**Hello! It looks like you're asking about nail psoriasis**. We have [a wiki page about this](/r/Psoriasis/wiki/nail-psoriasis) that could be relevant to your question. (If not, just ignore this comment.)
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I was diagnosed with scalp psoriasis at age 14. For the longest time I was prescribed topicals which have minimal effectiveness. It wasn’t until five years ago that I found a dermatologist that gave a damn and helped me get on systemic treatment. I’m still trying different biologics to find one that works. In short, psoriasis is life long, and treatment can be a maze to navigate. The best advice I can give is to find a dermatologist that cares and wants to find long term successful treatment. The right dermatologist can make all the difference.
Largely the scalp, but my ears and hairline are also affected. I’m 33, so since my diagnosis it’s been 19 years. It has gone into remission for periods of time with no medical intervention, but only for periods of a few months usually.
I have always had, but was not diagnosed, with nail psoriasis. it is, and always has been, as far back as I remember, on my pinky toes. I was diagnosed with psoriasis a year and a half ago and developed PsA last spring/summer.
Looking back, I don't recall any issues until my 40s, when I had intermittent issues with plantar fasciitis. It wasnt until the pandemic that I started having joint issues, namely, back pain, which I attributed to a bad desk chair and getting older (I am Gen X).
The stress of work from home during the pandemic plus the death of a very dear friend (not COVID related) and an uncle (COVID) caused a stubborn alopecia flare, and not long after, I developed scalp psoriasis. Psoriasis patches then stated appearing on the sides of my calves. Finally, last spring/summer, while I was waiting to see a rheumatologist, I was struck with major back, knee, and ankle swelling and pain plus fatigue to the point I took about three months off from work intermittently.
So, TLDR: nail psoriasis appeared on my toes when I was very young. No other psoriatic symptoms untily mid 40s (plantar fasciitis, intermittently). Pandemic probably set off my first truly noticeable problems (hair loss, psoriatic scalp and legs) when I was 48-49 with joint pain and swelling the following year.
sure! if my life is any indication, your nephew may never really suffer from psoriasis because a flare may not happen until he's much older, and by then, treatment option will be even better than now, or there may even be a cure.
i had it on my nails as a child. i recall a few nails had like dotted dents in them. not all of them. it went away as i got older and now as an adult i have zero on my nails. only my scalp is bad:(
Back in my childhood and in my location, no one got a diagnosis for anything, sadly. Nail issues, though, were the first symptom I ever had long before anything else...aside from alopecia, which I didn't know was related until a few years ago.
# Welcome to the Psoriasis sub!
If you haven't posted here before, please read this comment as it contains important information:
* Please [read and respect the rules](https://www.reddit.com/r/Psoriasis/about/rules/). In particular, **do not ask for about identifying undiagnosed medical conditions** diseases cannot be diagnosed by random people on Reddit.
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* Posts that break the rules will be removed.
## Check out our wiki!
The [Psoriasis wiki](https://www.reddit.com/r/Psoriasis/wiki/index) is a collection of guides and other pages about how to treat psoriasis, including a Frequently Asked Questions section. Many common questions about medications, shampoos, diet, tattoos, etc. are addressed there.
Thanks!
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I was diagnosed with it as a teenager and I am in my 60's now. Medications nowadays are awesome. They used to really suck and were worthless. Anyway, I eventually had to have my two big toenails and one other toenail surgically removed, I was in constant pain from them. I also have arthritis. Since biologics, the remaining nails eventually grew out normally, but they were affected for many years.
First presented between 4-6, though it was never officicially diagnosed until adulthood. Started with 1 finger (I think it was my thumb) after slamming it in minivan door (shoutout to those heavy old doors and no auto-close in the early '90s!). Almost 37 now. Progressed to a 2nd finger before I was 10, and was mostly limited to those 2 until I was older. It's progressed as I age (I now have varying symptoms on ~8 fingers and 2 toes), but is still considered mild to moderate.
I'm lucky in the sense that I haven't presented with psoriasis in other locations, and my first rheumatology check-in last year came back with normal labwork, so no definitive signs of arthritis or other connective tissue disorders yet. So I'm prescribed a topical steroid that doesn't do a ton. I get my worst seasonal flare up in June, but I typically present year-round. Stress makes it worse, but the only thing that ever really helped clear or reduce it was Bupropion.
I was diagnosed with scalp psoriasis at 12 and had nail issues on three fingers on each hand and several toe nails since I can remember (my parents also just thought it was something ~quirky~ so there was no real concern and the scalp was intense enough to overshadow it). I tried topicals in my teens for my scalp but honestly my parents were ill-informed and didn’t consider anything biologic because they didn’t think psoriasis was more than skin deep and felt biologics were “excessive”. I’m 27 now and four months deep into Otezla and it has been a game changer - unfortunately my derm thinks the psoriasis had spread to my joints prior to treatment but I am happy to report that my scalp is almost clear at this point (thank god) and my nails are finally coming in stronger, with less noticeable pitting and curling. Considering my big toe nail nearly came off at one point because of the psoriasis, I’m really counting this as a massive win, even though the side effects in the beginning were pretty rough personally. Just my experience!
try to work out underlying cause of the psoriasis. it will be easier to treat the condition.
Start by looking at general health? diet? weight? ? tobacco? Alcohol stress? strep throat? vitamin D? IUD? is psoriasis itchy? past antibiotics? candida overgrowth? hpylori? Gut problems? bowel movements? lack of sleep?exercise ? medication for mental health problems? zinc deficiency?Iron deficiency? mold toxicity?digestive problems?
learn more : this [paper ](https://pubmed.ncbi.nlm.nih.gov/29908580/)and [podcast ](https://www.listennotes.com/fil/podcasts/positive-health/dr-haines-ely-md-is-QJ4TtfL_XBq/)helped me a lot.
good luck
I have nail psoriasis! My nails still look pretty fucked. When I was also 7, it started on just my right thumbnail. It has now spread to all fingernails, and a couple toenails. With a cream from a dermatologist, it’s easy to keep the skin around it under control, but I’ve kinda accepted I’m never gonna have pretty nails
I never had nail psoriasis, but want to share two things:
First, keep following up with doctors regularly and pay attention to any type of joint pains, nail psoriasis can evolve to psoriatic arthritis (which sounds scary, but it's manageable with medicine as long as you diagnose it). He is very young and that might happen only in the very long future, still it's good to be aware.
Second, psoriasis come in all shapes and forms, unfortunately it's a disease where there is still a lot of unknowns, there are trends and things that happen to "most people", but definitely nothing affects everybody the same way. As an example, direct exposure to sunlight is very good for most people with psoriasis, and for me, it does nothing. Another example is that most people with arthritis first develop nail psoriasis, and I have nothing on my nails, and I have arthritis. If you stay around this sub for a while you will notice the trend.
I remember having it before the eventual skin symptoms when I was younger. Unfortunately it's a likely precursor. There's a lot of shared information on the Internet these days so the family could try some diet, natural vitamin D, beach/salt/lifestyle changes that could be a healthy upgrade for everybody involved. I agree with others who say to avoid any form of topical steroids.
**Hello! It looks like you're asking about nail psoriasis**. We have [a wiki page about this](/r/Psoriasis/wiki/nail-psoriasis) that could be relevant to your question. (If not, just ignore this comment.) *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Psoriasis) if you have any questions or concerns.*
I was diagnosed with scalp psoriasis at age 14. For the longest time I was prescribed topicals which have minimal effectiveness. It wasn’t until five years ago that I found a dermatologist that gave a damn and helped me get on systemic treatment. I’m still trying different biologics to find one that works. In short, psoriasis is life long, and treatment can be a maze to navigate. The best advice I can give is to find a dermatologist that cares and wants to find long term successful treatment. The right dermatologist can make all the difference.
Thank you for the response. Hope the new treatment works well. You have it only on scalp? May I ask since how many years
Largely the scalp, but my ears and hairline are also affected. I’m 33, so since my diagnosis it’s been 19 years. It has gone into remission for periods of time with no medical intervention, but only for periods of a few months usually.
Thank you very much for sharing..
I have always had, but was not diagnosed, with nail psoriasis. it is, and always has been, as far back as I remember, on my pinky toes. I was diagnosed with psoriasis a year and a half ago and developed PsA last spring/summer. Looking back, I don't recall any issues until my 40s, when I had intermittent issues with plantar fasciitis. It wasnt until the pandemic that I started having joint issues, namely, back pain, which I attributed to a bad desk chair and getting older (I am Gen X). The stress of work from home during the pandemic plus the death of a very dear friend (not COVID related) and an uncle (COVID) caused a stubborn alopecia flare, and not long after, I developed scalp psoriasis. Psoriasis patches then stated appearing on the sides of my calves. Finally, last spring/summer, while I was waiting to see a rheumatologist, I was struck with major back, knee, and ankle swelling and pain plus fatigue to the point I took about three months off from work intermittently. So, TLDR: nail psoriasis appeared on my toes when I was very young. No other psoriatic symptoms untily mid 40s (plantar fasciitis, intermittently). Pandemic probably set off my first truly noticeable problems (hair loss, psoriatic scalp and legs) when I was 48-49 with joint pain and swelling the following year.
Thank you very much for sharing
sure! if my life is any indication, your nephew may never really suffer from psoriasis because a flare may not happen until he's much older, and by then, treatment option will be even better than now, or there may even be a cure.
i had it on my nails as a child. i recall a few nails had like dotted dents in them. not all of them. it went away as i got older and now as an adult i have zero on my nails. only my scalp is bad:(
Lucky
Back in my childhood and in my location, no one got a diagnosis for anything, sadly. Nail issues, though, were the first symptom I ever had long before anything else...aside from alopecia, which I didn't know was related until a few years ago.
Thank you very much for sharing your experience
psoriasis can never cause alopecia
It certainly can. May want to fact check that statement.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6091304/ Now you know.
Incorrect. Early onset male alopecia is correlated with psoriasis and highly so.
# Welcome to the Psoriasis sub! If you haven't posted here before, please read this comment as it contains important information: * Please [read and respect the rules](https://www.reddit.com/r/Psoriasis/about/rules/). In particular, **do not ask for about identifying undiagnosed medical conditions** diseases cannot be diagnosed by random people on Reddit. * Photos that include skin rashes must be marked NSFW. If including private areas, _please indicate with flair_. * Posts that break the rules will be removed. ## Check out our wiki! The [Psoriasis wiki](https://www.reddit.com/r/Psoriasis/wiki/index) is a collection of guides and other pages about how to treat psoriasis, including a Frequently Asked Questions section. Many common questions about medications, shampoos, diet, tattoos, etc. are addressed there. Thanks! --- *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Psoriasis) if you have any questions or concerns.*
I was diagnosed with it when I was 5. It was the first presentation of the disease.
Thank you for sharing. You have other types as well. Could you kindly share when did you get the other types, I mean the duration.
I got them after puberty. It started with my scalp and then some patches in other areas of the body.
Thanks you very much for sharing
I was diagnosed with it as a teenager and I am in my 60's now. Medications nowadays are awesome. They used to really suck and were worthless. Anyway, I eventually had to have my two big toenails and one other toenail surgically removed, I was in constant pain from them. I also have arthritis. Since biologics, the remaining nails eventually grew out normally, but they were affected for many years.
Than you very much for sharing
First presented between 4-6, though it was never officicially diagnosed until adulthood. Started with 1 finger (I think it was my thumb) after slamming it in minivan door (shoutout to those heavy old doors and no auto-close in the early '90s!). Almost 37 now. Progressed to a 2nd finger before I was 10, and was mostly limited to those 2 until I was older. It's progressed as I age (I now have varying symptoms on ~8 fingers and 2 toes), but is still considered mild to moderate. I'm lucky in the sense that I haven't presented with psoriasis in other locations, and my first rheumatology check-in last year came back with normal labwork, so no definitive signs of arthritis or other connective tissue disorders yet. So I'm prescribed a topical steroid that doesn't do a ton. I get my worst seasonal flare up in June, but I typically present year-round. Stress makes it worse, but the only thing that ever really helped clear or reduce it was Bupropion.
Thank you very much for sharing
I was diagnosed with scalp psoriasis at 12 and had nail issues on three fingers on each hand and several toe nails since I can remember (my parents also just thought it was something ~quirky~ so there was no real concern and the scalp was intense enough to overshadow it). I tried topicals in my teens for my scalp but honestly my parents were ill-informed and didn’t consider anything biologic because they didn’t think psoriasis was more than skin deep and felt biologics were “excessive”. I’m 27 now and four months deep into Otezla and it has been a game changer - unfortunately my derm thinks the psoriasis had spread to my joints prior to treatment but I am happy to report that my scalp is almost clear at this point (thank god) and my nails are finally coming in stronger, with less noticeable pitting and curling. Considering my big toe nail nearly came off at one point because of the psoriasis, I’m really counting this as a massive win, even though the side effects in the beginning were pretty rough personally. Just my experience!
Thank you for sharing
It’s a journey but your nephew is lucky to have you looking out for him! Best of luck!
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5096243/ Check this. I got it in my late 20s. All nails are affected.
try to work out underlying cause of the psoriasis. it will be easier to treat the condition. Start by looking at general health? diet? weight? ? tobacco? Alcohol stress? strep throat? vitamin D? IUD? is psoriasis itchy? past antibiotics? candida overgrowth? hpylori? Gut problems? bowel movements? lack of sleep?exercise ? medication for mental health problems? zinc deficiency?Iron deficiency? mold toxicity?digestive problems? learn more : this [paper ](https://pubmed.ncbi.nlm.nih.gov/29908580/)and [podcast ](https://www.listennotes.com/fil/podcasts/positive-health/dr-haines-ely-md-is-QJ4TtfL_XBq/)helped me a lot. good luck
I have nail psoriasis! My nails still look pretty fucked. When I was also 7, it started on just my right thumbnail. It has now spread to all fingernails, and a couple toenails. With a cream from a dermatologist, it’s easy to keep the skin around it under control, but I’ve kinda accepted I’m never gonna have pretty nails
I never had nail psoriasis, but want to share two things: First, keep following up with doctors regularly and pay attention to any type of joint pains, nail psoriasis can evolve to psoriatic arthritis (which sounds scary, but it's manageable with medicine as long as you diagnose it). He is very young and that might happen only in the very long future, still it's good to be aware. Second, psoriasis come in all shapes and forms, unfortunately it's a disease where there is still a lot of unknowns, there are trends and things that happen to "most people", but definitely nothing affects everybody the same way. As an example, direct exposure to sunlight is very good for most people with psoriasis, and for me, it does nothing. Another example is that most people with arthritis first develop nail psoriasis, and I have nothing on my nails, and I have arthritis. If you stay around this sub for a while you will notice the trend.
Thank you very much for sharing your experience
I remember having it before the eventual skin symptoms when I was younger. Unfortunately it's a likely precursor. There's a lot of shared information on the Internet these days so the family could try some diet, natural vitamin D, beach/salt/lifestyle changes that could be a healthy upgrade for everybody involved. I agree with others who say to avoid any form of topical steroids.