Let’s Take A Look At Risk Factors
As discussed earlier, having psoriasis can put you at risk for nail fungal infections. While the only risk for getting nail psoriasis is having psoriasis on your hands and feet, there are quite a few risk factors for nail fungus.2,4
- Age: You are more likely to get nail fungus infections as you get older. This can because your nails grow slower, your circulation is not as good, and because you have been exposed to more fungi than when you were younger.
- Having other health issues: Patients with cancer, diabetes, poor circulation, and poor immune systems are more likely to have nail fungal infections.
- Exposure to damp environments: Fungus thrives in damp environments. If you notice that your socks are damp every time you take them off, you have to wear gloves a lot for your job, or you often walk barefoot in places like locker rooms, or pools, you are at higher risk for nail fungal infections.
- Wearing artificial nails: Make sure that your salon uses new or freshly sterilized instruments every time you get your nails done. Additionally, acrylic nails can separate from the natural nail, leaving a place for fungus to grow.
When Should I Call The Doctor
In rare cases, toenail fungus can cause an infection called cellulitis. Without prompt treatment, cellulitis may pose a serious danger to your health.
You should seek treatment guidance from a trusted healthcare provider if you have:
- Circulation problems.
- Redness, pain or pus near the toenail.
- Weakened immune system.
Symptoms Of Fungal Nail Infection
The first signs of a fungal nail infection are usually perceptible changes to the appearance of the infected nail. It is uncommon for an infected nail to cause severe pain or permanent disfigurement, but this does occur in some cases. If left untreated, fungal nail infections can cause difficulties with walking, exercising or manual tasks such as typing. The main symptoms of onychomycosis include the nail becoming:
- Brittle
- Lifted away from the nail bed
- Mildly painful
These symptoms could also indicate that an individual is suffering from nail psoriasis, a chronic autoimmune skin disease which can affect the skin under the nail. Nail psoriasis is more common in the fingernails than the toenails and can co-occur with fungal infections of the nail. If you think you may be experiencing the first signs of nail psoriasis or a fungal nail infection, get a free symptom assessment by downloading the Ada app.
Good to know:In people with diabetes, fungal toenail infections can increase the likelihood of developing ulceration and other complications, so medical attention should always be sought if a fungal nail infection is suspected.
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How Is Nail Psoriasis Diagnosed
Nail psoriasis is usually diagnosed clinically in a patient with psoriatic arthritis and/or cutaneous psoriasis.
The severity of nail psoriasis can be estimated using the Nail Psoriasis Severity Index in which each nail is divided into quadrants and scored for clinical signs to come up with a numerical score.
Nail clippings for fungal microscopy and culture should be taken as onychomycosis may precede or complicate psoriatic nail dystrophy, and immunosuppressive medications may be used in treatment.
A proximalnail matrix biopsy is occasionally needed to confirm the diagnosis of nail psoriasis, particularly in the absence of signs of psoriasis elsewhere or where only a single nail is affected and a tumour cannot be excluded by other means. Biopsy can lead to permanent nail deformity.
Increased Chances Of Athlete’s Foot
If the nail fungus spreads to the skin on your feet it is called Athlete’s foot. Symptoms include itchy and dry skin between the toes or on your soles, cracking, and peeling of the skin.
People suffering from athletes feet have high chances of developing nail fungus. As the name suggests, athletes are at high risk of contracting the disease. However, it can infect anyone if preventive measures are not taken timely.
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Psoriasis Can Affect Both Fingernails And Toenails
Psoriasis can affect both fingernails and toenails, with half of those with psoriasis alone having some form of nail involvement. The risk increases in those with psoriatic arthritis, and it is reported that this could be as high as 4 out of 5 people seeing changes to their nails. For some unknown reason fingernails are more often involved than toenails. For many people, nail psoriasis is often mild and causes few problems.
The nails are part of the skin, so it is perhaps not surprising that a skin disease such as psoriasis can affect the nails. No one knows why some people get nail involvement and others dont. Nails grow from the nail root , which is just under the cuticle. In people who develop nail psoriasis it is involvement of the nail root that causes pitting and ridging of the nails.
Onycholysis , subungual hyperkeratosis and splinter haemorrhages are all caused by disease of the nail bed. These conditions are explained in the next section.
The nail is made of modified skin and, once it has grown, it can only be altered by filing or clipping. Treatments are usually directed at the nail bed that supports the nail or the nail folds that tuck around the edges. Soothing these tissues can result in better nail growth with fewer features of psoriasis.
What changes can occur with nail psoriasis?
These are the most common changes in nail psoriasis:
What can be done about it?
Tips on general nail care
Medical treatments for nail psoriasis include:
What About The Cost Of Oral Medications For Fungal Nails
A further consideration is cost. Because newer oral antifungal agents are very expensive, some insurance companies balk at paying for what they consider a “cosmetic issue,” unless nail fungus causes pain or other functional symptoms. Terbinafine and fluconazole are now available as generic drugs and are quite inexpensive.
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What Can You Do To Help Improve Psoriatic Nail Disease
- Keep your fingernails and toenails as short as possible – long or loose nails are more likely to catch and can cause more damage to the skin underneath the nail.
- Keep your nails dry.
- Protect your nails by wearing gloves when doing any manual work.
- Avoid a manicure of the base of the nail. This may cause an infection.
- Avoid false nails as they may damage the cuticle and make it difficult to apply treatments to the nail.
- Nail varnish can be used to cover up pitting. Nail varnish remover containing acetone should not be used, as it can cause damage to the nail.
- If you have painful toenail psoriasis then you should see a person who is qualified to diagnose and treat foot disorders .
Note: if you have psoriatic nail disease and develop pain or swelling in one or more of your joints or if you develop pain in your heel then you should see your doctor as soon as possible. You may be developing psoriatic arthritis. It is important that you are seen by a doctor specialising in joint diseases early. It has been shown that the sooner this condition is treated, the less likely you are to suffer permanent damage to your joints.
Where Can Patients Find Support For Nail Psoriasis
Education is one of the foundations for managing this chronic and typically relapsing disorder. People with psoriasis should be familiar with the treatment options in order to make proper informed decisions about therapy. The National Psoriasis Foundation is an excellent organization that provides support to people with psoriasis.
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Treatment For Nail Psoriasis And Nail Fungus
There are a few treatments for nail fungus like laser treatment which is efficient but quite expensive. The guarantee that it may not reoccur with a laser treatment is uncertain as various studies based on this are still in progress. Pills are available for treatment of this condition but it needs to be taken over a very long period and like all pills it has the risk of side effects when taken for too long. Lamisil is one such pill that is used for treatment of nail fungus.
Ointments are available which are preferably used owing to the low cost and the easy use. It is essential not to use a single ointment continuously as this may cause the fungus to become resistant to the medicine. By using multiple effective ointments, the risk of resistance is eliminated. Most antifungal ointments contain an enhancer which aids the medicine in penetrating through the nail to contact the skin that is affected. For instance, antifungal medicine Fungicillin contains Keratrate which helps in reaching the infected area. In the absence of such enhancers, the ointment may not act on the affected area and will instead only be absorbed by the surrounding skin which will finally have no effect on the infected nail.
While fungus can be treated, nail psoriasis has no particular treatment. Treatments are available to only improve appearance of the nail by using certain ointments that contain vitamin A and vitamin D or by injecting the nail bed with steroids.
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How Can Nail Psoriasis Be Treated
Psoriasisis a condition that is unique to each person who has it, and so finding atreatment or combination of treatments that work can be a process of trial anderror. Due to how often we use our hands and feet, and the fact that nails growvery slowly, nail psoriasis can be quite difficult to treat.
Nailpsoriasis is mostly treated with topical treatment.Steroid-based treatments are likely to be offered and can be useful, but arenot suitable for long-term use. A moderately potent steroid tape isavailable on prescription and often used for nail psoriasis, as it can be cutto size and wrapped around the nail.
VitaminD-based treatments can also be useful in nail psoriasis. The treatment can beapplied to the affected area, and the fingers then wrapped or covered to helpit to absorb effectively. This should not be done with a steroid treatment. Similarly,topical retinoids applied around and under the nails atnight may be helpful for nail psoriasis. Occasionally, if a fungal infection isalso present, antifungal cream may also be prescribed.
Ultravioletlight therapy, systemic or biologic treatments are not likely to be prescribedfor nail psoriasis alone, but may improve the nails when being used to treatthe rest of a persons psoriasis. However, any nail improvement may lag behindthe rest of the skin for a few months.
Is There A Connection Between A Fungus Infection And Psoriasis
Is your fungus putting you at a higher risk of developing psoriasis?
An increasingly worrying number of studies are beginning to reveal this shocking truth. Fungus not only
- Causes brain fog and poor memory issues
- Drains you of your energy
- Causes you digestive problems
- Causes mood swings, anxiety, and depression
- Breeds severe seasonal allergies
- Generates strong sugar cravings
but it can unravel and impair your bodys ability to fight back against potentially FATAL disorders, including Psoriasis.
The worst part about this disorder is that people with a rash or skin patch usually ignore this annoying condition, and just wait for it to go away on its away.
Most of them believe they have just a simple case of allergy on their hands.
But when these mere breakouts begin to stack up in crusts, they can even disrupt your daily activities.
What Ive just described is a normal case of Psoriasis a skin disease that you wont notice until it actually GROWS on you.
You may be inclined to hide away the red, raised, scaly patches appearing on your skin or treat it with a few over-the-counter medications.
But thats just like trying to catch water with a shovel.
And in time, this disease will only grow stronger. Because you see, Psoriasis goes beyond being just a skin disease.
Related: Living With Psoriasis: How To Manage Your Condition
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Nail Psoriasis Care Tips
What Treatments Are Available For Nail Psoriasis
There are many treatments for nail psoriasis. Your treatment plan may include one or more of the following.Treatment you apply to the nails: This can be helpful for mild or early nail psoriasis. Nails grow slowly, so youll need to apply these treatments for several months, often once or twice a day. Because nail psoriasis can be stubborn, you may need to use more than one treatment. Sometimes, two medicines are combined to give you a faster response.
Treatment that you apply to your nails includes the follow.
-
A potent or very potent corticosteroid: This can be helpful for most signs and symptoms of nail psoriasis. Its safe to use this medicine once or twice a day for up to nine months.
-
Calcipotriol: In one study, researchers found this to be as effective as a potent corticosteroid at treating the buildup beneath the nail.
-
Tazarotene: This treatment can be especially helpful for treating pitting, a separating nail, and discoloration.
If you need stronger treatment, your dermatologist may recommend treatment given in a dermatologist office or clinic. This treatment may include one of the following.
Psoriasis medicine that can help clear the skin and nails includes:
-
A biologic
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What Are The Differences
There are a few key differences between the two conditions. Nail fungus has a few symptoms that generally dont occur in nail psoriasis. These include:
- Debris under the nail that can look dark in color2,4
- Brittle nails that are more likely to split2,4
- A mild, foul-smelling odor2
Nail psoriasis also has a few unique symptoms, that dont usually occur in fungal infections. These include:
- Pitting of the nail, 1
- Deformed nail shape3
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Nail Psoriasis Vs Fungus
If your nails are discolored, deformed, thickened, brittle, or separating from the nail bed, you may have a nail fungus infection or Psoriasis under your nail.
Psoriasis is an autoimmune disease that results in scaly red patches on the skin. This condition causes the body to overproduce skin cells. In most cases, symptoms can be seen on the skin but there is also a chance that they show up on the nails. It is more common in fingernails than toenails. Psoriasis of the nail is often seen in people with general psoriasis. This can be treated with vitamin D ointment, topical steroids, or light therapy
Symptoms of nail psoriasis include:
- Pitting of the nails
- Yellowing or browning of nails
- Nail plated detaching from the nail bed
- Chalky buildup under the nail
- Tenderness or pain
Nail fungus, also known as Onychomycosis, is an infection caused by a type of fungi called dermatophytes. It is related to fungal infections of the skin such as jock itch, athletes foot, and ringworm. Fungal nail infection is one of the most common nail conditions. You may not see the symptoms right away when you get infected. It starts as a white or yellow spot on the nail that can easily be ignored. Once it progresses, it can be very difficult to get rid of.
Symptoms of nail fungus include:
- Thickening of the nails
- Continuous deformation of the nails
- Brittleness
- Foul odor
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