Multiple hands against a blue background presenting varying levels of nail symptoms and psoriasis

PsA: Pitting of The Nails

Last updated: September 2022

Pitting your nails is often seen as one of the earliest signs of psoriatic arthritis. Let us start at the beginning, though, because many people do not know what pitting is.

Pitting of the nails is when your fingernails show parts that are dropping away. Little depressions that leave little pits, also known as little holes, on the surface of your nails. This can also happen on your toenails and become a somewhat troublesome issue.

Understanding the impact of pitted nails.

This might seem superficial to many people, and maybe to some extent, it is. Importantly though, it is about what matters for each person. This is so much more than just aesthetic to us. Pitted nails can cause a lot of pain and lead to infection. Making something as simple as typing a text to a loved one unbearable.

Chances are that is not the only health issue an individual with PsA deals with. Please keep this in mind when interacting with someone who has pitted nails. Telling them things like "it's just nails. Try not to worry about it" is less helpful.

Nails, nails, nails

There are many ways to improve the aesthetic and look of our nails, and even a few can cause further damage or harm to the nail bed, which would make the pitting worse.

Hard nail polishes and filing too hard can easily cause the nail to wear. This could lead to an infection leading to increased pain and a potential psoriasis flare. I find that I can get away with regular nail polish - not gel, not acrylic. Notably, the chemicals used to take it off it not as harsh.

Keeping that in mind, I do try and keep my nails nude most of the time. Nail polish is saved for special events.

Tips for nail care with psoriatic arthritis.

Keep your nails short. Clip them regularly and file the edges down. Longer nails tend to get hooked and lift off the nail bed. This, other than being otherworldly painful, can cause further complications. If you are working with your hands and your nails are badly pitted, please try and remember to use gloves.

Try your best not to over-clean under your nails. While you want to keep them clean, excessive cleaning could cause damage to the skin on the nail bed. I speak from experience when I say this will probably make your nail lift off your nail further from your nail bed and, again, open to infection.

Other signs to look out for

In closing, please remember that pitting is not the only nail symptom those with PsA experience. Other signs include discoloration, ridges, and brittle or crumbling nails can all be signs that there is something afoot. Make the time and get to your doctor and have them check it out.

Do you have any great tips for managing pitted nails or nail damage due to psoriatic arthritis in general? Getting infections is relatively common and can cause immense discomfort. I would love to hear your tips, tricks, and remedies.

This or That

When it comes to hobbies with PsA, I've had to:

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