Nail psoriasis often needs more than home care. A dermatologist may recommend topical medicines, injections, or systemic (whole-body) treatment for severe psoriasis affecting the nails. Improvement can take time because a healthy fingernail may need up to six months to grow out.

Some MyPsoriasisTeam members described getting relief from prescription treatments for nail psoriasis. “I have it on both fingernails and toenails. … I use calcipotriene cream 0.005 percent. … It has given me some relief,” one wrote.

Several members emphasized that improvement from ultraviolet light treatments or injections can take patience. “My nails were not as severe as yours, but the phototherapy has really helped. … I did have a couple of injections … but feel that it was the lights twice a week … for months.”

Long nails are more likely to catch on clothing or objects, which can make lifting and breakage worse. Medical experts suggest keeping your nails short to avoid separation from the nail bed. Trim carefully and file rough edges with a fine file rather than tearing or biting them. Biting or picking at your nails and the skin around them can cause small cuts or irritation, making infection more likely, which may trigger a psoriasis flare or make it worse. 

Some members said professional nail care made trimming thick toenails safer and more manageable. “Our practice has a podiatry clinic … and I have not looked back. My feet feel so much better, and they cut my nails every three months, deep joy!” a member shared.

Psoriasis can dry out skin and nails, and dry nails and surrounding skin can crack more easily.

Consider applying a thick cream or ointment to your hands, nails, and cuticles after washing and whenever they feel dry. Your dermatologist can help you choose a topical treatment that’s appropriate for your nails and surrounding skin. 

Using the right product as directed can help limit irritation and other side effects. Apply moisturizer after washing your hands and within three minutes of bathing to help seal in moisture and keep your skin hydrated. 

Leave your cuticles alone. It’s best not to cut or push them back since this can irritate or injure the skin around your nails and increase the chance of infection. With psoriasis, even a small skin injury can sometimes trigger a flare. This is called the Koebner phenomenon. 

MyPsoriasisTeam members frequently pair trimming with oils or moisturizers to keep nails and cuticles from getting too dry. “Buy cuticle oil or coconut oil and massage that into your hands as needed,” one member recommended. “Keep them moisturized as you would other problem areas.”

Water, cleaning products, gardening, and other manual work can dry or injure nails and the surrounding skin. Wear vinyl or nitrile gloves for tasks involving water or cleaning products and protective gloves for chores that may cause damage. Keeping your nails clean and dry can help reduce the risk of infection. 

“I never cook or clean without gloves. It’s hard to get used to, but it will save your nails,” one MyPsoriasisTeam member wrote.

Acrylics and some gel services can put extra stress on nails that are already lifting, brittle, or inflamed. If you want cosmetic coverage, ask your dermatologist whether regular polish or gentle buffing is appropriate. 

“Best advice I can give is to stop wearing false nails,” shared one MyPsoriasisTeam member. “Can’t stress enough how much damage they’ll be doing to already damaged and weak nails.”

Nail psoriasis can resemble nail fungus, and the two conditions need different treatments. Don’t scrape buildup or start an antifungal or steroid product based only on appearance. A dermatologist may need to examine or test the nail. 

“If you haven’t already, get a nail clipping test, as psoriasis can look very similar,” wrote one member. “Mine came back as a fungal infection. It’s an absolute swine to get rid of; I was on low-dose antibiotics for a year.”

Also tell your doctor about nail changes if you have swollen, stiff, or painful joints because nail psoriasis is sometimes a sign of psoriatic arthritis.