Lichen planus in nails: what to know

The condition is an inflammatory skin disorder that may involve the nail matrix, nail bed, or surrounding folds. You may notice lengthwise ridges, grooves, roughness, crumbling, separation from the bed, or a thinner plate. One nail or several can be affected. Nail changes may occur with skin or mouth symptoms, but their appearance alone cannot confirm the diagnosis. A dermatologist may examine the nails closely and consider other causes such as injury, infection, or another inflammatory disorder.

Keep nails short and file rough edges gently. Wear gloves for prolonged contact with water, detergents, or solvents, and avoid biting, picking, acrylic extensions, and aggressive cuticle work. Do not start steroid treatment on or around a nail without tailored instructions, because the correct medicine and delivery site matter. A clinician may discuss [Topical Corticosteroids](/treatments/medical-dermatology/topical-corticosteroids/) or, when several areas are active, [Oral Corticosteroid Treatment](/treatments/medical-dermatology/oral-corticosteroid-therapy/).

Arrange a dermatology review for new, spreading, painful, or persistent nail changes, especially if the nail is lifting or the surrounding skin is inflamed. Seek prompt care for increasing warmth, swelling, pus, severe tenderness, or difficulty using the finger or toe. Bring a list of medicines and photographs showing how the nail has changed.

Could this be nail lichen planus or another nail condition? Which nail structure is involved? Should the nail be tested for infection? What treatment is appropriate for this location, and how should I protect the nail during regrowth?