Nail Psoriasis

Half of all psoriasis patients will have nail disease. Nail psoriasis may present as tiny pits, thickened nails, or staining of the nail plate. Psoriasis of the nails can be distressing to many patients both in terms of pain as well as the unsightly look of this condition. Treatments such as creams and lotions are partially effective, however tablets can make a significant improvement. The Specialists at The Psoriasis Institute can assess the severity of your nails and provide treatment options.

  • Most people confuse nail psoriasis with fungal nail infections
  • Simple measures can provide the most benefit for patients
  • Vitamin A and D creams can be effective in the treatment of nail disease


Psoriasis can affect all aspects of the nails, including the nail fold, the nail plate and the matrix. Depending on which part of the nail psoriasis affects, the findings may differ.

Pitting of the nails is the most common finding- tiny pits maybe seen on the nail plate, and may affect the finger and toe nails.

Crumbling and thickened nails may occur on a few nails, or in severe cases all nails.

Discolouration of the nails maybe the only sign of psoriasis. This may give a dirty or oily look in the nail bed. Discolouration maybe seen in one or two nails or affect all nails. Many patients who have this form of nail psoriasis may have been treated for a fungal infection in the past.

Nail psoriasis can affect up to 50% of psoriasis patients. The cause is though to be genetic, made worse with trauma and stressors. The different clinical presentations of nail psoriasis depends on which area of the nail is being affected. In some cases, removing the traumatic cause can improve the nails without the need for medication. If in doubt, ask your GP to undertake a nail clipping to exclude a fungal infection, as this may mimic nail psoriasis.

To date, there is no cure for nail psoriasis, however the condition may improve over time without treatments. A simple prescribed hand care guide by our experts may assist in reducing trauma to your nails without the need for treatments however prescription medical treatments may provide a solution to your condition.

Severe nail psoriasis maybe a marker for psoriatic arthritis.

General nail care for psoriasis patients forms the basis of treatment. Trimming nails and protecting from trauma can improve the nail disease without the need for treatments. Nail clippings should be done to ensure that the condition is not due to fungus, which may mimic nail psoriasis.

As psoriasis affects the nail when the nail is being formed, any form of treatment may take months to be effective. The nail plate acts as a barrier, so creams to this area have limited success.  Creams are best applied to the nail folds.

Vitamin D creams and solutions (Calcipotriol)  can be applied twice a day to the nail folds.

Vitamin A creams can be used in the same manner.

Steroid creams can be used successfully, but only under medical supervision.

Phototherapy of the hands and feet may improve nail psoriasis, especially if the nail folds are involved.

Tablets such as Methotrexate, retinoids and biologics usually provide the most success but side effects need to be considered.

The treatment of nail psoriasis is individualised for each and every patient, the specialists at The Psoriasis Institute will provide a tailored program for each patient.

General care of your nails can improve the look of nail psoriasis, and help prevent any secondary infection.

Trim back the nails as far as possible, and never pick at the cuticles. Loose nails can be injured as they can catch onto things and traumatise your nail plate. Avoid trauma to nail plates, no not manicure your nails as this can worsen nail psoriasis. Ensure you protect your hands and nail whist washing up.

The experts at The Psoriasis Institute can assess the severity of your nail psoriasis and provide you with the necessary treatment of your condition.

A Medicare care gap of $ 25 applies for the first consultation with our Psoriasis Practitioner.

Most nail psoriasis treatments are PBS listed medications and cost between $18- $50 dollars on a prescription.

Call The Psoriasis Institute on 07 3871 3437 for an appointment time.

NO referrals are required.

Nail psoriasis may present in many forms including staining of the nails, pits, and thickened ‘crumbly’ nails. Many patients have been treated for ‘nail fungus’ with no success. A nail clipping and scraping should be done as the first step. Protecting the nails from trauma, including a hand or foot care guide forms the basis of treatment. Creams, including vitamin A and vitamin D creams can improve nail psoriasis.

Phototherapy for hand and foot psoriasis can improve the nail folds, however have very little impact on nail disease.

Nigel Harris -  Specialist Psoriasis Nurse Educator


  • It's great they have dieticians here. I like that the treatment here is more than just about pushing medications, but also about lifestyle and dietary changes - this is the best my psoriasis has been in about 15 years!
    - Phillip W, Capalaba