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Nail Psoriasis (cont.)

Medical Treatment for Nail Psoriasis

A doctor may recommend that a part of the nail be removed, either chemically or surgically. Chemical removal of the nail involves putting an ointment on the nails for seven days. The nail comes off by itself with no bleeding.

Even with effective treatment, an improvement in symptoms may take a long time, since eight to 12 months can be needed to generate a new fingernail.

Medications for Nail Psoriasis

A doctor may prescribe any of the following medications:

  • Creams or ointments to rub on and around the nail, including steroid, topical vitamin A (tazarotene) or vitamin D derivatives (calcipotriene or calcitriol), antimetabolite drugs (such as 5-fluorouracil, which is also used to treat certain cancers) or, occasionally, antifungal solutions may be needed if a fungal infection is present. However, delivery of medications to the nail area is difficult because of the barrier presented by the nail plate. Topical treatments (applied directly to the nail) may not be effective in all cases.
  • Steroids can applied to the skin under the nail or injected under the nail; injection under the nail may be more effective than when steroids are applied in cream or ointment form.
  • PUVA: This therapy is a combination of the prescription medicine, psoralen, and exposure to UVA ultraviolet light.
  • Systemic therapy may be appropriate if you have both skin and arthritis symptoms or if the skin and nail symptoms are severe or persisting. Systemic therapy is medication that spreads throughout the body. It is often in pill or injectable form, including methotrexate or cyclosporine tablets, and injectable etanercept (Enbrel), adalimumab (Humira), and ustekinumab (Stelara) as well as infusible infliximab (Remicade). A new oral medication for both plaque psoriasis and psoriatic arthritis is apremilast (Otezla).

See the article Understanding Psoriasis Medications for more information.

Medically Reviewed by a Doctor on 6/8/2015

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