What should you know about thick pitted nails?

Nail pits are small depressions in the surface, while thickening can make the nail rough, raised, or hard to cut. Nail psoriasis may affect one or several nails and can occur with skin plaques or joint symptoms, but nail changes can sometimes appear before other signs. Trauma, eczema, and fungal infection may produce overlapping changes. A clinician may ask when the change began, inspect the skin and joints, and test a clipping if infection is possible. Discolouration can add useful context without proving a diagnosis.

Keep nails short by filing gently rather than picking at pits. Protect them from repeated knocks, avoid cutting cuticles, and use moisturiser on dry surrounding skin. Photographing the nails over time can help show whether the pattern is changing. Do not start antifungal or steroid medicine without advice, because the right treatment depends on the cause. For confirmed nail psoriasis, options may include Steroid Injection Into The Skin for selected nails or Biologic Therapy when broader psoriasis requires systemic treatment.

Book an assessment if pitting persists, several nails change, or the nail lifts, cracks, or becomes tender. Seek prompt care for pus, marked swelling, spreading redness, fever, or sudden severe pain. Mention morning joint stiffness, swollen fingers or toes, or heel pain, since these symptoms can change the assessment. A new dark streak or colour change that does not grow out also deserves medical review.

Could this be Nail Psoriasis, infection, or injury? Would a clipping or other test help? Are my joints showing signs of psoriatic inflammation, and which treatment fits the number of nails involved?