Isla Bennett
Nail psoriasis is a long-lasting (chronic) autoimmune condition that affects the nails on your fingers and toes. It causes discoloration, pitting, crumbling, and changes in the nail bed. While there is no cure for nail psoriasis, there are various treatment options available to alleviate symptoms, including corticosteroids, calcipotriol, tazarotene, oral medicines, and phototherapy. The time it takes to treat nail psoriasis depends on the severity of the condition and the chosen treatment plan, ranging from weeks to months. It is important to follow the treatment plan consistently and explore different options with your dermatologist if needed.
| Characteristics | Values |
|---|---|
| Treatment | Corticosteroids, calcipotriol, tazarotene, injections, oral medicines, phototherapy, laser therapy, over-the-counter creams and ointments, prescription creams and ointments, medications that affect the whole body, biologic drugs |
| Time to see results | 4-12 months |
| Treatment duration | As long as directed |
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What You'll Learn
- There is no cure for nail psoriasis, but treatments can alleviate symptoms
- Corticosteroids are a common treatment, but they must reach the nail bed
- Other treatments include injections, oral medications, and phototherapy
- Laser therapy targets blood vessels under the nails to reduce severity
- Home remedies include aloe vera gel and capsaicin creams
There is no cure for nail psoriasis, but treatments can alleviate symptoms
There is currently no cure for nail psoriasis, but treatments can alleviate symptoms. It is a long-lasting (chronic) condition, which means flare-ups can occur throughout a person's life. Treatment can help clear nail psoriasis and reduce pain or other symptoms.
Nail psoriasis is an autoimmune condition that causes discoloration, pitting, crumbling, and changes in the fingernails and toenails. It can develop years after psoriasis begins, and it may be a risk factor for the development of psoriatic arthritis. Nails grow slowly, so it can take six months or longer to clear debris beneath the nail, a common sign of nail psoriasis.
There are various treatment options available, including over-the-counter and prescription topical medications, oral medications, and injections. Topical treatments include corticosteroids, calcipotriol (derived from vitamin D), and tazarotene (derived from vitamin A). Oral medications include methotrexate, cyclosporine, or apremilast. In more severe cases, healthcare providers may inject medicine into the skin around the nails, such as etanercept, adalimumab, or ustekinumab.
Laser therapy is another treatment option, typically occurring every six months. Home remedies such as aloe vera gel and capsaicin creams or ointments may also help relieve symptoms. It's important to follow the treatment plan provided by a dermatologist and practice regular care and attention to improve the management of nail psoriasis symptoms.
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Corticosteroids are a common treatment, but they must reach the nail bed
Corticosteroids are a common treatment for nail psoriasis, but they must reach the nail bed to be effective. Nail psoriasis is an autoimmune condition that causes changes to the fingernails and toenails, including discoloration, pitting, and alterations in the nail bed. It can take a long time for treatments to improve the symptoms of nail psoriasis, due to the slow growth of nails. Corticosteroids can be applied topically, with creams, ointments, or nail polish, or they can be injected directly into the nail bed.
Topical corticosteroids, such as clobetasol propionate and betamethasone dipropionate, can be applied directly to the nail once or twice per day. It may take at least four to six months to see noticeable improvements with topical treatments. Corticosteroid injections can be used in more serious cases of nail psoriasis, or when topical treatments have not been effective. Injections target the nail bed and the area where the nail starts to grow (nail matrix), which can be difficult for topical treatments to reach.
In addition to corticosteroids, other treatments for nail psoriasis include calcipotriol (derived from vitamin D), tazarotene (derived from vitamin A), and anthralin (an anti-inflammatory ointment). These topical treatments can help reduce inflammation and slow excess skin cell production, which can relieve nail thickness and buildup under the nails. Laser therapy, phototherapy, and oral medications may also be used in more serious cases of nail psoriasis.
It is important to consult with a dermatologist or healthcare provider to determine the most appropriate treatment plan for nail psoriasis. Early treatment can help prevent nail psoriasis and psoriatic arthritis from worsening and reduce their impact on an individual's life. While there is no cure for nail psoriasis, various treatments can provide relief from symptoms and improve nail appearance over time.
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Other treatments include injections, oral medications, and phototherapy
While there is no cure for nail psoriasis, treatments can help alleviate symptoms. Treatment can prevent nail psoriasis from worsening and reduce pain.
In addition to prescription and over-the-counter medications, other treatments for nail psoriasis include injections, oral medications, and phototherapy.
Injections
Your dermatologist will inject medication directly into or near your nails. Most patients receive a series of injections every four to six weeks. Injections of corticosteroids or other psoriasis medications can effectively treat the buildup under your nails, nail ridges, thickening, and separating nails.
Oral medications
If you have severe psoriasis and nail psoriasis, your dermatologist may prescribe oral medication that can treat both your skin and nails. It can take months to see results.
Phototherapy
Phototherapy is usually given at a psoriasis treatment centre or hospital. To be effective, most patients need two or three treatments a week for several weeks. There are different types of phototherapy, including UVB light, laser treatment, and PUVA baths or pills.
It is important to note that phototherapy is not recommended for anyone with a medical condition that makes them more sensitive to UV light or anyone taking medication that increases sensitivity to UV light.
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Laser therapy targets blood vessels under the nails to reduce severity
Nail psoriasis is an autoimmune condition that causes changes to the fingernails and toenails, such as discoloration, pitting, crumbling, and alterations in the nail bed. While there is currently no cure for nail psoriasis, various treatment options can help alleviate symptoms and reduce its severity. One such treatment option is laser therapy.
Laser therapy, specifically pulsed dye laser (PDL) therapy, has emerged as a promising modality for treating nail psoriasis. PDL targets the blood vessels under the nails, utilizing the concept of selective photothermolysis to achieve photocoagulation of smaller blood vessels. This process leads to the destruction of the blood vessels, thereby reducing the severity of nail psoriasis lesions.
The use of PDL in treating nail psoriasis is based on the highly vascular nature of psoriatic lesions. In addition to blood vessel destruction, PDL therapy can also help reduce the number of helper T-cells in the dermis and exhibit immunomodulatory effects. These combined actions contribute to the overall reduction in the severity of nail psoriasis.
PDL therapy for nail psoriasis is generally well-tolerated and has shown significant improvement in psoriatic nail lesions. In a randomized controlled study, patients treated with PDL showed a 22.24% improvement in their nail psoriasis, as assessed by the Nail Psoriasis Severity Index (NAPSI). While the improvement was slightly lower than that observed with intralesional steroid treatment (24.11%), the difference between the two groups was not statistically significant.
It is important to note that PDL therapy for nail psoriasis may take some time to show noticeable results. In the aforementioned study, the improvement in the PDL group was observed at the 36th week, indicating a slower onset of action compared to intralesional steroid treatment, which showed improvement at the 24th week. Therefore, patients considering PDL therapy should be aware that it may take several months for the full benefits of the treatment to be realized.
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Home remedies include aloe vera gel and capsaicin creams
Treating nail psoriasis can be challenging and time-consuming. While there is no cure for nail psoriasis, home remedies such as aloe vera gel and capsaicin creams can help alleviate symptoms.
Aloe Vera Gel
Aloe vera is a traditional medicine that has been used for thousands of years to treat a range of skin conditions, including psoriasis. It has anti-inflammatory properties that may relieve the symptoms of nail psoriasis. The gel may improve skin hydration initially, but this effect may not last with regular use. It is generally safe to use as a moisturizer and on skin affected by psoriasis.
To use aloe vera gel for nail psoriasis, apply it to your nails and the surrounding skin up to several times a day, including before bed. When using aloe vera directly from the plant, it is recommended to do a patch test before applying the gel more liberally. If you are using an over-the-counter aloe vera gel extract, ensure that it contains a high concentration of aloe vera.
Capsaicin Creams
Capsaicin is a chemical compound naturally found in hot peppers that gives them their spicy taste. Capsaicin creams or ointments may relieve nail psoriasis symptoms. However, be careful not to touch or rub your eyes after applying it, as it can cause eye irritation.
A double-blind study on the effects of topically applied capsaicin on moderate and severe psoriasis vulgaris showed significantly greater overall improvement on sides treated with capsaicin compared to sides treated with a vehicle. Burning, stinging, itching, and redness of the skin were common on initial applications but diminished or vanished with continued use.
While home remedies are generally safe, it is advisable to consult your healthcare provider before trying them to ensure you are not at risk of an allergic reaction.
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Frequently asked questions
Treatment for nail psoriasis can take anywhere from 4 to 12 months, and symptoms may return later on. Nails grow slowly, so it takes time for treatments to work.
Topical treatments, such as corticosteroid creams, ointments, or injections, can be applied directly to the nail. Other options include oral medications, phototherapy, and biologic drugs.
Aloe vera gel and capsaicin creams or ointments can be applied to the nails and surrounding skin to relieve symptoms.
Common signs of nail psoriasis include nail pitting, discoloration, nail bed separation, and crumbling. If you notice any of these symptoms, it is important to consult a dermatologist.
Unfortunately, there is currently no cure for nail psoriasis. However, various treatment options can help manage symptoms and provide relief.
