Psoriatic arthritis (PsA) is a form of inflammatory arthritis that causes swelling and stiffness in the joints. “Psoriatic disease” is the umbrella term for both PsA and psoriasis, which is a condition associated with scaly, discolored patches on the skin.

If you’re living with PsA, you may develop symptoms that affect your nails. Healthcare professionals refer to this as PsA with nail involvement. You may notice changes to your nails, such as pitting or pulling away from the nail bed.

Nail involvement may make you more hesitant to get a manicure, but you don’t need to completely skip this popular form of self-care. However, you should take some precautions to help protect your nails and prevent damage and disease progression.

Here’s what you need to know about how PsA affects your nails and how to get a manicure safely if you have the condition.

PsA can negatively affect your nails in several ways.

Nail involvement could be a sign of worsening psoriatic disease. Experts state that nail involvement could indicate the development of PsA in people who haven’t had other symptoms, like joint pain and stiffness.

Almost 90 percent of people living with PsA develop nail involvement. Both fingernails and toenails can be affected. Nail involvement can affect any number of your nails. Some people have symptoms on only a single nail, while others have symptoms on all 20.

Though everyone may experience symptoms differently, some common symptoms of PsA in the nails include:

  • Pitting: shallow or deep holes in the nails
  • Onycholysis: separation of the nail from the nail bed
  • Thickening of the nail plate: creates a heavy sensation in the nails
  • Deformation: changes to the nail bed
  • Beau’s lines: horizontal ridges in the nails
  • Onychomycosis: fungal infection in the nails
  • Discoloration: nails turn white, yellow, or brown
  • Crumbling: nails have a crumbly appearance

In some cases, you may develop nail involvement without other symptoms of psoriasis. In this case, be aware that your doctor may misdiagnose nail involvement, particularly if the changes appear on your toenails.

Getting a manicure when living with PsA is a bit complicated. While you can get your nails done, there are some parts of the process you will likely want to avoid.

When you get a full manicure, the process typically involves filing your nails and applying several harsh chemicals. This can damage the nails and worsen symptoms.

Cutting or pushing in the cuticles can also have a harmful effect on your nails. In some cases, it can lead to an infection in your skin.

However, gentle buffing, nail hardeners, and nail polishes are generally OK to apply to the nails. They can help cover up nail pitting or other signs of psoriasis.

When you get your nails done at a salon or do them at home, you can take steps to help prevent complications with your nails. When you get a manicure, you should ask the person doing your nails to use only gentle buffers and avoid:

  • touching the cuticles
  • using harsh chemicals
  • putting on artificial nails

You should follow the same advice at home or when doing your nails with friends.

Nail polish and manicures can be part of your nail care routine as long as you avoid artificial nails, harsh chemicals, and heavy scraping of the nails.

You can take more steps to help care for your nails. According to the American Academy of Dermatology, some healthy nail care tips you should try include:

  • keeping your nails cut short
  • avoiding cutting, scraping, or pushing down your cuticles
  • wearing gloves during manual labor
  • keeping your hands moisturized
  • not picking or biting at your nails or skin around them
  • not picking or scraping away any buildup under or around your nails

Some additional tips from the National Psoriasis Foundation that you may want to keep in mind include:

  • Apply Vaseline under the nails to help keep out moisture, such as from handwashing.
  • Keep your nails dry at all times.
  • Use only nail polishes with the label “5-free” (or with a number greater than 5, which indicates the product is free of most toxic chemicals typically used in nail polish).

You may also want to avoid using your nails as tools to open cans or for other similar applications.

Nail psoriasis can indicate severe psoriasis and, in some cases, might be the only sign of psoriatic disease.

When you get your nails done using typical methods, such as scraping, cutting, pushing on the cuticles, and using harsh chemicals, it can lead to damage and dry nails. The damage can lead to infection.

Damage to the nails, skin, or joints can also lead to worsening symptoms and disease progression.

Living with PsA and nail psoriasis doesn’t mean you have to entirely skip a manicure, but you should make a few adjustments. You can apply nail polish and lightly buff your nails, but you’ll want to avoid fake nails, chemicals, and cutting or pushing on your cuticles.

You may also want to take steps to better protect your nails. These steps include moisturizing, keeping your nails dry and clean, and wearing gloves when working.

If your nail symptoms get worse or change after a manicure, speak with your doctor about possible new treatments and management.