Psoriasis in nails: causes and what the changes mean

The nail matrix makes the nail plate, so inflammation there may create tiny pits, grooves, or an uneven surface as the nail grows. Nail-bed inflammation can cause yellow-brown colour, separation from the skin underneath, or a buildup of material beneath the nail. One or several nails may change, and the appearance can develop gradually. A fungal infection, injury, or another nail disorder can look similar, so colour alone cannot confirm psoriasis. Nail involvement may occur with skin psoriasis, but nail changes can also appear when skin symptoms are subtle. Learn more about [Psoriasis](/conditions/psoriasis/).

Arrange a dermatology assessment if a new change persists or affects daily tasks. The clinician may inspect the nail, surrounding skin, scalp, and joints, and may test a nail sample when infection is possible. Keep nails trimmed, avoid cutting or pushing back cuticles, and wear gloves for wet or irritating tasks. Do not scrape beneath a lifted nail or start antifungal treatment without advice. Moisturising the surrounding skin can reduce dryness and cracking; related symptoms are described in [Dry Skin](/symptoms/dry-skin/) and [Cracked Skin](/symptoms/skin-cracking/). Treatment depends on which nail structures are involved and how many nails are affected.

Seek prompt medical review for increasing pain, warmth, swelling, pus, or a rapidly changing nail. A dark mark that begins near the cuticle, follows a single nail, or does not grow out also needs assessment. Contact a clinician when nail lifting catches on objects, interferes with walking or hand use, or occurs with new joint stiffness or swelling.

Could this be nail psoriasis, infection, injury, or a combination? Which part of the nail appears inflamed? Would a sample or other examination help? What nail-care routine and treatment are suitable for me? Should my joints or skin be checked as well?