Oregon Grape Root for Psoriatic Nail Pain: What the Evidence Shows

No study has tested Oregon grape on psoriatic nails. The one good trial used a cream on skin psoriasis, not on nails.

This page covers what that trial found, what dermatologists use for nail psoriasis, and who should not use Oregon grape at all.

Does Oregon grape root work for nail psoriasis?

There is no nail data. The only controlled trial we have is on skin.

In that trial, 200 people with mild to moderate plaque psoriasis used either a cream or a placebo twice a day for 12 weeks. The cream was Reliéva, which contains an extract of Mahonia aquifolium, the plant also called Oregon grape. The Oregon grape group did better on the psoriasis severity score and the quality of life score. Side effects were infrequent and minor: rash, burning when the cream went on, and clothing stains. (Bernstein et al., 2006)

That result covers one branded cream on skin. It doesn’t tell you what a tea, a soak, a capsule or an oil does to a nail.

What do dermatologists use for nail psoriasis?

The American Academy of Dermatology lists these treatments for nails:

• A strong or very strong corticosteroid applied to the nail, for mild or early disease or when only a few nails are affected
• Calcipotriol, a vitamin D-derived medicine, for build-up under the nail
• Tazarotene, a vitamin A-derived medicine, for pitting, separation or discoloration
• Injections into the nail area every 4 to 6 weeks if creams don’t work
• Whole-body medicines such as biologics, methotrexate, acitretin, cyclosporine or apremilast for severe skin and nail disease

Nails grow slowly. The AAD says you need to apply nail treatments for at least six months. (AAD)

Thick, crumbling or separated nails can also come from a nail infection, and that needs its own treatment. A dermatologist can test for it.

Is Oregon grape root safe?

Not for everyone. RxList says:

• Oregon grape is likely unsafe in pregnancy. Berberine, one of its chemicals, may pass to the fetus.
• It is likely unsafe while breastfeeding, because berberine can reach the baby through breast milk.
• It might slow how fast your body breaks down cyclosporine, which can raise cyclosporine levels and side effects. This is a moderate interaction.
• It might slow how fast the liver breaks down other drugs, such as lovastatin, clarithromycin, indinavir, sildenafil and triazolam. This is also a moderate interaction.
• There isn’t enough information to know whether it is safe by mouth in medicinal amounts.

Cyclosporine is one of the drugs used for severe psoriasis. If you take it, or any prescription medicine, ask your doctor or pharmacist before you try Oregon grape. (RxList)

What should you do about painful psoriatic nails?

See a dermatologist. Nail changes can come with psoriatic arthritis, and early treatment helps keep both from getting worse. Keep taking any prescribed treatment unless your doctor tells you to stop.

Plain nail care helps too. The AAD recommends keeping nails trimmed short, not picking at nails and cuticles, avoiding artificial nails and wearing gloves for housework.

Questions