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This Trending Bad Habit Could Be Making Your Nail Psoriasis Worse

New research uncovers a surprising link.

Wisps of white smoke curling and swirling against a black background.
Unsplash / Pascal Meier

Cigarettes may be making an unexpected comeback. From chain-smoking scenes in movies and television to celebrities and fashion campaigns embracing the "smoking aesthetic," the habit is creeping back into the cultural spotlight, despite decades of public health efforts to move past it.

But while smoking may be getting a rebrand, the health consequences haven't changed. And for people living with psoriasis, the effects may extend beyond the lungs. According to new research reported by Dermatology Times, smoking may significantly worsen nail psoriasis, increasing symptoms such as pitting, discoloration, thickening and even lifting of the nail away from the nail bed.

The researchers found that people with psoriasis who smoked had substantially more severe nail involvement than nonsmokers, even though smoking wasn't associated with more severe psoriasis affecting the skin overall.

To better understand the connection, researchers compared 218 people with psoriasis with 218 people without the condition, looking at both smoking history and disease severity. Nearly 28 percent of participants with psoriasis were current smokers, compared with just 6 percent of those without the disease.

When researchers examined nail symptoms specifically, they found that smokers had nearly twice the severity of nail psoriasis as nonsmokers. Interestingly, smoking wasn't linked to more severe skin psoriasis or a higher rate of psoriatic arthritis, suggesting its effects may be especially pronounced in the nails.

The researchers say the findings add to growing evidence that smoking may influence psoriasis through several pathways. Tobacco use has long been associated with increased inflammation throughout the body, and researchers believe it may also contribute to oxidative stress, changes in blood flow to the nail matrix and other inflammatory processes that can worsen nail disease.

The study also examined other lifestyle factors but did not find a significant association between obesity and the severity of nail psoriasis. While the research doesn't prove that smoking directly causes nail symptoms to worsen, the authors say the findings reinforce the importance of discussing smoking cessation as part of comprehensive psoriasis care.

More research is needed to determine whether quitting smoking can improve nail psoriasis over time. For now, the study is another reminder that lifestyle habits can play an important role in managing chronic inflammatory conditions.

Adapted from original reporting by Dermatology Times.

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