Many of us dream of sporting a flawless manicure, but sometimes, our nail health betrays us, leading to peeling, cracking, and discoloration. While a coat of nail polish might hide the damage, the root problems, often nail psoriasis or nail fungus, persist beneath the surface. These conditions can look strikingly similar, making it challenging to distinguish between them. To shed light on these differences, we've consulted with dermatology experts.

Defining Nail Psoriasis

Nail psoriasis is an autoimmune condition that affects the nail matrix, leading to characteristic changes such as pitting, oil spots, and onycholysis, explains dermatologist James Kilgour, MD. This condition can strike anyone, particularly those over 40 or with a family history of psoriasis, indicating a strong genetic link.

What is Nail Fungus?

On the other hand, nail fungus, or onychomycosis, is a fungal infection that targets the nails, causing thickening, discoloration, and sometimes lifting of the nail from the bed. This infection is more common in toenails and can be associated with athlete's foot, according to Dr. Kilgour.

Spotting the Differences

While both conditions can appear similar, nail fungus often presents with thickening and discoloration, whereas nail psoriasis may cause the nail surface to feel rough and display yellow or orange patches. Distinguishing between the two can be tricky without professional help, especially since isolated nail psoriasis is rare and usually accompanies other psoriasis symptoms.

Treatment Options for Nail Psoriasis

For those diagnosed with nail psoriasis, treatment may include topical or injectable steroids, vitamin D and retinoid creams, and advanced therapies like biologic injectable medicines. Dermatologist Neil Sadick, MD, emphasizes the importance of a tailored treatment plan based on the severity of the condition.

Addressing Nail Fungus

Treating nail fungus typically involves antifungal medications, with oral antifungals being the most effective. However, these treatments require careful monitoring due to potential side effects and high recurrence rates. Maintaining nail health and hygiene is also crucial in managing and preventing nail fungus.

Deciphering whether you're dealing with nail psoriasis or nail fungus can be overwhelming. The key to proper management and treatment lies in consulting with a dermatologist, who can help identify the condition and develop an appropriate treatment strategy.