Topic Overview

Many people who have psoriasis have nail changes. This can involve:

• Pitting on the surface of the nail.
• Defects in the nail, such as ridges or crumbling nails.
• Yellowish color to the toenails (and sometimes fingernails).
• Thickening of the fingernails or toenails.
• Spots under the fingernails, such as yellow-red patches.
• Separation of the nail from the nail bed.
• Total loss of the nail bed.

Nail changes rarely happen without other signs of psoriasis. And sometimes changes in the nails can confirm a diagnosis of psoriasis. Nail problems happen most often in people with psoriatic arthritis.

Psoriasis of the nail can be very hard to treat, and treatment is not always successful. Treatment is aimed at the white half-moon–shaped root of the nail (the matrix).

Treatments include some of the same topical and systemic therapies that are used to treat psoriasis that affects the skin. In some cases, medicines can be injected into the nail bed.

Treatments take time to work, and you may not see improvement for months. New, healthy nails may need up to a year to grow.