What is the Best Treatment for Nail Psoriasis?

Introduction

Psoriasis is a condition caused by an overactive immune system that starts attacking its own cells. The result is rapid inflammation throughout the body that might also affect your nails. Yes, you heard it right. Nails are one of the main body parts impacted by psoriasis. In fact, around 50% of people living with psoriasis are reportedly suffering from nail psoriasis.

Still, with the right nail psoriasis treatment, many people can significantly improve nail appearance, strength, and comfort. The key lies in choosing the best treatment based on severity, symptoms, and overall health. Also, there is a clear difference between psoriasis and eczema; therefore, the distinction is the first step.

In this guide, we will explore the most effective treatments for nail psoriasis, from topical therapies to advanced systemic options. We will also explain how dermatologists personalize care plans and what you can do to achieve the best long-term results.

Let’s Gain Insights about Nail Psoriasis First

Nail psoriasis is a chronic condition caused by an overactive immune system. It affects the fingernails, toenails, or both and often occurs alongside skin psoriasis, although it can appear on its own and affect people of any age. The condition disrupts normal nail growth, leading to visible and sometimes painful changes.

Common signs include nail pitting, discoloration, thickening, ridging, crumbling, and separation of the nail from the nail bed. Because nails grow slowly, symptoms often persist unless treated consistently. Therefore, early diagnosis and an appropriate nail psoriasis treatment plan make a meaningful difference.

Why Treating Nail Psoriasis Takes Time?

Before choosing the best Treatment for nail psoriasis, it is important to understand why results do not appear overnight. Fingernails take about six months to grow fully, while toenails may take up to a year. As a result, treatments must continue for months before healthy nail growth replaces damaged nail tissue.

Moreover, nail psoriasis tends to be resistant to treatment. For this reason, dermatologists often combine therapies to improve outcomes. Consistency, patience, and regular follow-ups play a crucial role in success.

Topical Treatments for Mild to Moderate Nail Psoriasis

For mild or early-stage disease, treatment applied directly to the nails often works well.

However, for a few nails getting affected, dermatologists usually recommend these options.

Corticosteroids

Strong or very strong topical corticosteroids form the foundation of many Nail Psoriasis Treatment plans. These medications reduce inflammation and slow excessive skin cell growth under the nail.

Patients typically apply corticosteroids once or twice daily. When used as directed, they safely improve pitting, discoloration, and nail separation. However, dermatologists monitor duration closely to prevent skin thinning.

Calcipotriol

Calcipotriol, a vitamin D derivative, effectively treats the buildup of skin cells beneath the nails. It helps normalize nail growth and works particularly well for subungual hyperkeratosis, which causes thick debris under the nail.

Often, dermatologists combine calcipotriol with corticosteroids to enhance results. This combination strengthens the overall Nail Psoriasis Treatment approach.

Tazarotene

Tazarotene, derived from vitamin A, targets nail pitting, discoloration, and nail separation. While effective, it may irritate surrounding skin if applied incorrectly. Therefore, dermatologists provide precise instructions to ensure safe use.

When patients follow directions carefully, tazarotene becomes a valuable treatment for nail psoriasis, especially in resistant cases.

Injectable Treatments for More Stubborn Symptoms

If topical therapies fail or symptoms worsen, dermatologists may recommend injectable treatments.

Corticosteroid Injections

Injectable corticosteroids deliver medication directly into or near the affected nail. This approach treats nail thickening, ridging, buildup under the nail, and nail separation more aggressively.

Patients usually receive injections every four to six weeks. Although injections may cause temporary discomfort, many patients experience noticeable improvement after a few sessions. For persistent cases, this nail psoriasis treatment option often provides relief when topical therapies alone fall short.

Laser Therapy: An Emerging Option

Laser treatments have shown promise in managing nail psoriasis. They aim to reduce inflammation and abnormal blood vessel growth associated with psoriasis.

However, experts still need more research before lasers become a standard treatment for nail psoriasis. While some patients notice improvement, dermatologists usually recommend lasers as an adjunct rather than a primary therapy.

Systemic Treatments for Severe Nail Psoriasis

When nail psoriasis becomes severe or occurs alongside widespread skin psoriasis, dermatologists may prescribe treatments that work throughout the body. These therapies address the underlying immune response rather than just surface symptoms.

Biologic Medications

Biologics target specific immune pathways responsible for psoriasis. They often deliver impressive results for both skin and nails. Although improvement takes several months, biologics remain one of the most effective nail psoriasis treatment options for severe disease.

Methotrexate

Methotrexate suppresses the immune system activity and reduces inflammation. Dermatologists often prescribe it for patients with severe psoriasis affecting multiple areas, including the nails.

Acitretin

Acitretin, an oral retinoid, helps normalize skin and nail cell growth. It works well for thickened or deformed nails but requires careful monitoring due to potential side effects.

Cyclosporine

Cyclosporine acts quickly to suppress immune responses. Dermatologists often use it for short-term control in severe cases. As part of a comprehensive Treatment for nail psoriasis, it can provide rapid symptom relief.

Apremilast

Apremilast offers an oral option that modulates immune signaling. It suits patients who prefer non-injectable therapies and can improve both nail and skin symptoms over time.

Treating Nail Infections Alongside Psoriasis

Nail psoriasis increases the risk of fungal or bacterial infections. Therefore, dermatologists examine nails carefully at every visit. If they suspect an infection, they may collect nail clippings or debris for laboratory testing.

When an infection is present, treating it becomes essential. Antifungal or antibacterial therapy supports the primary nail psoriasis treatment plan and prevents further nail damage.

How do Dermatologists Customize Treatment Plans?

No single Treatment for nail psoriasis works for everyone. Dermatologists consider several factors before recommending therapy, including:

• Number of nails affected
• Severity of nail changes
• Presence of skin or joint psoriasis
• Lifestyle factors and patient preferences

Because nail psoriasis responds slowly, dermatologists often adjust treatment plans over time. Some patients try several therapies before finding the most effective solution. Fortunately, ongoing advancements continue to improve outcomes.

Lifestyle and Nail Care Tips to Support Treatment

In addition to medical therapy, proper nail care supports healing and prevents worsening symptoms. While these steps do not replace nail psoriasis treatment, they enhance results.

• Keep nails trimmed short to reduce trauma
• Avoid aggressive manicures or artificial nails
• Wear gloves during household chores
• Moisturize nails and cuticles regularly
• Avoid picking or biting nails

By protecting the nails, patients allow treatments to work more effectively.

Setting Realistic Expectations

Treating nail psoriasis requires commitment. Even the best treatment for nail psoriasis takes months to show visible improvement. However, with persistence and professional guidance, many patients achieve healthier, stronger nails.

Dermatologists emphasize following instructions carefully and attending follow-up visits. Over time, adjustments improve outcomes and reduce frustration.

Final Thoughts: What Is the Best Treatment for Nail Psoriasis?

The best nail psoriasis treatment depends on disease severity, nail involvement, and individual response. Mild cases often improve with topical therapies like corticosteroids, calcipotriol, or tazarotene. More resistant symptoms may require injections, while severe disease benefits from systemic medications such as biologics or methotrexate.

Additionally, the best treatment option might be the one yet to be discovered. The only way to unleash it is through clinical trials. MetroBoston Clinical Partners is conducting Psoriasis Clinical Trials to help find the treatment option that might be more viable and help in treating or at least managing the condition. Enroll with us today and help make a greater impact.