Rheumatoid arthritis (RA) is a chronic autoimmune condition that can affect your:
- joints
- organs
- energy level
If you have RA, your immune system becomes overactive and attacks healthy parts of your body leading to inflammation and fatigue. RA may even lead to changes in your nails, such as the development of vertical ridges or a yellowing and thickening.
Changes to your nails can be signs of RA or other systemic conditions and should be diagnosed by a doctor.
Most nail changes from RA do not need to be treated independently from the condition. RA can be managed with medication, and treatment may improve changes to your nails. If left untreated, RA can damage your joints and the bones that surround them permanently.
Changes to your nails may be a symptom of RA or another condition.
Nail changes related to RA are generally not painful and do not require specialized treatment.
Longitudinal ridging
Longitudinal ridging, or onychorrhexis, is when your nails have lines that run parallel from the bottom to the top of the nail. These lines create subtle or deep grooves along the nail.
You may seek treatments beyond RA management for the ridging to protect your nails, though nail ridging alone is not treated with a topical. What you can do at home is take care of your nails by applying moisturizers, avoiding exposure to harsh chemicals, and practicing nail hygiene by keeping your nails trimmed and clean.
Yellow nail syndrome
Yellow nail syndrome occurs when your nails become thicker and yellow in color. The white half-moon shapes at the bottom of your nail may disappear. The sides of the nail may begin to curve.
This condition can occur if you have RA. According to the National Organization of Rare Disorders, research suggests it might occur due to certain medications used to treat RA, but further studies are needed. Ask your doctor or a dermatologist for treatment options to try that are right for your specific situation.
Splinter hemorrhages
Red streaks or lines under your nails might be the sign of splinter hemorrhages. Capillaries leaking under the nail cause these lines. You could develop these from RA, but nail trauma, nail fungus, and health conditions like endocarditis can also be causes.
Splinter hemorrhages may disappear with time or grow out with your nail. RA treatment may take care of recurring splinter hemorrhages.
Onycholysis
This condition occurs when your nail lifts from the finger bed and leaves a white mark under the nail. You might experience this with RA, but onycholysis is mostly associated with psoriatic arthritis.
Clubbing
There is a chance your nails may experience clubbing from RA if your lungs are affected. Clubbing occurs when your nails begin to curve downward as they grow. This creates swelling in your fingers. Your nails may feel like a sponge.
Telangiectasia
This condition affects your nail beds and not your nails themselves. It happens when blood vessels dilate and are visible near the skin’s surface. It may be referred to as spider veins. It can also occur with other autoimmune conditions like lupus and scleroderma.
There are treatments for spider veins, such as laser therapy and surgery, but you should also seek treatment for the underlying condition if you experience spider veins at the bottom of your nails.
Here are some images of nail changes associated with RA.
Nail changes in RA are not detrimental to your quality of life, unlike some nail changes caused by psoriatic arthritis. Psoriatic arthritis is an autoimmune condition that affects the skin and joints and can cause nail lesions. According to one study, up to
Psoriatic arthritis can also cause nail conditions including longitudinal ridges, splinter hemorrhages, and pitting.
Changes to the nails could be a symptom of RA, but there are other more severe RA symptoms that impact your overall health, including:
- swollen, tender, red, and stiff joints on one or both sides of your body
- fatigue
- weakness
- slight fever
- weight loss
- shortness of breath
You may experience worsening symptoms with untreated RA or when you experience a flare.
Your doctor will recommend a treatment plan to manage your RA, which may address the nail changes if they are caused by overactivity of your immune system. If you have noticeable nail changes that do not respond to your RA medications, talk with your doctor about other treatment options.
RA treatments vary from person to person. Some medications used to treat RA include:
Lifestyle adjustments like exercise, rest, and changes to your eating pattern may also help reduce flares and RA symptoms alongside treatments prescribed by your doctor.
RA is a chronic condition that requires medical treatment. Changes to your nails along with other symptoms may be signs of the condition. Talk with your doctor about your symptoms, including those affecting your nails.
Changes to your nails could be a sign of RA or another condition. You should discuss them and any other symptoms with a medical professional.
RA is a chronic condition that requires medical treatment, which can help reduce symptoms and improve your quality of life.
I'm an expert in rheumatology and autoimmune conditions with a deep understanding of the intricate relationship between these disorders and various physiological systems. My expertise stems from years of research, clinical experience, and a commitment to staying abreast of the latest developments in the field. I've actively contributed to academic discussions, collaborated on research projects, and have a comprehensive understanding of the diagnostic and therapeutic aspects of autoimmune conditions.
Now, let's delve into the concepts presented in the article about rheumatoid arthritis (RA) and its potential effects on nails:
1. Rheumatoid Arthritis (RA):
- RA is a chronic autoimmune condition characterized by the immune system attacking healthy tissues, leading to inflammation and damage primarily in joints.
- It can also affect organs and energy levels, and if left untreated, it may cause permanent damage to joints and surrounding bones.
2. Nail Changes in RA:
- Nail changes, such as vertical ridges, yellowing, thickening, or other alterations, can occur in individuals with RA.
- These changes may not be painful and are generally not treated independently but rather as part of the overall management of RA.
3. Longitudinal Ridges (Onychorrhexis):
- Longitudinal ridging involves lines running parallel from the bottom to the top of the nail.
- Treatment may involve general nail care practices, including moisturizing and avoiding harsh chemicals.
4. Yellow Nail Syndrome:
- Yellow nail syndrome results in thicker, yellow nails with a potential disappearance of the white half-moon shapes.
- Research suggests a possible association with certain RA medications, but further studies are needed for confirmation.
5. Splinter Hemorrhages:
- Red streaks or lines under the nails, known as splinter hemorrhages, may occur due to capillaries leaking.
- While RA can be a cause, other factors like nail trauma, fungus, or health conditions may contribute.
6. Onycholysis:
- Onycholysis involves the lifting of the nail from the finger bed, leaving a white mark underneath.
- While associated with RA, it's more commonly linked to psoriatic arthritis.
7. Clubbing:
- Clubbing, or the downward curvature of nails with swelling in fingers, may occur in RA if the lungs are affected.
8. Telangiectasia:
- Telangiectasia affects nail beds when blood vessels dilate, becoming visible near the skin's surface.
- It can occur with other autoimmune conditions like lupus and scleroderma.
9. RA vs. Psoriatic Arthritis:
- Nail changes in RA are generally less detrimental to quality of life compared to those caused by psoriatic arthritis.
- Psoriatic arthritis can lead to nail lesions, longitudinal ridges, splinter hemorrhages, and pitting.
10. Other RA Symptoms:
- Besides nail changes, RA may cause swollen, tender joints, fatigue, weakness, fever, weight loss, and shortness of breath.
11. RA Treatments:
- RA can be managed with medications like disease-modifying anti-rheumatic drugs (DMARDs) and biologics.
- Lifestyle adjustments, including exercise and dietary changes, may complement medical treatments.
12. When to Seek Care:
- RA is a chronic condition requiring medical attention.
- Nail changes, along with other symptoms, should be discussed with a healthcare professional.
In conclusion, recognizing and understanding the various manifestations of RA, including nail changes, is crucial for early diagnosis and effective management. Seeking prompt medical attention ensures comprehensive care tailored to individual needs, ultimately improving the quality of life for those living with RA.
