What are the treatment options for nail psoriasis?

Nail psoriasis can affect the nail plate, the skin beneath it, or the area where the nail grows. Pitting, crumbling, thickening, lifting, or colour change can resemble fungal infection, so examination is useful before treatment. Some people have skin or joint psoriasis as well, and that wider pattern can influence the plan.

A steroid injection into the skin can deliver anti-inflammatory medicine close to an affected nail in selected cases. Biologic therapy works on specific immune pathways and may be considered when nail disease is persistent, extensive, or part of psoriasis affecting other areas. Treatment decisions balance expected benefit, medical history, and monitoring needs.

Keep nails trimmed, avoid biting or picking, and protect the nail folds from repeated trauma. Tell your dermatologist about joint stiffness, swollen fingers or toes, scalp symptoms, and treatments used previously. A photo record can help compare gradual changes, because nail improvement follows nail growth rather than appearing immediately.

Read about [Nail Psoriasis](/conditions/nail-psoriasis/), [Steroid Injection Into The Skin](/treatments/injectables/intralesional-steroid-injection/), and [Biologic Therapy](/treatments/medical-dermatology/biologic-therapy/).

Seek an earlier review if a nail becomes acutely painful, drains, or the surrounding skin becomes hot and swollen, as these changes can suggest infection or another problem. Tell your clinician about new joint pain, morning stiffness, or difficulty moving a finger or toe. During systemic treatment, report fever, unusual infection symptoms, or a concerning medicine reaction promptly.

Could this nail change be fungus or another condition as well as psoriasis? Is an injection suitable for the affected nail? Would biologic therapy also help my skin or joints? What monitoring is needed, and what improvement should we expect as the nail grows?