Nail Eczema vs. Nail Psoriasis: Symptoms and Treatment

Eczema and psoriasis are both chronic skin diseases, but they can damage the nails in different ways, whether from discoloration, grooving, pitting, or something else.

What Is Nail Eczema?

Eczema is a common skin disease affecting about 32 million Americans. It's also called atopic dermatitis. Atopic dermatitis is only one of the multiple types of eczema.

Eczema is characterized by red, itchy skin, and can spread from one part of the body to another. Usually, someone with fingernail or toenail eczema has eczema elsewhere on their body. When eczema affects the hands and feet, it's called pompholyx eczema.

Hand eczema is common, and fingernail changes are more common than toenail changes. Pompholyx eczema can affect the nail folds and skin around the nails (cuticles), resulting in swelling. Nail eczema can cause pitting in the nails (dents that look like your nail was poked by an icepick), and requires treatment to avoid worsening of the condition.

Nail Eczema vs. Nail Psoriasis

Nail eczema and nail psoriasis are similar in that having eczema or psoriasis elsewhere on the body is usually a precursor. Both conditions can cause pitting in the nails, but nail psoriasis also causes lifting and white discoloration in the nails. While nail eczema can appear at any age, nail psoriasis typically shows up in older adults.

Symptoms of Nail Eczema

The main symptoms of nail eczema include:

• Longstanding eczema elsewhere on the body
• Hand or foot eczema rash
• Ridged nails presenting as lines across the length or width of the nail
• Nail pitting, where there are tiny dents in fingernails or toenails
• Wavy nails
• Soft nails
• Nail shedding

A 2019 study looked at the nails of 235 patients aged 2 to 19 with eczema. Of the group, 10% of people had nail abnormalities. The most common nail changes found were grooved nails (25%), nail pitting (16.7%), and koilonychia, which refers to thin or concave nails (16.7%).

Nail Eczema: Diagnosis and Treatment

Allergy testing or tests of nail clippings may be done to rule out a fungal infection.

Treatment starts with seeing a dermatologist for proper diagnosis, specifically differentiating nail eczema from another skin disease like nail psoriasis.

Your doctor may recommend the following treatment for nail eczema:

• Avoiding touching irritating products
• Wearing rubber gloves to protect hands from water
• Moisturizing your hands
• Using topical steroids

Nail eczema may improve in a few weeks with the proper treatment.

When to See a Doctor

When you notice changes to your skin and nails, it's best to consult a dermatologist for proper diagnosis. If you have concerns, your symptoms are getting worse, or your treatments aren't working, consult your physician.

Summary

Nail eczema and nail psoriasis can both cause changes to your nails, specifically picking in your nails, which look like dents made by a sharp object. However, there are some distinct nail changes associated with each condition. For example, nail psoriasis may cause white discoloration and lifting, while nail eczema could also cause grooved and thin nails.

A Word From Verywell

Skin diseases like eczema that spread to the nails can be stressful and frustrating. With the proper diagnosis and treatment of symptoms, however, nail eczema can get better. When in doubt, consult your dermatologist for specific recommendations.

Frequently Asked Questions

Does eczema or nail psoriasis loosen the toenail?

Usually, eczema or psoriasis in the nail doesn't loosen the toenail. However, it can cause other symptoms like crumbling nails.

What does severe nail eczema look like?

Any nail deformity is a sign to seek medical attention for diagnosis and treatment. More severe cases of nail eczema can cause nail deformity that requires medication and lifestyle changes.