White matter and other changes around the toenails and fingernails can occur with psoriasis or nail fungus. However, fungal infections are contagious, and psoriasis is not. The causes and treatment are different.
The autoimmune activity in psoriasis causes the rapid overgrowth of skin cells. These cells build up in the skin, contributing to the characteristic lesions of condition.
Nail fungus is a type of infection. People often pick up fungal nail infections in moist locations, such as pool decks and locker rooms. However, the fungus can have many other sources.
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Most people with lesions under or on the nails develop psoriasis symptoms elsewhere, too. In some people with psoriasis, nail symptoms are the first to appear.
A person can pick up a fungal infection through physical contact with an object or surface that another person with a fungal infection has touched.
However, people with a suppressed immune system, such as those with diabetes or HIV, may develop sores that do not heal after a fungal infection. Prompt treatment is essential for this reason.
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Quickly starting treatment will yield better results and reduce the risk of a severe infection. Any delay in treatment may permanently damage the nail bed.
When other symptoms of psoriasis accompany lesions on the nails, symptoms are likely to indicate that psoriasis is affecting the nails too.
At the outset, the nails might look a little dry, then develop ridges that end up forming deep pits or even holes.
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The nails may fall off entirely or break off in pieces. Before a nail falls off, a gap usually develops between the nail and the fingertip.
Keratin is a protein that promotes the development of the skin and nails. Nail psoriasis sometimes causes too much keratin to grow under the nail. This overgrowth is called subungual hyperkeratosis.
People with hyperkeratosis may notice a white, chalky substance under the nail. When this occurs in the toenails, the pressure of shoes pushing down on the nails might cause pain.
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Symptoms of nail psoriasis often appear after an injury in the affected area. It is possible to overlook a small injury, such as a cut or bruised toe because people sometimes cram their feet into tight shoes or expose them to the ground.
While an open wound on the hands or feet makes it easier for fungal infections to enter the body, the wound will not directly trigger a fungal infection.
Fungal infections usually affect the toes, not the fingernails. This is because the feet are more likely to come into contact with fungus when walking barefoot.
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Unlike psoriasis, fungal infections do not cause pits in the nails. Instead, the nails tend to change shape over time. They may become thin or develop thick patches and sometimes break.
Nail fungus often grows with the nail. It attaches to a specific portion of the nail, and as the nail grows and that portion of the nail moves, so too does the fungus.
Both psoriasis and fungal infections tend to get worse with time. Psoriasis, however, does not spread through contact in the same way as a fungal infection.
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People with a fungal infection of the toenails may notice color changes between the toes, or other signs that the infection has spread to the skin between the toes.
Knowing the difference between nail psoriasis and nail fungus can prevent people with fungal infections from spreading it to others. However, people with nail symptoms from either condition should not self-diagnose.
People with psoriasis may also be more vulnerable to fungal nail infections. This can complicate the process of getting an accurate diagnosis.
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Only a doctor can confidently determine the cause of any changes in the fingernails and toenails. Prompt medical care can address symptoms of both nail psoriasis and nail fungus.
Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Jackson Thomas , University of Canberra, Gregory Peterson , University of Tasmania, Julia K. Christenson , University of Canberra, Sam Kosari , University of Canberra
Jackson Thomas received funding from government e.g. RIRDC, ACT gov, NSW Pharmacy Council, Goodwin aged care facilities, and consultant fee and/or grants from biotech companies
Nail And Toenail Fungus Treatment,perfect For Both Toenails And Fingernails For Healthier Thinner And Extra Strength Nails With Natural Ingredients Formula (30 Ml*3pack)
Gregory Peterson receives funding from the Commonwealth Department of Health, National Heart Foundation, National Health & Medical Research Council, and Royal Hobart Hospital Research Foundation.
Sam Kosari received funding from Capital Health Network, NSW Pharmacy Council, University of Canberra, Goodwin aged care services, ASCEPT and several consultancy projects.
Julia K. Christenson does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
What Should I Do If My Nails Are Fungal?
About 10% of us (including 20% of people over 60 and 50% of people over 70) suffer from fungal nail infections. So why do we get them, and does it matter?
Technically called “onychomycosis”, fungal infection of the nail plate (the hard outer nail) or nail bed (that lies under the hard nail) will most often appear as yellowish, white, black or green discolouration of the nail. The infected nail may also appear thickened or brittle. In severe cases, from long-term infection (where all the tissues of the nail have been infected), the infected nail may break up and fall off.
Fungal nail infections can be difficult to cure, and they typically don’t go away without antifungal treatment. The fungus can spread to other areas of the hands or feet, and can be mild with purely cosmetic implications, or more severe with pain, low self-esteem and embarrassment due to disfigurement.
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Toenails are more often affected than fingernails, possibly because they’re larger, slower to grow, suffer pressure from footwear, often have poorer hygiene, and are often in a closed environment (shoes) where fungi can grow.
Although fungal nail infections are not life-threatening, they’re an important health problem because of their high prevalence and poor response to therapy.
Fungal nail infections are thought to have become more prevalent during the 20th century thanks to people migration, longer life expectancy, increasing numbers of people with compromised immune systems (such as HIV sufferers), use of stifling foot wear and locker rooms in the gym.
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Fungal nail infections are caused by different types of fungi, yeasts (such as Candida) and moulds. Fingernail fungal infections are typically caused by yeast fungi, especially Candida.
Fungal nail infections are more common among people who are of lower socioeconomic background, older, male, diabetic, obese, immune deficient (such as HIV or cancer), lacking personal hygiene, and environmental factors such as fungal contamination of swimming pools, public toilets and communal bathing facilities.
One of the problems with treating fungal nail infections is the fungus that causes it is difficult – if not impossible – to eliminate from the environment. These fungi thrive in warm, moist environments that you typically find in gyms, swimming pools, bathrooms, socks of unnatural fibres and enclosed shoes.
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Because fungal spores can remain viable for months in these environments, frequent exposure can increase the risk of infection (and re-infection). Fungal spores can be picked up in many ways – such as wearing shoes that harbour the organism, by walking barefoot in areas where the fungus is prevalent (especially public showers and locker rooms), by wearing wet shoes or socks for long periods, through previous injury to the toe or toenail that opens a path for easy entry of the fungus, or by wearing improperly-fitting shoes.
Fungal infection occurs when the organism invades through an opening in the nail, meaning fungi will usually attack nails that are already damaged. After infection occurs, the growth of the fungi leads to mild inflammation, which causes the nail to thicken and the nail plate to detach from the nail bed. The space underneath the nail can then serve as a reservoir for bacteria and moulds, which can cause the nail to become discoloured.
Fungal nail infections and the resultant nail destruction can promote other sources of infection like cellulitis (a bacterial skin infection) and other forms of tinea, and aggravate foot problems resulting from other illnesses such as diabetes. Diagnosis is usually confirmed by looking at nail clippings through a microscope or other tests before starting treatment.
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Treatment may not be required if the infection is minor. The severity is judged by looking at the degree of discolouration, nail thickening and pain.
Topical agents such as amorolfine (Loceryl 5% nail lacquer; applied once or twice a week) and ciclopirox (Penlac 8% nail lacquer; applied daily) are usually prescribed for mild forms of the disease, but the treatment periods are long and their efficacy is somewhat limited due to poor nail plate penetration. These medications kill fungi by interfering with their cell membranes, which leads to their death.
For more severe cases, oral antifungal medications might be required. These include fluconazole (an antifungal agent also commonly used to treat thrush), terbinafine (a broad-spectrum antifungal) and griseofulvin (usually used for skin
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