Lupus can cause a variety of symptoms. Some individuals may experience changes in their fingernails and toenails, including discoloration, infections, and changes to the nail shape.

Lupus refers to a long-term autoimmune condition. It occurs when the immune system mistakenly attacks healthy tissue, which can result in several possible symptoms.

Potential symptoms of lupus can include changes to skin and nails. Some of these changes may occur as a direct result of lupus, a side effect of certain medications, or a consequence of certain symptoms of lupus.

This article discusses how lupus can affect a person’s nails and provides tips to help manage nail health.

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Potential changes that may occur to nails due to lupus can include:

  • Nail infections: Certain medications for lupus, such as immunosuppressants, may affect a person’s resistance to nail infections. These infections may not initially cause symptoms but can result in the nails crumbling or splitting, along with discoloration.
  • Discoloration: Certain medications or complications of lupus can lead to color changes in the nails. For example, discoloration can be a sign of kidney issues that may occur due to lupus.
  • Loose nails: Certain comorbid conditions, such as Raynaud’s phenomenon, can cause poor circulation to the nails, resulting in loose nails that fall off.
  • Spoon-shaped nails: Also known as koilonychia, this symptom can occur due to autoimmune conditions such as lupus.
  • Thickened nails: These can occur due to infections, such as fungal infections, or comorbid conditions, such as psoriasis.
  • Brittle nails: It is not uncommon for a person with lupus to develop a skin condition known as lichen planus. This can result in brittle nails that may split.
  • White nails: A loose nail, fungal infections, or a reduction in blood supply can cause the nail to have a white appearance.
  • Red or brown stripes: Lupus may cause red or brown stripes to appear below the nail bed. Also known as splinter hemorrhages, these stripes occur due to damage to the blood vessels.
  • Grooves across the nails: Grooves across the nails, known as Beau’s lines, can occur due to lupus or Raynaud’s phenomenon.

Additionally, there are different types of lupus, which may manifest differently in the nails. For example, in a 2019 case study, a person with a rare type of lupus, known as chilblain lupus erythematosus, experienced full nail bed destruction due to issues with blood vessels.

Learn more about how other conditions may affect the appearance of nails.

A person can take some measures to help protect their nails. One of the first things someone can do is follow treatment recommendations from healthcare professionals to help prevent lupus flares.

To address symptoms specific to the nails, a person can also try one or more of the following:

  • wearing comfortable, well-fitting shoes
  • eating a healthy diet
  • applying moisturizer to the nails and around them
  • using an emery board or file to keep nails shaped and shortened
  • avoiding biting their nails
  • not using false nails
  • using gloves when working with chemicals or washing items, such as dishes
  • applying nail hardener
  • wearing gloves and taking other steps to protect against cold temperatures
  • using as little nail polish as possible and not using acetone to remove it

Additionally, a person can also help prevent fungal nail infections by:

  • keeping their nails short, dry, and clean
  • avoiding walking barefoot in wet, public areas
  • applying antifungal creams to the nails and foot
  • keeping feet clean and dry
  • cleaning socks and other laundry in hot water

A person may want to contact a specialist for specific nail care tips and treatments.

A podiatrist can help with treating fungal nail infections on the toenails. They may also be able to help with ingrown toenails.

For fingernails, a person may find that a dermatologist can provide specific treatments for their fingernails and skin in general. People with lupus that affects the skin may find that a dermatologist is a helpful member of their treatment team.

When living with lupus, a person may want to consider the following when caring for their nails:

  • keeping nails short, clean, and dry
  • avoiding the use of acetone nail polish remover
  • using only limited amounts of nail polish
  • avoiding the use of false nails
  • using only emery boards and files to shape and shorten the nails

When attending a manicure or pedicure, a person with lupus may want to be careful about who they select. The technician should be gentle on the nails, avoid using acetone, only use a limited amount of polish, and avoid UV nail drying lamps.

Lupus can negatively affect the nails in several ways. A person may experience physical changes, such as lifting or crumbling. They may also notice discoloration of the nails or recurring nail infections.

A person can take several measures to help care for their nails. This can help prevent complications due to lupus itself as well as help to prevent other issues, including fungal infections. This may involve lifestyle changes, such as wearing comfortable shoes, avoiding biting the nails, and wearing gloves when in cold weather or handling chemicals.