Psoriatic Arthritis Nail Changes: Symptoms & Treatments

If you have psoriatic arthritis, you might notice psoriatic arthritis nail changes that make your nails look different. These nail changes are quite common.

• Almost 90 percent of individuals with psoriatic arthritis experience nail problems.
  Identifying these signs early assists doctors in diagnosing the issue. They can initiate treatment quickly to support your joints.

  If you observe nail changes, you are not alone. Many people experience psoriatic arthritis nail changes before they even feel joint pain.

   

Key Takeaways

• Nail changes happen a lot in psoriatic arthritis. Almost 90% of people get them. Finding these changes early helps you get treated faster.
• Watch for nail pitting, color changes, and weak nails. These signs can show up before you feel joint pain.
• Take care of your nails every day. Keep them short and use lotion. Stay away from strong chemicals to stop more damage.
• Talk to your doctor if your nails keep changing. Getting help early can save your nails and joints.
• Treatments include special creams, steroid shots, and other medicines. Your doctor will pick the best treatment for you.

Psoriatic Arthritis Nail Changes

Psoriatic arthritis can change how your nails look. These changes help doctors find the disease early. You might see one or more of these signs.

The table below lists the most common nail changes and what they look like:

Nail Pitting

Tiny dents or holes can show up on your nails. This is called nail pitting. It is the most common nail change in psoriatic arthritis.

About one out of three people with psoriatic arthritis have nail pitting. The pits look like someone poked your nail with a pin.

Nail pitting happens more in psoriatic arthritis than in other joint diseases. You might also see white spots, called leukonychia, along with the pits.

If you see lots of small pits on your nails, tell your doctor. This can help your doctor find the problem early.

Onycholysis

Onycholysis means your nail lifts up from the skin under it. You might see a space or gap under your nail. The tip of your nail can look white or yellow.

Onycholysis is very common in psoriatic arthritis nail changes. Up to 80% of people with psoriatic arthritis have this problem. Other skin problems can also cause onycholysis, but it is most common in psoriatic arthritis.

Discoloration

Your nails might change color if you have psoriatic arthritis. You could see yellow, brown, or pinkish spots under your nail. Sometimes, your nail looks like it has an oil stain.

This happens when skin cells build up under the nail. Discoloration is a main sign of psoriatic arthritis nail changes. Fungal infections can also make nails change color, but they usually do not cause pitting or nail lifting.

Common types of discoloration:

• • Yellow or brown patches
  • Pink or purple oil spots

Brittleness and Crumbling

Your nails can get weak and break easily. They might split, flake, or crumble at the edges. Up to 80% of people with psoriatic arthritis have brittle or crumbling nails.

This happens because the disease changes the nail’s structure. Your nails may lose their smoothness and feel rough or soft.

Brittle nails can make daily tasks harder. Try to keep your nails short and stay away from harsh chemicals.

Thickening and Deformation

You might see your nails getting thicker than normal. They can also look bent or grow in a strange way. Thickening and deformation are very common in psoriatic arthritis nail changes.

Most people with psoriatic arthritis will have some nail changes in their life. The nail may look bumpy, ridged, or curved. Sometimes, the nail grows in a weird direction.

Beau’s Lines and White Spots

Beau’s lines are deep grooves or lines that go across your nail. These lines mean your nail stopped growing for a while. About 12% of people with psoriasis get Beau’s lines.

You might also see small white spots on your nails. Doctors call these spots leukonychia. Around 38% of people with psoriasis have white spots on their nails. Both Beau’s lines and white spots show changes in how your nail grows.

If you see new lines or spots on your nails, write down when you notice them. This can help your doctor understand your psoriatic arthritis nail changes.

Recognizing Symptoms

Visual Signs

You can find psoriatic arthritis nail changes by looking at your nails. Some signs are easier to see than others.

The table below lists the most common signs:

You might see your nails turn yellow or brown. You could notice small dents or lines. Sometimes, the nail lifts up from the skin. These changes can happen on one nail or many.

Around 80-90% of people with psoriatic arthritis have nail problems. Sometimes, nail changes are the only sign of the disease.

When Changes Occur

Psoriatic arthritis nail changes often show up early. You may see nail pitting or shallow lines before joint pain starts.

The table below shows when these symptoms can begin:

Some things make nail changes more likely. These include smoking, being a man, and having psoriasis for a long time. If you have psoriasis on your scalp or groin, your risk is higher.

• Nail problems in psoriasis raise your chance of getting psoriatic arthritis.

Differences from Other Conditions

Many nail problems look alike, but some clues help tell them apart. Psoriatic arthritis nail changes often have pitting, thick nails, color changes, and nails lifting up.

Fungal infections can also change nail color and cause nails to lift, but they rarely cause pitting. Nail eczema usually makes nails wavy or soft, not lifted or white.

Doctors might use tests like looking at the nail under a microscope or growing cultures to check for fungus.

If you see new or strange nail changes, write down what you see and tell your doctor. Finding changes early helps you get the right treatment.

Treatments and Care

Medical Treatments

There are different ways to treat psoriatic arthritis nail changes. Doctors often start with creams or ointments you put on your nails.

These include corticosteroids, calcipotriol ointment, anthralin, 5-fluorouracil, and tazarotene. Sometimes, doctors give steroid shots into the nail area every few weeks. Laser therapy, like fractional CO2 laser, can help when used with creams.

If your nail changes are very bad, you might need medicine that works through your whole body. These medicines include biologics, methotrexate, cyclosporine, or apremilast.

Doctors usually use strong medicine only if your skin or joints are really bad. Creams and ointments work best for small nail problems.

Stronger medicine can take longer to work and might affect your organs. Your doctor will pick the best treatment for you based on how you feel and live.

Nail Care Tips

You can help your nails by taking care of them every day.

• Cut your nails often so they do not get caught or hurt.
• Put lotion on your nails and skin to keep them from breaking.
• Use soft pumice stones and foot files only on healthy skin.
• Stay away from fake nails and strong nail polish removers.
• Pick nail polish that says ‘5-free’ or more.
• Clean your nail tools before you use them.
• Wear gloves when you clean or work in the garden.
• Do not pick at your nails or cuticles.
• Do not use buffers or files if your nails are weak.

Taking care of your nails often can stop more damage and help them look nicer.

Home Remedies

You can try some things at home to help your nails. Soak your nails in warm water with gentle soap or oils. Try to lower stress by moving your body, relaxing, or talking to someone.

Wear gloves when you use chemicals or do chores. These changes can help make psoriatic arthritis nail changes less serious.

When to Seek Help

Warning Signs

You should watch your nails for changes that do not go away. Some nail problems mean you need to see a doctor soon. These signs can show that psoriatic arthritis is getting worse or that you need a new treatment plan.

• Nail pitting, which looks like small holes or dents in your nails
• Nails that change shape or become deformed
• Nails that turn yellow, brown, or have other color changes
• Nails that get thick and hard to trim
• Nails that start to lift or separate from the skin underneath

If you notice any of these changes, do not wait. Early care can help protect your nails and joints.

Sometimes, nail changes come with pain, swelling, or redness around the nail. You might also see pus or feel warmth. These signs could mean an infection. You should call your doctor right away if you see these symptoms.

Preparing for a Doctor Visit

Getting ready for your doctor visit helps you get the best care. You can make your appointment easier by planning ahead.

• Bring a photo ID or driver’s license.
• Have your health insurance card with you.
• Make a list of all medicines, vitamins, and supplements you take.
• Write down any treatments that did not work or caused problems.
• Note any new symptoms, such as nail changes, flares, or mood shifts.
• Prepare questions or concerns you want to discuss.
• List other health problems you have.
• If you are seeing a new doctor, bring past medical records.

When you talk to your doctor, be open about your symptoms. Explain which nails are affected and how the changes have made daily life harder. You can take notes during your visit or bring someone to help remember details.

Ask your doctor to explain anything you do not understand. Good communication helps you get the right treatment.

You might see nail changes like pitting, ridges, splitting, or thickening. These signs can show up before you feel joint pain. Finding these changes early helps you get the right help.

• Dermatologists are important for finding these nail changes.
• Nail psoriasis can look different for each person.
• Most people notice skin and nail problems before joint pain.
• Nail changes can make psoriatic arthritis more likely.

Treatments can be creams, steroid shots, or biologic medicine. You can help your nails by not hurting them and caring for them every day.

If your symptoms get worse, talk to your doctor. You can take care of your nails and feel good about your treatment.

FAQ

What causes nail changes in psoriatic arthritis?

Psoriatic arthritis makes your immune system attack your nails. This causes pitting, discoloration, and thickening. You may notice these changes before joint pain starts.

Can nail changes heal with treatment?

You can improve nail health with medicine and good care. Some changes may fade, but others can last. Early treatment helps you get better results.

Should you avoid nail polish if you have nail changes?

You can use gentle nail polish labeled “5-free.” Stay away from harsh removers and fake nails. These products can make nail problems worse.

How do you protect your nails at home?

Wear gloves when you clean or garden. Keep nails short and moisturized. Avoid picking or biting your nails.

Use mild soap and lotion to help your nails stay strong.