“I have lost almost all my fingernails,” one MyPsoriasisTeam member wrote. Another said, “My nails are ridged, and they splinter and crack along the ridges, so I keep them as short as possible.”

MyPsoriasisTeam members often talk about the challenges of keeping their nails looking healthy while living with psoriasis or psoriatic arthritis (PsA).

Whether your psoriatic disease affects your skin, fingernails, toenails, or all three, it’s important to understand how to care for your nails and how products like nail polish and nail polish remover may affect you.

In general, people diagnosed with skin psoriasis and nail psoriasis can still get basic manicures with nail polish and light buffing.

Here, we’ll take a look at nail polish and nail polish removal options for people with psoriasis and PsA. We’ll also talk about some general nail care tips that work well for people with psoriatic disease. In general, it’s best to talk to your doctor or dermatologist about how nail treatments may affect your psoriasis or PsA.

How Does Psoriasis Affect Your Nails?

Nail issues are common among people with psoriatic disease, with one study reporting that nearly 50 percent of people with psoriasis and up to 80 percent of those with PsA experience nail lesions, known as nail psoriasis.

Psoriasis of the nails can cause many nail changes, such as:

• Brittle nails
• Discolored nails
• Nail pitting
• Nail splitting
• Onycholysis (separation of the nail plate from the nail bed)
• Subungual hyperkeratosis (buildup of a chalky substance under the nail)

These symptoms may worsen in people who get their nails done regularly. In particular, the drying chemicals in nail products can aggravate the symptoms of nail psoriasis.

What Are the Risks of Doing Your Nails With Psoriatic Disease?

Psoriasis can be a skin disease, a nail disease, or both. If you have been diagnosed with psoriasis or PsA, the biggest risk when it comes to doing your nails is that you may trigger a flare. No matter what part of your body your psoriasis affects, any injury can cause an inflammatory response called the Koebner phenomenon.

What Do You Need To Know About Nail Polish and Nail Polish Remover?

Chemicals in both nail polish and nail polish remover might cause sensitivity or irritation in individuals diagnosed with psoriatic disease. These chemicals include toluene and formaldehyde (found in many nail polishes) and acetone (found in many nail polish removers). These chemicals can cause skin irritation and allergic reactions (allergic contact dermatitis).

Picking at your nails — or even cleaning under them too roughly — can injure the skin and cause an infection or psoriatic disease flare.

However, some types of nail polishes and nail polish removers are designed for people with sensitive skin. These products may be labeled “5-free,” “7-free,” or “10-free.” These terms mean that the products were made without some common chemical irritants or allergens. You may need to try several of these products before you find one that doesn’t irritate your skin.

You can also find nail polish remover without acetone. These products won’t dry out your nails as much, but they might not remove polish as effectively. If that’s the case for you, take extra care to avoid scrubbing your nails too hard and inadvertently damaging them.

Can You Get a Professional Manicure if You Have Psoriatic Disease?

In general, people diagnosed with skin psoriasis and nail psoriasis can still get basic manicures with nail polish and light buffing. Make sure to ask your manicurist to be gentle, and explain what can happen to your skin and nails if the manicurist is too rough or uses abrasive chemicals.

Ask your nail technician to err on the side of caution with anything that might damage your skin. You may, for example, ask that they don’t trim or push your cuticles. You could also ask before your appointment if you can bring your own tools, which may decrease the risk of infection.

You can also purchase nail polish and nail polish remover designed for sensitive skin and bring them along to your nail appointment. Your nail technician will likely understand and be happy to use them, but it may be a good idea to check in advance when scheduling your appointment.

If psoriasis or PsA affect the appearance of your nails, be sure to explain the cause to your nail technician. Most are wary of working on nails affected by fungal infections, such as onychomycosis, which can create an unsanitary environment. Let the manicurist know before your appointment that you have a noncontagious medical condition that affects your nails and that you aren’t dealing with an infection.

Gel Nails and Psoriatic Disease

There are differing opinions on gel nails and psoriasis. One small study says that basic gel nails are a good option for hiding cosmetic nail changes, as long as the person isn’t sensitive to the chemicals involved in the application process and the technician is knowledgeable about the special needs of psoriatic nails.

However, some medical practitioners say that gel nails don’t help the situation. Gel nails may add to the strain your affected nails are under, causing damage or even making existing psoriatic disease worse.

If you want to get gel nails or artificial nails, talk to your healthcare provider or dermatologist about whether these techniques might be right for you. You may also want to try them on just one nail at first to gauge your reaction. Whether your nail symptoms worsen or not may indicate whether it’s safe for you to proceed with a full set of gel or acrylic nails.

Tips for Maintaining Healthy Nails With Psoriasis or Psoriatic Arthritis

Whether you choose to use nail polish, get professional manicures, or leave your nails natural, there are some ways you can care for your nails as someone with psoriatic disease. If you’re struggling with your nails or aren’t sure how to care for them, talk to your dermatology team. They can give you suggestions that are specific to your body and your needs.

Cut Your Nails

Keeping your nails trimmed will make them less likely to snag on something, which helps prevent injuries that may lead to the Koebner phenomenon. Trimming your nails also prevents buildup under the nails, which can occur in cases of psoriasis with nail involvement.

Sterilize Your Nail Tools

If the skin around your nails is inflamed, be sure to disinfect your nail tools before you use them. Inflamed areas have microscopic breaks and are more likely to become infected, which will only make your skin problems worse. To disinfect tools, swipe them with a cotton swab dipped in rubbing alcohol. Sanitize any tools before using them near wounds or raw areas.

Use Moisturizer Regularly

Make sure to keep your hands, cuticles, and nails moisturized. Use a thick, oil-based ointment or a cream designed for people with psoriasis every time you wash your hands, or at least several times a day. Moisturizing helps prevent injury to your hands and keeps your nail beds hydrated, which can improve their appearance.

Don’t Pick at Nails, Nail Beds, Nail Plates, or Cuticles

Picking at your nails, biting them, or even cleaning under them too roughly can injure the skin and cause an infection or psoriatic disease flare. If you must remove a hangnail, soak your hands in warm water, then remove it as gently as possible. If you have debris under your fingernail, warm water might help remove that too.

Wear Gloves

If you’re doing any work where you might irritate your skin, wear gloves. Some people with psoriasis or PsA find that latex gloves alone don’t protect their hands enough. You may need to wear a cotton glove with a nitrile glove over the top, and possibly a latex one over that. Although it might sound like overkill, this protection can play a big role in helping manage your psoriatic disease.

Avoid Buffers and Files

Nail files can do more damage than good — especially if your nails are already damaged due to psoriatic disease. If you want to file your nails, do so gently with a fine-grit nail filer, but overall, it’s best to trim your nails with scissors or clippers, and smooth them with products like glycolic acid.

Ask About Medical Treatments

Ask your dermatologist about prescription nail polishes that can help reduce the appearance of nail psoriasis. Also, talk to your dermatologist about systemic treatments known as biologics that help stop the inflammation leading to psoriatic nail disease.

Join the Conversation

On MyPsoriasisTeam, people share their experiences with psoriasis and psoriatic arthritis, get advice, and find support from others who understand.

How do you care for your nails with psoriasis or psoriatic arthritis? Let others know in the comments below.