What Your Fingernails Can Reveal About Psoriatic Arthritis

If your eyes are the windows to your soul, your fingernails may just be the windows to your psoriatic arthritis. According to the National Psoriasis Foundation, at least 80 percent of people with psoriatic arthritis also have fingernail psoriasis, a condition that can cause changes to the nails and surrounding skin.

Fingernail psoriasis is also an early symptom of psoriatic arthritis. “When patients come in with reports of painful or swollen joints and changes to their fingernails, that’s a major clue that someone could have psoriatic arthritis, says Leah Alon, MD, a board-certified rheumatologist at Harlem Health Center and Queens Health Center in New York City. 

What’s more, the condition of your nails also says a lot about how severe your psoriatic arthritis is. “The worse your nail symptoms, the more serious your psoriatic arthritis can be,” says Dr. Alon.

Symptoms of Fingernail Psoriasis

The most common change Dr. Alon sees in her patients is called “pitting,” which are small pin-prick holes in the nails. Other nail changes may include:

• Crumbling nails
• Separation of the nail from the nail bed. “This can look like a fungal infection but it’s not,” says Dr. Alon.
• Ridges or splitting in the nails
• Spots of blood under the nails
• Changes in the nail colors, such as green, yellow, or brown

Treating Fingernail Psoriasis

“Taking care of your nails is extra important if you have psoriatic arthritis,” says Dr. Alon. “Nail psoriasis can be tricky to treat.”

Here are Dr. Alon’s tips for keeping your nails healthy if you have psoriasis or psoriatic arthritis:

• Keep your nails trimmed and as short as possible. If loose nails rub against a surface, they can cause injury of make psoriasis worse.  
• Wear cotton gloves when you do chores around the house (Latex are not recommended). Trauma to the nails can trigger a nail psoriasis flare.
• Moisturize your nails and cuticles every day, especially after you shower or wash your hands.

If you’re experiencing symptoms, especially if they’re painful or uncomfortable, talk to your doctor. There are medical treatments available that may help treat nail psoriasis.