In addition to skin, psoriasis can also affect the nails. In these cases we are in presence of nail psoriasis, a condition that tends to affect about half of the patients with psoriasis, although the case of psoriasis that affects only the nails is not to be excluded. What can be done in order to take care of the nails that are altered due to psoriasis? We asked Professor Antonio Costanzo, Head of the Dermatology Unit at Humanitas and lecturer at Humanitas University.
In general, nail psoriasis occurs more frequently on fingernails than toes. The nail undergoes various alterations including flaking, the formation of a rough and irregular surface, the change of color and the formation of horizontal lines. The nail can also loosen up to the point it detaches from its bed (onycholysis) and be affected by fungal infections.
The treatment of nail psoriasis will differ depending on the condition of each patient and the characteristics of the nails: ‘There is no standard treatment’, replies Professor Costanzo. ‘However, there are different topical treatments (solutions able to cross the nail plate and transport drugs under the nail or gel that is applied on the nail plate) or systemic drugs that by treating the mechanism at the base of the disease also cure the nails’.
‘It should be emphasized that any therapy works much slower on the nails than on the skin because you have to wait for the “regrowth” of the healthy nail’.
Cardboard files for manicure
The first advice is to take care of the nails affected by psoriasis and, if possible, to always keep them short, so they are firmly attached to the nail bed. It is important to protect them from traumas that can further damage their structures, even when wearing gloves. For this reason, it is better to not use metallic files, even for cleaning, but the ones made of cardboard. Hygiene will be guaranteed by adequate washing with soap and water.
Less effective are emollient oils, creams and gels: ‘Emollient oils etc. have very little efficacy on psoriatic nails. Finally, some products can thin the nail a little without achieving optimal results’, concludes the specialist.