Psoriatic arthritis nails treatment

Psoriatic nail changes can include tiny pits, separation from the nail bed, thickening, ridges, crumbling, or altered colour. Nail involvement can occur with psoriasis and may accompany psoriatic arthritis, but a nail change alone does not establish the diagnosis. Fungal infection, trauma, and other skin disorders can look similar. A clinician may examine the nails, skin, and joints together and may test a nail sample when infection is possible. Mention tenderness, difficulty gripping, and changes in joint pain or swelling.

Treatment is matched to the whole pattern rather than the nail appearance alone. Options may include a prescribed topical treatment for selected nail changes, treatment directed at skin disease, or a plan that also controls joint inflammation. Do not start steroid or antifungal products without advice when the diagnosis is uncertain. Keep nails trimmed, wear gloves for wet or irritating tasks, avoid biting or picking, and protect the skin around the nail. Physiotherapy will not repair the nail itself, but it may help hand function when joint stiffness or pain limits daily tasks.

Book a medical review for new nail separation, persistent thickening, repeated crumbling, or nail changes with joint pain, swelling, or morning stiffness. Seek prompt advice for redness, pus, increasing warmth, or severe tenderness around a nail, because infection may need separate treatment. Rapidly worsening hand function also merits timely assessment.

Could this be psoriasis, infection, or injury? Do my nails suggest broader psoriatic disease? Which treatment fits my skin and joint symptoms? How should I protect the nail while it grows out, and what changes require follow-up?