Most people think of psoriasis as dry, scaly patches on the skin. But for many people, it also shows up in their fingernails and toenails. Nail psoriasis is common, can be painful, and can make everyday tasks harder. The good news is that treatments can help. Here's what you need to know, in plain English.
What is nail psoriasis?
Psoriasis is thought to be caused by a problem with your immune system (your body's defence system), which leads to inflammation (NHS, 2026a). When that inflammation reaches the parts of your finger or toe that make and hold your nail, the nail can change shape, colour or texture.
It affects about half of all people with psoriasis (British Association of Dermatologists, 2023). Some people only ever get it in their nails, with no skin patches at all (Psoriasis UK, 2025).
The signs to look out for
| What you might see | What it looks like | Medical name |
|---|---|---|
| Tiny dents | Small dents in the surface of the nail | Pitting |
| Nail lifting off | The nail lifts or comes away from the skin underneath | Onycholysis |
| Coloured patches | Salmon-pink or yellow-red areas under the nail | Discolouration |
| Thick nails | The nail, or the skin beneath it, builds up and turns yellowish | Thickening |
| Ridges and crumbling | Rough, grooved nails that split or break up easily | Ridging |
Nail changes can be sore and make fiddly jobs harder, like doing up buttons (British Association of Dermatologists, 2023). Many people also feel self-conscious and try to hide their hands or feet (Psoriasis UK, 2025). If that's you, you're not alone.
The link with your joints
Key insight
Around 8 in 10 people with psoriatic arthritis have nail changes (Psoriasis UK, 2025). If you have nail psoriasis and stiff, swollen or painful joints, tell your GP.
Psoriatic arthritis is a type of arthritis linked to psoriasis that affects the joints (NHS, 2026b). NICE, which sets health guidance in England, says everyone with psoriasis should be offered a check for it every year, using a short questionnaire such as PEST (National Institute for Health and Care Excellence, 2012). Ask your GP about it.
Could it be a fungal infection?
The two can look very alike, and you can have both. Your doctor may send a nail clipping to a lab to check for fungus (British Hair and Nail Society, 2020).
Treatment options
| Treatment | What it involves | Usually used for |
|---|---|---|
| Creams, gels and lotions | Strong steroid creams or vitamin D-based treatments, rubbed into the nail and surrounding skin. Steroids aren't suitable for long-term use | Milder nail psoriasis |
| Steroid tape | A prescription tape, cut to size and stuck over the nail area | Individual affected nails |
| Steroid injections | Small injections into the skin around the nail | 3 to 4 nails at most |
| Light therapy | Ultraviolet light treatment. Rarely used for nails alone, but can help nails while treating skin | Psoriasis on the skin too |
| Tablets | Medicines that calm the immune system, such as methotrexate, ciclosporin, acitretin or apremilast. Some need regular blood tests | Severe nail disease, or skin or joints affected too |
| Biologics | Injections or drips that block specific parts of the immune system, such as adalimumab or secukinumab | Severe psoriasis or psoriatic arthritis |
Sources: British Hair and Nail Society (2020); Psoriasis UK (2025).
For example, people taking methotrexate have blood tests every 1 to 2 weeks at first, then every 2 to 3 months once treatment is settled (NHS, 2023). NICE says you should be referred for specialist advice if nail psoriasis has a major effect on what you can do or how your nails look (National Institute for Health and Care Excellence, 2012).
Be patient with your nails
A fingernail takes around 6 months to grow out fully, and a toenail around 12 months (Muneer, Sathe and Masood, 2024). Taking regular photos helps you and your doctor see whether treatment is working.
Paying for prescriptions
In England, each prescription item costs £9.90 (NHS Business Services Authority, no date b). Unless you already get free prescriptions, a Prescription Prepayment Certificate could save you money if you need several items: £32.05 for 3 months or £114.50 for 12 months (NHS Business Services Authority, no date b). Prescriptions are free in Scotland and Wales (NHS Business Services Authority, no date a).
Help at work
If sore nails make your job harder, your employer may need to make reasonable adjustments, such as providing different equipment (GOV.UK, 2026). Access to Work can also help pay for support if you have a health condition (GOV.UK, no date).
Looking after your nails
- Keep nails short, and use clippers rather than scissors.
- Avoid damaging your cuticles, and don't pick or bite your nails.
- Wear protective gloves for messy or rough jobs.
- Keep nails clean and dry.
- Choose roomy shoes to protect your toenails.
Sources: British Hair and Nail Society (2020); Psoriasis UK (2025).
Common questions
Is nail psoriasis contagious?
No. Psoriasis is not contagious, so you can't catch it or pass it on (NHS, 2026a).
Can I wear nail varnish or false nails?
Some people use varnish or false nails to cover changes while nails grow. Gently applied stick-on nails are often fine, but avoid anything that could damage the cuticle. Gel or semi-permanent nails can stop treatment reaching the nail (Psoriasis UK, 2025).
When to see your GP
See your GP if your nails have changed and you're not sure why, if they're painful or getting in the way of daily life, or if treatment isn't helping. Mention any joint pain or stiffness too.
Where to find support
- The Psoriasis UK helpline offers confidential information and a listening ear by phone, email or WhatsApp, Monday to Friday.
- Arthritis UK's free psoriatic arthritis booklet explains joint symptoms and treatment.
References
Arthritis UK (no date) Psoriatic arthritis information booklet. Available at: https://shop.arthritis-uk.org/products/psoriatic-arthritis-information-booklet (Accessed: 4 October 2026).
British Association of Dermatologists (2023) Psoriasis: an overview. Available at: https://www.skinhealthinfo.org.uk/condition/psoriasis/ (Accessed: 4 October 2026).
British Hair and Nail Society (2020) Nail psoriasis: patient information leaflet. Available at: https://bhns.org.uk/uploads/pages_media/1876655972_0_NailpsoriasisPIL.pdf (Accessed: 4 October 2026).
GOV.UK (no date) Access to Work: get support if you have a disability or health condition. Available at: https://www.gov.uk/access-to-work (Accessed: 4 October 2026).
GOV.UK (2026) Reasonable adjustments for workers with disabilities or health conditions. Available at: https://www.gov.uk/reasonable-adjustments-for-disabled-workers (Accessed: 4 October 2026).
Muneer, H., Sathe, N.C. and Masood, S. (2024) Nail psoriasis. StatPearls. Treasure Island (FL): StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK559260/ (Accessed: 4 October 2026).
National Institute for Health and Care Excellence (2012) Psoriasis: assessment and management (NICE guideline CG153). Available at: https://www.nice.org.uk/guidance/cg153/chapter/Recommendations (Accessed: 4 October 2026).
NHS (2023) How and when to take methotrexate. Available at: https://www.nhs.uk/medicines/methotrexate/how-and-when-to-take-methotrexate/ (Accessed: 4 October 2026).
NHS (2026a) Psoriasis. Available at: https://www.nhs.uk/conditions/psoriasis/ (Accessed: 4 October 2026).
NHS (2026b) Psoriasis: symptoms. Available at: https://www.nhs.uk/conditions/psoriasis/symptoms/ (Accessed: 4 October 2026).
NHS Business Services Authority (no date a) Help with NHS prescription costs. Available at: https://www.nhsbsa.nhs.uk/help-nhs-prescription-costs (Accessed: 4 October 2026).
NHS Business Services Authority (no date b) What is a Prescription Prepayment Certificate (PPC) and how do I apply? Available at: https://faq.nhsbsa.nhs.uk/knowledgebase/article/KA-03627/en-us (Accessed: 4 October 2026).
Psoriasis UK (2025) Nail psoriasis. Available at: https://psoriasisuk.org.uk/information-and-support/page.aspx?ID=808 (Accessed: 4 October 2026).
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Important medical disclaimer
The content provided in this blog post is for educational and informational purposes only and does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of your GP, psychiatrist or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Never start, stop or change a prescribed medicine without speaking to your prescriber first.
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