The prevalence of nail involvement in those living with psoriasis is common. Estimates of nail psoriasis range from about 50 percent to as high as 80 percent in those with psoriasis. In a small percentage of individuals, there may even be nail psoriasis without skin lesions.

According to Tamy Buckel, M.D., board certified dermatologist and fellow of the Academy of Dermatology, treatment options for psoriasis vary based on the severity of the disease. However, the most important step to keep nails healthy is to be gentle to your nails and moisturize your nails and cuticles at least daily with an emollient cream or ointment.

According to the National Psoriasis Foundation, biologic drugs are among the most effective treatments for nail psoriasis, especially when other treatments have failed. In several studies, patients receiving biologics saw sustained nail improvement.

Steroid creams have been used successfully to treat skin irritation related to psoriasis. There has been some research using steroids in a special nail lacquer applied directly to the nail bed to treat nails damaged by psoriasis. In at least one small study, applying the steroid to the nails twice a week for 16 weeks showed nail improvement.

Intralesional injections involve injecting medication directly into the problem area. In some studies, patients’ nails responded positively, but the treatment can be painful. Needle-free injections are being developed and researched, which could reduce the pain of the treatment.

The herb indigo naturalis has been shown to improve nail psoriasis in patients, according to the National Psoriasis Foundation. In one treatment experiment, the herb was mixed with olive oil and applied to the nails twice daily. The nails improved compared to the control group. While new to the market and most likely untested on large numbers of people, herb-based nail oils can be found online containing indigo naturalis.

Light and laser therapies involve ultraviolet light or intense pulsed light. While more specific research is needed, light therapies are generally well tolerated and may be a cost-effective treatment for nail psoriasis.

Try to keep your nails short and only use natural products. When your nails are trimmed and filed neatly, they are less likely to be ripped or damaged. It is also a good idea, especially during a flare up, to avoid harsh nail chemicals that can be found in some nail polishes and removers.

Think about how much time your feet spend in shoes each day. If your shoes are fitting too tightly, this could add extra stress onto your toenails and further weaken them. A good shoe store will be able to size your feet properly.

Most of us think about wearing gloves only when we do yard work. However, there are other jobs that we do that can damage our nails. For example, working with cleaning supplies or even acidic foods can be hard on our nails. Even though you might think that water would be moisturizing, repeated or prolonged contact with water can actually weaken nails.