Psoriasis is an autoimmune condition in which the immune system is unusually active. This causes immune cells to attack the cells at the surface of the skin. The resulting inflammation causes rapid growth and division of skin cells, resulting in the appearance of red and raised plaques on the skin. Psoriasis can also affect the nail beds, resulting in thick and pitted nails. There are a number of different ways in which this form of psoriasis can be treated and managed.
Step 1
Keep your nails protected. If the nails become damaged or irritated, a Koebner phenomenon may occur, notes the website Psoriasis Rx. This is an acute worsening of the nail psoriasis. Patients should try to keep their nails trimmed short so as to avoid having the nails get caught on hard surfaces and tearing. Patients should also try to soak and file down toenails that are affected by psoriasis. Comfortable shoes can also help keep psoriasis of the nail beds in the feet from getting worse by reducing the risk of toenail damage.
Step 2
Apply calcipotriol and/or 5-fluorouracil creams to the affected nails. These two treatments, the New Zealand Dermatological Society explains, can help relieve psoriasis of the nail bed. Calcipotriol should be applied two times each day to the nail folds and can be effective when applied regularly for an extended period of time. 5-fluorouracil cream should be applied daily or according to your dermatologist's recommendations, and can help relieve nail pitting and thickening over the course of 6 months.
Step 3
Apply high-strength corticosteroid creams. These ointment work best when they are added to the nail surface at bedtime and covered with cellophane to prevent them from being rubbed off during the night. Corticosteroid creams should not be used on a long-term basis, however, and should not be used for more than 2 weeks at a time. The New Zealand Dermatological Society explains that corticosteroid creams can be applied two consecutive days each week for long-term therapy.
Step 4
Receive corticosteroid injections into the nail bed. These injections can be performed by a dermatologist, but should not be used concurrently with corticosteroid ointments.
Step 5
Utilize psoralen and ultraviolet light therapy. Psoralen and a special type of ultraviolet light known as UVA can be used to treat severe cases of psoriasis. Patients utilizing this kind of therapy should do so under the care of a trained dermatologist due to the increased risk of skin cancer and eye damage that can occur if UV light therapy is not properly administered.
Step 6
Take systemic treatments for psoriasis. Systemic medications for psoriasis are treatments that are taken orally and treat psoriasis throughout the body. These medications, which include corticosteroids, retinoids and methotrexate, are typically only used for severe cases of psoriasis, but can also relieve nail symptoms, reports the New Zealand Dermatological Society.
Step 7
Take antifungal medications. One-third of all patients with nail psoriasis also have a fungal nail infection known as onychomycosis, notes the National Psoriasis Foundation. This infection can cause thickening of the nails and can make the symptoms of nail bed psoriasis worse. Antifungal medications such as terbinafine and ketoconazole can help treat this fungal problem.
Things You'll Need
- Calcipotriol cream
- 5-fluorouracil cream
- Corticosteroid cream
- Antifungal medications
