Psoriatic & Inflammatory
Nail Changes
at Foot Foundation
Psoriatic and inflammatory nail changes can cause pitting, thickening, discolouration, and brittle or painful nails. These issues are commonly linked to psoriasis, psoriatic arthritis, eczema, and other systemic conditions—and may even signal early joint disease.
At Foot Foundation, our podiatrists deliver expert nail care to restore nail health, reduce pain, and improve appearance. Using advanced podiatry treatments, protective nail care, and collaborative care when needed, we help patients maintain long-term nail function and confidence.
What are Psoriatic &
Inflammatory Nail Changes?
Nails are often affected by systemic inflammatory conditions, most commonly psoriasis, but also eczema, lichen planus, and autoimmune diseases. These conditions can cause visible changes to the nail plate and nail bed, including pitting, discolouration, thickening, and crumbling.
Psoriatic nail disease affects up to 50% of people with psoriasis and may also occur in those with psoriatic arthritis, sometimes serving as an early warning sign of joint disease.
At Foot Foundation, we provide specialist nail management to reduce pain, improve appearance, and protect nail function.
Causes & Risk Factors
Psoriasis – most common cause, due to abnormal keratin production in nail matrix
Psoriatic arthritis – nail changes often present with joint disease
Eczema / dermatitis – chronic inflammation leading to brittle or ridged nails
Lichen planus – autoimmune condition affecting skin, mucosa, and nails
Fungal infection – may coexist with inflammatory nail disease
Genetics – family history of psoriasis or autoimmune disease
Immune dysregulation – systemic inflammatory response targeting nail structures
Treatment at Foot Foundation
Nail reduction & thinning – professional podiatry care to reduce thickness and relieve pressure
Protective nail care – trimming, smoothing, and footwear strategies to minimise damage
Topical treatments (with dermatologist/GP) – medicated creams, ointments, or biologic therapies for psoriasis
Antifungal therapy – if fungal infection confirmed alongside inflammatory nail disease
Custom orthotics & footwear advice – reduce toe pressure and prevent secondary trauma
Education & monitoring – recognising when nail changes may indicate progression to psoriatic arthritis
Symptoms
Pitting – small depressions in the nail surface
Onycholysis – nail detaching from nail bed, leaving gaps
Discolouration – yellow-brown patches (“oil drop” sign) under the nail
Thickening or ridging – irregular nail plate growth
Crumbling or brittle nails – in severe cases
Pain or tenderness – particularly when nails detach or deform
Difficulty with footwear due to thickened or damaged nails
Diagnosis
At Foot Foundation, diagnosis includes:
Clinical assessment – nail appearance, history of psoriasis or systemic disease
Differentiation from fungal infection – as both can look similar
Fungal testing – nail clippings for microscopy/culture if infection suspected
Referral collaboration – with dermatologists or rheumatologists when systemic disease suspected
Psoriatic & Inflammatory Nail Changes – FAQs
They may show pitting, discolouration, thickening, crumbling, or lifting from the nail bed.
No. They can look similar, but psoriatic nails are caused by inflammation, while fungal nails are due to infection. Testing may be needed to confirm.
Yes. Podiatrists can thin thickened nails, reduce pain, and manage footwear pressure, improving comfort and appearance.
Not always, but psoriatic nail disease is a risk factor. Patients with nail involvement are more likely to develop arthritis.
There is no cure, but symptoms can be effectively managed with podiatry care, medical treatments, and lifestyle strategies.
A classic feature of psoriatic nails – a yellow-brown discolouration beneath the nail plate.
Yes. They are prone to fungal and bacterial infection, especially if nails are thickened or detached.
Shoes with a wide toe box and soft uppers to reduce pressure on thick or deformed nails.
If you have nail changes, pain, or difficulty cutting your nails, podiatry assessment helps reduce complications and improve quality of life.
Why Choose Foot Foundation?
Foot Foundation provides specialist care for psoriatic and inflammatory nail disease, offering nail reduction, protective care, footwear advice, and collaboration with dermatology and rheumatology teams. Our goal is to relieve pain, improve appearance, and protect nail health.
With clinics in Rosedale, Takapuna, Remuera, Botany, Hamilton, and Tauranga, expert nail condition care is available across New Zealand.
