Can nail psoriasis cause nail separation?

Onycholysis is the medical term for a nail plate lifting away from its bed. Nail psoriasis may produce pitting, ridges, roughness, colour change, thickening, or a chalky build-up beneath the nail. These changes can weaken the attachment and create a pale or yellow-looking space under the free edge.

Nail findings may occur with skin psoriasis, joint symptoms, or on their own. A lifted nail is not enough to diagnose psoriasis because fungus and repeated trauma can cause the same sign. A clinician may inspect the nail and test a sample when infection is possible.

Keep the nail trimmed to the point where it remains attached, and smooth sharp edges with a clean file. Protect it from knocks, prolonged moisture, and pressure from tight shoes. Do not clean underneath with a sharp object or tear away loose nail. Moisturise surrounding skin, but use prescribed nail or skin treatment exactly as directed.

Treatment can target nail psoriasis, nearby skin disease, or a coexisting infection. Improvement is gradual because the altered nail has to grow forward. Tell your clinician about joint stiffness, swelling, or morning pain, since these symptoms may change the assessment.

Arrange review if separation is spreading, several nails are changing, or the nail becomes painful. Redness, warmth, swelling, drainage, or fever needs prompt assessment for infection. A changing dark mark or unexplained bleeding should be examined rather than attributed to psoriasis.

Ask whether the nail pattern is more consistent with psoriasis, fungus, or trauma; whether a sample should be tested; and which treatment is safest for the nail bed. Ask when to return if separation progresses and whether your skin or joints should also be checked.