Osteoarthritis and Nail Changes: What You Need to Know

Changes in how your nails look and feel can be confusing and worrying. Sometimes, these changes are caused by arthritis, and other times, there may not be a clear reason. Noticing these changes early can help with treatment.

Types of Nail Changes from Arthritis

• Longitudinal Ridges: These are raised lines that run along the length of the nail. They are common as people get older and are often seen in those with osteoarthritis. They can also be caused by poor blood flow or not getting enough nutrients. Keeping your nails moisturized and avoiding injury can help.

• Yellow Nail Syndrome: Nails turn yellow, grow slowly, and may get thicker and curved. The exact cause isn’t known, but it can be linked to arthritis, breathing problems, or swelling in the body. Treating the health problem causing the yellow nails can help.

• Splinter Hemorrhages: These look like tiny, reddish-brown lines under the nails, running from the base to the tip. They happen when small blood vessels under the nail are damaged, sometimes because of inflammation or injury from arthritis. They usually go away on their own, but you should see a doctor if you notice them.

• Onycholysis: This is when the nail separates from the nail bed, creating a gap. The area may look white or yellow. It can be caused by injury, fungal infections, or diseases like psoriatic arthritis. Treatment depends on the cause.

• Clubbing: The base of the nail becomes wider and rounder, and the nail curves downward. Clubbing can be caused by arthritis, lung disease, heart problems, or stomach issues. Treating the main health problem can help.

• Telangiectasia: Small red or purple lines or dots appear under the nail. This happens when blood vessels change because of arthritis. Treating arthritis can help improve this symptom.

• Koilonychia (Spoon Nails): Nails become thin and scoop out like a spoon. This is often linked to not having enough iron, which can happen in people with long-term inflammation like arthritis. Iron supplements and treating arthritis can help.

• Terry’s Nails: Most of the nail looks white with a narrow, reddish-brown or pink band at the tip. This can be linked to arthritis, liver disease, or kidney failure. Treating the main health problem is important.

• Beau’s Lines: These are horizontal grooves or lines across the nail. They happen when nail growth is interrupted by illness, stress, or injury, which can be made worse by arthritis. Treating the cause helps.

• Nail Plate Thickening: Nails become thicker and harder, making them tough to trim. This can be caused by long-term inflammation from arthritis. Managing arthritis and taking care of your nails can help.

Causes

• Inflammation: Arthritis causes inflammation, which can affect the blood vessels and tissues around the nails, leading to changes like pits, ridges, and discoloration.

• Altered Blood Flow: Changes in blood flow can make nails brittle and slow their growth.

• Mechanical Stress: Changes in the joints can put pressure on the nails, causing them to separate or become thick.

• Medication Side Effects: Some arthritis medicines can make nails thin or fragile.

• Systemic Factors: Poor nutrition and aging can affect nail health.

• Secondary Infections: Damaged nails are more likely to get fungal or bacterial infections.

Symptoms

• Nails changing color (yellow, brown, or with red lines)

• Nails getting thicker or changing texture

• Nails separating from the nail bed

• Visible blood vessels under the nails

• Small dents or ridges in the nails

1. Medications

• Topical Treatments: Creams like corticosteroids can reduce swelling and redness. Antifungal creams help if there is a fungal infection.
• Oral Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, can reduce pain and swelling. Oral antifungal medicines are used for serious nail infections.

2. Nail Care

• Regular Maintenance: Keep nails short and smooth rough edges to prevent damage. Keep nails clean and dry.

• Moisturization: Use creams and cuticle oil to keep nails and skin soft.

3. Protective Measures

• Gloves: Wear gloves during activities that might hurt your nails or in cold weather.

• Avoid Trauma: Be gentle with your nails and don’t bite or pick at them.

4. Nutritional Support

• Balanced Diet: Eat foods rich in vitamins and minerals like biotin, vitamin E, and zinc. Take supplements if needed, but only with a doctor’s advice.

5. Professional Treatments

• Nail Procedures: Doctors may thin and reshape thick nails or use laser therapy for fungal infections.

• Injection Therapies: Steroid injections can help with severe nail inflammation.

6. Addressing Underlying Arthritis

• Disease-Modifying Medications: Medicines like DMARDs can help control inflammation in rheumatoid arthritis.

• Lifestyle Changes: Exercise regularly and keep a healthy weight to help manage arthritis.

7. Monitoring and Follow-Up

• Regular Check-Ups: See your doctor regularly to check on your arthritis and nail changes.

• Specialist Referral: You may need to see a skin or foot specialist for serious nail problems.

Nail changes from osteoarthritis are less common than joint symptoms, but they can give important clues about your health. Understanding these changes can help you manage your arthritis better. If you notice big changes in your nails, talk to your doctor for a full check-up and treatment plan.