Have you ever looked at your fingernails or toenails and thought, "Oh, what's wrong with them? They've changed color, they've got spots, or they've just formed little pits?" Sometimes we don't pay much attention to them. However, these changes in our nails can sometimes be a sign of something else going on inside our bodies. Nail psoriasis is a condition that affects the nails. Let's talk about it in more detail today.
What is Nail Psoriasis?
Simply put, nail psoriasis is a condition that occurs due to a problem with our own immune system. This is called an autoimmune disease . What happens here is that our skin cells start to grow faster than they should. To be precise, this is a part of the skin disease called psoriasis. But it especially affects the nails of our hands and feet. Often, people who have psoriasis elsewhere on their body also see this condition in their nails.
Who is at higher risk of developing nail psoriasis?
Actually, anyone can develop this nail psoriasis. However, some people are more likely to develop it. Let's take a look at who they are:
- People over 40 years old.
- Men (women also get it, but it's a little more common in men).
- People who already have psoriasis, or if someone in the family has psoriasis.
- This is also more likely to occur in people with the joint disease psoriatic arthritis .
How common is this situation?
This is actually not as rare as you might think. It is quite common. More than 50% of people with psoriasis have nail psoriasis. Also, a whopping 86% of people with psoriatic arthritis also have these nail problems. So, if you have these symptoms, remember that you are not alone.
Is nail psoriasis a fungus?
Many people think, "Oh, this must be a fungus" when they see a change in their nails. However, nail psoriasis is not a fungus. As mentioned earlier, it is an autoimmune disease. This means that our body's defense system, the immune system, becomes overactive and rapidly produces new skin cells. Fungal infections are a completely different matter. However, when the nails become weak due to nail psoriasis, sometimes fungal infections can also be added to it.
What are the symptoms of nail psoriasis?
Okay, now let's see what changes you can see in the nails of someone with nail psoriasis. See if you have one or more of these symptoms.
- Nail Discoloration: The skin under your nail (called the nail bed) may change color. These can be yellow, red, pink, or brown. Sometimes these look like salmon patches or oil drop spots . It looks like there is an oil drop stuck under the nail.
- Pitting: Small depressions, called cupuliform depressions, can appear on the surface of the nail. Imagine a sewing needle making small holes in the nail. These pits can be very small (about 0.4 mm), or they can be as large as the tip of a pencil (about 2 mm). They can vary in depth. There may be one or two pits on one nail, or more than ten pits on one nail.
- Changes in nail structure:
- Lines may appear across the nail and into the hand. These are called `Beau's lines` .
- The nails become very thin and can start to crumble easily, like a biscuit.
- The thick layer of skin under the tip of the nail can peel off and begin to separate from the nail. This is called `onycholysis` . When this happens, it is possible for a secondary fungal infection `(nail fungus)` to develop.
Some of these symptoms may simply cause discomfort, pain, or a stinging sensation when you touch your nails. This may make it difficult for you to stand, walk, or even do simple tasks with your hands.
Why does this nail psoriasis develop?
The main reason for this is a malfunction in our immune system. Specifically, a type of cell called T-cells, which are like our body's defense soldiers, mistakenly starts attacking healthy skin cells. Because of this, our skin normally produces new cells every 28 to 30 days, but in people with psoriasis, these new cells are produced every three to four days and come to the surface of the skin. This is why the skin becomes red and scaly. In some people with psoriasis, the nails are also affected in this way.
Is this contagious?
This is a problem that many people have. Nail psoriasis is not contagious. You cannot spread it from skin-to-skin contact with someone else if you have it. So don't worry about it. You can live normally with other people.
How do you recognize this?
A doctor can usually tell if you have nail psoriasis by examining you, asking about your symptoms, and asking if anyone in your family has this condition.
Once your doctor has confirmed this, they may use a method called the Nail Psoriasis Severity Index (NAPSI) to measure the severity of your condition. This involves dividing your nail into four quadrants and giving each quadrant a score from 0 to 4 based on the severity of the psoriasis symptoms. The scores are then added together. A low score indicates that your condition is not that severe. A high score indicates that your condition is somewhat severe.
Sometimes, if there is a strong suspicion that this is a fungal infection, the doctor may do a `Potassium Hydroxide (KOH) preparation` or a fungal culture. If those tests are not clear, a `PAS stain` (Periodic Acid-Schiff - PAS stain)` can be used to confirm this.
Will this get better on its own?
To be honest, there is no permanent cure for nail psoriasis. It is a long-term, or `chronic`, condition. This means that it can come and go throughout your life. There may be periods of flare-ups and remissions. However, with good treatment, symptoms can be controlled and you can get relief. So don't worry.
What is the treatment for this?
Managing nail psoriasis can sometimes be a bit challenging, as it doesn't respond well to some treatments. So you and your doctor may need to try different treatments together.
- Corticosteroids: Your doctor may give you a cream, ointment, or nail polish that contains corticosteroids. To work properly, these medications need to reach the skin under the nail (nail bed) and the area where the nail begins to grow (called the nail matrix). This is a bit tricky. You'll need to apply them about twice a day, and it can take four to six months to see significant improvement.
- Medicine injections: If the condition is more severe, your doctor may use a fine needle to inject medicine into the skin around your nails. This may involve biologic drugs such as Etanercept , Adalimumab , or Ustekinumab .
- Oral medicines: In severe cases, your doctor may prescribe oral medications, either liquid or tablets. Examples include methotrexate , cyclosporine , or apremilast. These should only be used under medical supervision.
- Phototherapy: This uses ultraviolet light from special lamps. Your doctor may use either ultraviolet A ( PUVA - Psoralen + Ultraviolet A ) or ultraviolet B ( UVB - Ultraviolet B ) light with a drug called psoralen. These light waves can help with some skin and nail conditions, including nail psoriasis.
- Laser therapy: Your doctor may use a type of laser called a Pulsed Dye Laser (PDL) to target the blood vessels under your nails. This can help reduce the severity of your nail psoriasis. This laser treatment is usually done about once every six months.
What are the remedies and tips that can be done at home?
There are a few home remedies and tips you can follow to help manage the symptoms of nail psoriasis.
But remember, while these home remedies are safe for most people, it's important to talk to your doctor before starting them, as you may have an allergic reaction.
- Aloe vera: Aloe vera gel has anti-inflammatory properties. This can help reduce the symptoms of nail psoriasis. Apply aloe vera gel to your nails and the surrounding skin several times a day, especially before bed.
- Capsaicin: This is the chemical that gives chili peppers their heat. Creams or ointments containing capsaicin can help relieve symptoms of nail psoriasis. However, avoid touching your eyes after applying them, as they can cause irritation.
- Dead Sea salt: This salt, sourced from the Dead Sea in Southwest Asia, can help relieve symptoms of nail psoriasis. Add a little salt to a bowl of lukewarm water (about 95 degrees Fahrenheit) and soak your nails in it for at least 10 minutes. Do this several times a week.
- Turmeric: Turmeric is a spice that contains a chemical called curcumin . Studies have shown that curcumin has anti-inflammatory and anti-fungal properties, which may help with nail psoriasis symptoms. You can add turmeric to your food or take it in pill form at a specific dosage. (Ask your doctor about this too.)
Also, be aware of these things:
- Wash your hands and nails regularly to prevent infections.
- Apply a moisturizer to your nails and the skin around them.
- Keep your nails trimmed short.
- Apply a nail hardener polish.
- Cut and remove the hangnails.
- Wear gloves when doing things that can damage or dry out your nails, such as washing dishes, playing sports, or working outdoors.
If you are embarrassed or embarrassed by nail psoriasis, you can buff your nails and apply nail polish to cover up any pits or discoloration. However, avoid using fake nails. They can damage your natural nails.
How can you reduce the risk of developing nail psoriasis?
There's really no way to prevent nail psoriasis. If you have it, it will likely come and go throughout your life, sometimes getting better and sometimes getting worse. However, with good treatment, symptoms can be reduced, even for people with severe nail psoriasis.
What should I expect if I have nail psoriasis?
Nail psoriasis can have flare-ups and remissions throughout life. However, it can usually be well controlled with treatment. So, stay strong.
Can nail psoriasis cause other complications?
If you have nail psoriasis, you may be at slightly increased risk for certain other conditions. These include:
- Diabetes
- Heart attack
- High cholesterol
- Obesity
- Stroke
This doesn't mean that everything will work out. However, it is important to be aware of this, live a healthy lifestyle, and follow medical advice.
How do I take care of myself?
If you have nail psoriasis, the best way you can take care of yourself is to:
- Take your medications and apply ointments exactly as prescribed by your doctor.
- Always keep your nails clean, cut them short, apply moisturizer, and take care not to damage your nails.
- Eat a balanced diet and exercise. These things are good for your health in general.
When should I see a doctor?
You should definitely see your doctor if you experience any of the following:
- If you develop new symptoms.
- If symptoms do not improve after treatment.
- If the skin around the nail looks infected (red, purple, gray, or white; inflamed and swollen).
What questions should I ask the doctor?
When you go to see the doctor, it will be helpful for you to ask questions like these:
- How exactly do you tell if I have nail psoriasis?
- If I don't have nail psoriasis, what other condition could I have?
- How can I prevent these symptoms from escalating and manage my symptoms?
- What kind of medications do you recommend?
- Are there any side effects to those medications?
- What home treatments do you recommend?
- Are there any side effects to those home treatments?
- What else should I do to improve my symptoms?
- Is there a cream or ointment you can prescribe?
- Should I see a dermatologist or another specialist?
Finally, things to remember (Take-Home Message)
Okay, so from what we've discussed, I hope you've got a good idea about Nail Psoriasis. Finally, here are some important things to remember:
- Nail psoriasis is an autoimmune disease. This means it is caused by a change in our own immune system. This can cause changes in the color of the nails, the formation of pits, and changes in the shape of the nails.
- This condition may make you feel embarrassed and uncomfortable. However, you can improve your appearance by brushing your nails and applying nail polish. But don't even touch artificial nails!
- This is not a contagious disease. So don't worry about infecting someone else. The symptoms can be controlled with good treatment.
- Always pay attention to your nails. If you notice any changes in your nails, see a doctor immediately. The sooner you start treatment, the better the results.
Don't forget, you are not alone. Many people live with these conditions. With the right medical advice and good care, you too can control this condition and live a normal life.
` Nail Psoriasis, Nail Psoriasis, Skin Diseases, Nail Diseases, Immune System, Psoriasis, Nail Care
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