Rheumatoid arthritis (RA) is a form of inflammatory arthritis that affects the joints. It can also cause some changes in nail appearance, including ridging, discoloration, and more.

RA is an autoimmune condition that involves systemic inflammation. This means the immune system mistakes healthy tissue for a foreign invader and attacks it.

RA is not well known for causing nail changes, but a person living with RA may notice some changes to their nails. Treatment for the changes typically involves continuing treatment for RA.

Read on to learn more about how RA can affect the nails and what treatments may help.

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Yellow nail syndrome is a rare condition where the nails appear to have a yellow tint, grow slowly, and become hard. Although little evidence links RA to yellow nail syndrome, RA may be an underlying cause in some cases.

A person with yellow nail syndrome may also experience upper respiratory infections and swelling in the lymphatic system. A person may need additional treatment for these signs of yellow nail syndrome.

Learn more about yellow nail syndrome.

Longitudinal ridging, also known as onychorrhexis, is a potential symptom of RA. However, its importance to RA is still unknown.

Longitudinal ridging refers to the appearance of lines or ridges that run parallel to the fingers. These ridges can be faint or more obvious.

Treatment for longitudinal ridging typically involves treating the underlying cause. This means that treating RA may help a person to manage nail ridging.

Learn more about fingernail ridging.

An older study from 2004 notes that splinter hemorrhages can occur alongside RA.

Splinter hemorrhages are reddish or brownish lines that appear under the nails. They appear due to the presence of inflamed blood vessels.

Treatment for splinter hemorrhages focuses on addressing the underlying cause.

Learn more about splinter hemorrhages.

The 2004 study from above noted that RA may cause telangiectasia, or spider veins.

Telangiectasia does not affect the nails directly. Instead, it occurs when blood vessels dilate and become visible under the skin. People often refer to them as spider veins.

Spider angiomas can appear similar to spider veins. They can also occur due to RA and cause a central red spot with spiderweb-like lines around it.

Depending on the type of changes, a person may not require treatments that specifically target nail symptoms. In some cases, treating RA directly may help manage nail changes.

For yellow nail syndrome, a doctor may prescribe vitamin E or medications to address swelling or lung complications.

If nail changes worsen or do not improve with a person’s current RA treatment, a doctor may recommend adjusting medications or trying other therapies. These might include disease-modifying antirheumatic drugs (DMARDs) and biologics to target the immune system’s response.

Learn more about RA treatments.

The following sections provide answers to frequently asked questions about nail changes in RA.

What do rheumatoid arthritis fingernails look like?

RA may cause nail ridging or yellowing of the nails. It may also cause the appearance of blood vessels or spider veins under the nails in the beds. Treating RA directly may help reduce these nail changes.

Why do rheumatologists look at the nails?

During diagnosis, a rheumatologist may examine a person’s nails as part of the diagnostic process. This may help them rule out certain conditions that present similarly to RA but have some distinct features.

For example, psoriatic arthritis and RA both affect the joints and involve inflammation throughout the body. However, psoriatic arthritis often causes changes in the nails that can include pitting, discoloration, and detachment from the nail bed. These are not typically present in RA.

Rheumatologists treat both conditions, so they may check the nails to help rule out psoriatic arthritis.

Can rheumatoid arthritis cause nail clubbing?

RA may indirectly cause nail clubbing. It can happen when a person develops interstitial lung disease, a lung manifestation that can occur in people with RA.

RA may affect a person’s nails, causing changes in color and appearance. Possible nail changes include yellow nail syndrome, longitudinal ridging, splinter hemorrhages, spider veins, and spider angiomas.

A person may only need to continue treatment for RA in order to manage nail changes. It is best for a person to contact a doctor to discuss their current treatment plan if they have concerns about nail symptoms associated with RA.