Nail Psoriasis

Patients who have psoriasis will commonly experience symptoms that affect their nails, causing discoloration, thickening, pitting, or other issues. Many systemic psoriasis therapies will improve nail psoriasis symptoms, but topical treatments or other options may be necessary. Patients experiencing nail psoriasis can trust in treatment from Dr. Liz Damstetter and the team at Reserve Dermatology.

What is Nail Psoriasis?

Psoriasis is a condition in which the skin cells multiply faster than they should. This can also apply to the nails, which may become thickened, develop small holes, or change in color or shape. Nail psoriasis will affect about 90% of patients who experience psoriasis symptoms on their skin and is more common among adults. Patients who experience nail psoriasis are also at a higher risk for psoriatic arthritis.

What Causes Nail Psoriasis?

Nail psoriasis is caused by inflammation and excess cell growth in the nails. In some cases, trauma or injury to the nails can cause nail psoriasis symptoms. Generally speaking, psoriasis is believed to be an immune system disorder. Nail psoriasis is not typically affected by triggers such as cold and dry weather or stress as other psoriasis symptoms can be.


“I had a recent visit to Dr Damstetter’s clinic and would like to share my experience. I am a Navy vet(corpsman) and usually get seen at the VA but since we don’t have a Derm provider right now, I was fortunately sent out to her clinic to be evaluated. It’s a nice clinic in a nice area and was relatively easy to find. A pleasant Ms. Nancy at the front desk was helpful in completing the check-in process. Easy day. I did not have to wait long and was soon met by Dr. Damstetter’s assistant, who for classified reasons I will refer to as “Agent 8”. I am sure if she gets tired of providing excellent medical care, her slick-ninja skillset could get her a job with the CIA or MI6 maybe. Short story long, Agent 8 brought me back to the patient area, where I was introduced to Dr Damstetter, who was all the things you would want in a doctor: a knowledgeable provider with a great bedside manner. She gave me a thorough exam which did end up showing that I needed a minor procedure. No worries. I felt well taken care of throughout my visit. No one likes to have to see the doctor, but if you have a dermatological concern, this is a good place with good people who did great by me, and I am thankful to have been sent here.”

“Dr. Liz is truly the best dermatologist I’ve ever been to. She is attentive, kind, and genuinely cares about her patients and their overall skin health. I can not recommend her enough!!!”

“Wonderful experience here! The doctor took the time to educate me on a variety of cosmetic options and gave her candid opinion resulting in just the right amount of cosmetic adjustments! Her staff was delightful and attentive! I would highly recommend for general derm needs and cosmetic adjustments.”

“Dr. Damstetter was the first dermatologist I trusted to do my Botox. She is both knowledgeable and professional and did a fantastic job. I will be using her for any and all of my future needs.”

Common Nail Psoriasis Symptoms

Nail psoriasis can cause changes in the color, texture, or shape of the nails. The nails can turn white, yellow, or brown and may develop red or white spots. Grooves or pinprick holes on the nails’ surface is also common. Chalky white debris may build up below the nail, which can in some cases cause the nails to lift from the skin. This can also cause pain. Finally, the nails may loosen or separate from the nail bed.

Fungal nail infections are also more common in those with nail psoriasis. This typically causes the nails to thicken, become brittle, or break.

Liz Damstetter, MD

Board-Certified Dermatologist

Meet the Doctor

Nail Psoriasis Diagnosis and Treatment

If you suffer from psoriasis, a diagnosis of nail psoriasis can be achieved simply by reviewing your medical history and visually examining the nails. However, Dr. Damstetter may also suggest a fungal microscopy and/or culture to rule out a fungal nail infection, as the symptoms can be similar. This is done simply by clipping the nails so they can be observed under a microscope or tested in a lab.

Topical treatments can be effective for nail psoriasis. Options include topical steroids, calcipotriol, or retinoid products, which can help reduce inflammation. Steroid injections can also be beneficial for this reason.

Systemic therapies that improve psoriasis symptoms, in general, can also be beneficial for those suffering from nail psoriasis. This includes various oral medications which Dr. Damstetter may prescribe. Finally, some patients benefit from light therapy treatments.

Do hair skin and nail vitamins really work?

Specific types of vitamins may be formulated to help reduce temporary or hormonal types of hair loss. Biotin has never been shown to regrow hair unless someone has a dietary deficiency.

How can I improve my nail health?

Moisturize after every hand washing, avoid frequent manicures and repetitive trauma to nails, and maintain a well-balanced diet for optimal nail health. Low levels of biotin may help strength nail plate formation.

How long does it take biotin to work on hair?

Biotin does not regrow hair unless someone has a true biotin deficiency. The FDA has warned against taking high levels of biotin. The recommended dose for daily use is up to 2,000 micrograms (2 milligrams) daily.

Is nail growth a sign of hair growth?

Although they are different processes and compounds, good nail growth can indicate healthy hair growth. Sudden changes in your hair or nails may affect one or both.

What causes vertical ridges in nails?

There might be many causes of the appearance of vertical nail ridges, from stress to thyroid disease to kidney problems. Most of the time this symptom is harmless.

What deficiencies cause hairloss?

The most common deficiency in modern society to cause hair loss is iron deficiency anemia. About 2-3 months after a major dip in iron (menstrual losses, accident, surgery, or poor dietary absorption) hair may start to dramatically shed. Other deficiencies leading to hair loss include biotin, other B vitamins, vitamin C (scurvy), folic acid and vitamin D. Fortunately, modern societies almost always have these vitamins in a normal diet.

What helps female thinning hair?

A board-certified dermatologist can make recommendations for medications for female pattern hair loss. Vitamins formulated for female pattern hair loss may be modestly helpful. Gentle shampoos and conditions are recommended.

Preventing Nail Psoriasis Symptoms

If you have psoriasis, there are some steps you can take to prevent nail psoriasis symptoms. Keeping the nails short and clean, moisturizing the nails and cuticles, and maintaining smooth edges with a nail file can help reduce nail psoriasis symptoms. Some patients also find it helpful to wear comfortable shoes or gloves when cleaning or otherwise working with their hands.

Schedule an Appointment

To learn more about your nail psoriasis treatment options, schedule an appointment with Dr. Damstetter. Call Reserve Dermatology in Glenview, IL or contact us online.

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