Psoriasis on fingers and nails: what to know

Finger psoriasis can appear as red, dry, scaly patches around the knuckles, fingertips or nail folds. Cracks may sting when you wash or grip objects. Nail psoriasis may cause tiny pits, roughness, discoloration, thickening or separation from the nail bed. These changes can resemble fungal infection, eczema or injury, and more than one problem can occur together. A clinician may inspect several nails and the surrounding skin; testing may be useful when infection is possible. Psoriasis is not passed from person to person.

Moisturise your hands after washing with a fragrance-free cream or ointment, working it around the nail folds without forcing product beneath a lifted nail. Wear gloves for wet work and household cleaners, using a cotton liner if sweating is a problem. Keep nails trimmed, avoid cutting cuticles and do not pull away separated nail. Reduce repeated trauma from biting, picking or aggressive manicures. Follow the treatment plan prescribed for the skin or nails; nail improvement can take time because the nail must grow out. Photograph changes so your clinician can compare them.

Book a dermatology review for unexplained nail changes, painful cracks or symptoms that interfere with work. Seek prompt help if a nail becomes acutely swollen, hot, draining or very painful. Report morning stiffness, swollen fingers, heel pain or difficulty making a fist, since these may signal joint involvement that benefits from early assessment. A sudden change after an injury may need a different approach.

Do the nail changes fit psoriasis or could infection be contributing? Which hand treatment is suitable for cracked skin? Should my joints be checked? How can I protect my nails during work and grooming?