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Nail Eczema vs Psoriasis: What You Should Know

Pediatric dermatology recognizes nail eczema vs psoriasis as distinct conditions that severely impact nail function. Previous eczema anywhere on the body increases the risk of developing nail eczema. In contrast, older adults typically develop nail psoriasis, which emerges as an autoimmune-based skin condition.

These two conditions lack definable cues but professional dermatologists offer various treatments to enhance nail health. Combined medical treatment with lifestyle should further improve conditions.

What is Nail Eczema?

Fingernail alterations are observed with greater frequency than toenail changes (Quaade et al., 2021, Prevalence, incidence, and severity of hand eczema in the general population – A systematic review and meta‐analysis). When appearing on hands and feet, the condition is termed pompholyx eczema. Pompholyx eczema can result in inflammation of the nail folds and the adjacent skin to the nails. This leads to the small indentation formation, known as pitting, resembling closely ice-pick punching feelings. It’s important to promptly address this condition to avoid any exacerbation.

Recent findings indicate nail eczema is one of the most common dermatological disorders that develops in about 5.5% of American adults. Patients usually experience itchy, skin inflamed parts scattered over various body sections (Quaade et al., 2021, Prevalence, incidence, and severity of hand eczema in the general population – A systematic review and meta‐analysis).

What is Nail Psoriasis?

According to the Cleveland Clinic, nail psoriasis is an autoimmune disorder in which the immune system turns against the body’s cells instead of protecting them, leading to increased skin cell generation rates. People with nail psoriasis typically also develop psoriatic eruptions on other areas of their skin.

While nail psoriasis may affect anybody, some circumstances increase the risk of acquiring the illness, including:

  • People over 40

  • People having a family history of psoriasis

  • People diagnosed with psoriatic arthritis

Nail psoriasis is a common disorder, affecting more than half of all psoriasis patients and nearly 86% of those with psoriatic arthritis (Cleveland Clinic, 2022, Nail psoriasis: What it is, causes, nail pitting, treatment).

Nail Eczema vs. Psoriasis

Although they have certain similarities, there are distinctions between nail eczema vs psoriasis. Both conditions can cause nail pitting in individuals who have psoriasis or eczema elsewhere on their body. However, nail psoriasis is also linked to symptoms like nail lifting and white discoloration, particularly in older adults. Nail eczema, on the other hand, can also cause grooved, thin, and brittle nails and may occur at any age

Causes

The primary cause of nail psoriasis is the immune system. Skin proliferation is accelerated in those who have this disorder, resulting in frequent cell regeneration and the emergence of a rash every few days. Thus, psoriasis can affect the nails in addition to the skin (Cleveland Clinic, 2022, Nail psoriasis: What it is, causes, nail pitting, treatment).

Symptoms

The symptoms of nail eczema vs psoriasis differ significantly, thus it is important to recognize their unique characteristics.

Verywell Health (2024) indicates the symptoms of nail eczema include:

  • Longstanding eczema in other body regions

  • Rash on the hands or feet

  • Ridged nails as lines across their length or width

  • Nail pitting, which leads to small dents in the nails

  • Wavy or soft nails

  • Nail shedding

In severe cases, nail eczema can cause deformities requiring medical intervention (Charleson, K. (2024). What’s the difference between nail eczema and nail psoriasis? Verywell Health)

Symptoms of nail psoriasis may include:

  • Color changes in the nail bed may appear in yellow, red, pink, or brown patches.

  • Pitting, with dents varying in size and depth

  • Structural changes such as grooves (Beau’s lines) across the nails

  • Thinning nails that may crumble

  • Nail separation from the nail bed (known as onycholysis) can potentially lead to fungal infections (Cleveland Clinic, 2022, Nail psoriasis: What it is, causes, nail pitting, treatment).

Diagnosis and Tests

A healthcare expert can diagnose psoriasis or nail eczema by doing a complete physical examination, allergy testing, and nail clipping tests while ruling out fungal diseases. When dealing with nail psoriasis, medical practitioners can use the Nail Psoriasis Severity Index (NAPSI) to determine the severity of the problem. This index divides the nail into regions and assigns a score based on the symptoms identified.

Treatment

Management strategies vary for nail eczema and nail psoriasis.

According to Verywell Health (2024), nail eczema can be managed through proper personal hygiene.

  • Avoid irritating products

  • Wash hands with mild, fragrance-free soaps

  • Dry hands well after washing

  • Wear gloves while washing dishes

  • Protect hands with fragrance-free moisturizers after drying them

With appropriate treatment, nail eczema may improve within a few weeks.

Whereas the Cleveland Clinic (2022) highlights that nail care for psoriasis can consist of both prescription and home remedies to manage symptoms:

  • Wash hands and nails regularly

  • Moisturize nails and skin around nails

  • Trim nails short

  • Avoid biting or picking at nails

  • Avoid artificial nails

  • Wear gloves when doing manual work

  • Avoid manicures of the base of the nail

  • Use ointments, or nail polish to conceal nail pitting and improve appearance while advising against acetone-based removers to prevent further damage

  • Consider injections of medication into the skin around the nails for severe cases

  • Take oral medications if prescribed

  • Explore phototherapy or laser therapy as treatment options.

To mitigate the symptoms, it's crucial to maintain nail care, including hydrating the area surrounding the nails and often washing your hands.

When to Consult a Doctor

If you notice changes in your skin or nails, encounter new symptoms, or therapy does not alleviate your existing ones, consult a dermatologist for an accurate diagnosis.

Get medical attention if you also see any redness or swelling in the skin around your nails, as these are signs of an infection.

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  • Active ReLeaf Spot Gel: This gel reduces redness and soothes irritated skin, providing immediate comfort. It effectively addresses wounds and redness while promoting overall skin health.

  • Liverty Dynamic Drops: These drops target internal inflammation—a major trigger for psoriasis and eczema—to support healthier skin from within. They contain essential herbs and vitamins that protect against oxidative stress.

  • Dynamic ReLeaf Duo: This duo combines Active ReLeaf Spot Gel and Liverty Dynamic Drops to soothe itching and inflammation associated with both eczema and psoriasis, offering comprehensive care for affected individuals.

Find Relief from Nail Eczema and Psoriasis with Phoilex

Although nail psoriasis and eczema can significantly impact your life, knowing the differences between nail eczema vs psoriasis, recognizing symptoms, and applying effective management techniques can alleviate symptoms. Incorporating Phoilex into your skincare remedy will provide quick and efficient solutions to soothe your nails and promote healthier skin. Explore Phoilex options for long-lasting relaxation and relief.

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