care of nails at home can aid patients in getting the best results from their treatments.

To help improve nail psoriasis at home, Dr. Scher recommended that patients be provided with the following tips:

  • Keep nails trimmed short. This helps prevent the nails from lifting off of patients’ fingers and toes. It can also help prevent buildup under the nails—a common issue associated with nail psoriasis. Hangnails should be clipped immediately.

  • Individuals should avoid biting or picking their nails, the area under the nails and the cuticles. Injuring the skin increases risk of infection, which could worsen psoriasis. To aid in avoiding biting and picking, patients can try applying bitter-tasting nail polish, or replacing this habit with a better one, such as playing with a stress ball.

  • Patients should moisturize their hands and nails. Moisturizer should be applied immediately after bathing or washing hands to lock in moisture. They should use ointments or creams, as these are more effective than lotions.

  • Nails should be protected. Any time patients irritate their skin or nails, their psoriasis can flare. To prevent this, individuals should wear gloves when doing housework, yard work or other labor-intensive work to prevent their psoriasis from flaring. When doing wet work such as washing dishes, it is best to wear a cotton glove and then place a vinyl or nitrile glove over the cotton glove. Latex gloves cannot give nails enough protection.

  • Consider nail polish: If patients are concerned about the appearance of their nails, they can consider gently buffing them to help smooth the surface or wearing nail polish, which is a way to hide nail issues, such as dents or discolouration. Artificial nails should be avoided, as they may contribute to nails separating and lifting from the fingers.

“Nail psoriasis can be stubborn, however, the combination of treatment and the recommended at-home care can help clear nail psoriasis and reduce pain,” said Dr. Scher. “Nail psoriasis may also be a sign of psoriatic arthritis, a type of arthritis that can occur in psoriasis patients.”

He said that if patients notice any changes to their fingernails and toenails, or nail changes coupled with swollen, stiff and sometimes painful joints when waking up, they should see a board-certified dermatologist, as the sooner their issue is addressed, the better their results can be.

These tips are demonstrated in “How to Improve Nail Psoriasis,” a video posted to the AAD website and YouTube channel. This video is part of the AAD’s “Video of the Month” series, which offers tips people can use to properly care for their skin, hair and nails.

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