There are many treatments for nail psoriasis.

Treatment you apply to the nails: This can be helpful for mild or early nail psoriasis. Nails grow slowly, so you’ll 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:

• A potent or very potent corticosteroid: This can be helpful for most signs and symptoms of nail psoriasis. It’s safe to use this medicine once or twice a day for up to 9 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.
  Treatment given in a dermatologist office or clinic: If you need stronger treatment, your dermatologist may recommend one of the following:
• Injections of corticosteroids (or another psoriasis medicine): This involves getting injections directly into or near your nails with psoriasis. If the first treatment shows poor results, you may get another one in a few months. Corticosteroid injections can be effective for treating buildup under the nail, nail ridges, nail thickening, and nails separating from fingers or toes.
• Laser treatment: Some lasers can be effective.
• PUVA: This involves first soaking in (or taking) a medicine called psoralen. Afterwards, you are carefully exposed to UVA rays. PUVA can be effective for treating discolored nails and nails that are separating from fingers or toes. It does little to treat nail pitting.

Treatment that works throughout the body: If you have severe psoriasis and nail psoriasis, your dermatologist may prescribe medicine that can treat both your skin and nails. As with other treatment for nail psoriasis, it can take months to see results.

Psoriasis medicine that can help clear the skin and nails includes:

• A biologic
• Methotrexate
• Retinoid
• Cyclosporine
• Apremilast

Nail infection needs treatment, too

A nail infection can develop if you have nail psoriasis. Because a nail infection can look a lot like nail psoriasis, it’s important to find out if you have an infection. Testing, which usually consists of scraping the nail, can find an infection.

If you have a nail infection, treatment can get rid of it.

For best results from treatment

Treating nail psoriasis can be a challenge. It often takes time to treat. To get results, you need to treat your nails as directed — and for as long as directed. Some patients need to try a few treatments to find one that works.