Understanding Nail Psoriasis: What to Look For and How to Manage It

London Dermatology | 17 June 2025

Nail psoriasis is a condition that affects the fingernails and toenails, often causing changes in appearance and texture. These changes can include discolouration, thickening, and nail separation. The condition is linked to psoriasis, a chronic autoimmune disorder that speeds up the skin cell renewal process.

Although nail psoriasis is not life-threatening, it can have a significant impact on a person’s daily life. In addition to physical discomfort, visible nail changes may lead to self-consciousness and emotional distress. While treatments are available, results can take time and vary from person to person.

Nails are a part of the skin. They develop from the nail matrix located beneath the cuticle, which is also where psoriasis-related inflammation tends to begin. In people with psoriasis, the immune system mistakenly attacks healthy tissue, including the nail-producing cells, resulting in a variety of nail abnormalities.

In a healthy person, skin cells usually renew every 28 to 30 days. In someone with psoriasis, this process is much faster, often occurring every three to four days. This rapid turnover leads to thick, flaky patches on the skin and, in the case of nail psoriasis, causes changes in nail structure and appearance.

Common signs of nail psoriasis include:

• Pitting or small dents in the nail surface

• White spots or patches

• Ridges or grooves along the nail

• Changes in shape, size, or thickness

• Nail crumbling or brittleness

• Onycholysis, which is the separation of the nail from the nail bed

• Discolouration, often appearing yellow or brown

• Red or dark streaks of blood beneath the nail

Treatment options for nail psoriasis vary depending on the severity of the symptoms. These may include topical treatments such as corticosteroid creams, medicated nail lacquers, and in some cases, steroid injections directly into the nail area. For more persistent or severe cases, systemic treatments such as biologics or oral medications may be considered.

While nail psoriasis cannot be cured, its symptoms can be managed effectively with the right treatment and support. Early diagnosis can help prevent complications and limit long-term damage to the nails.

At Devonshire Dermatology, we offer personalised care for patients with psoriasis and nail-related symptoms. If you are experiencing any of the above signs or are unsure about changes to your nails, book a consultation with one of our specialists for expert guidance and support.