Rheumatoid arthritis (RA) is an autoimmune disease that can affect any of the following:

  • joints
  • organs
  • energy level

When you have RA, your immune system becomes overactive and assaults healthy body parts, causing inflammation and exhaustion. Changes in your nails, such as the formation of vertical ridges or a yellowing and thickening, may occur as a result of RA.

The majority of RA-related nail alterations don’t need to be treated separately from the disease. RA can be controlled with medication, and treatment may help to improve nail changes. If untreated, RA can permanently destroy your joints and the bones that surround them.

Nail changes


Changes in your nails could be a sign of RA or another illness.

Nail alterations caused by RA are usually painless and don’t necessitate specific treatment. Longitudinal ridging was found to be strongly related with RA in a 1997 studyTrusted Source, and persons with RA could also experience additional nail abnormalities, but these were not as consistent.


Rigging along a long axis

Longitudinal ridging, also known as onychorrhexis, occurs when your nails have parallel lines running from the bottom to the top. These lines make shallow or deep grooves in the nail.

You can seek treatment for the ridging in addition to RA management to protect your nails, while nail ridging is not addressed with a topical. You can take care of your nails at home by using moisturizers, avoiding harsh chemicals, and maintaining nail cleanliness by keeping your nails clipped and clean.


Yellow nail syndrome

When your nails become thicker and yellow in color, you have yellow nail syndrome. It’s possible that the white half-moon shapes at the bottom of your nail will vanish. It’s possible that the sides of the nail will begin to curl.

If you have RA, you may develop this disorder. According to the National Organization for Rare Disorders, research suggests it could be caused by some RA medicines, but further research is needed. Inquire with your doctor or a dermatologist about treatment options that are appropriate for your circumstance.


Splinter hemorrhages


Splinter hemorrhages can be identified by red streaks or lines under your nails. These lines are caused by capillaries seeping under the nail. These can be caused by RA, but they can also be caused by nail damage, nail fungus, and other disorders like endocarditis.

Splinter hemorrhages may fade over time or grow out with the growth of your nail. Recurrent splinter hemorrhages may be treated with RA medication.



When your nail lifts from the finger bed and leaves a white mark beneath it, you have this ailment. Onycholysis is most commonly associated with psoriatic arthritis, however it can also occur with RA.




If your lungs are impacted by RA, it’s possible that your nails will get clubbed. When your nails begin to curl downward as they grow, this is known as clubbing. Your fingers will enlarge as a result of this. It’s possible that your nails will feel like a sponge.




Your nail beds, not your nails, are affected by this disorder. When blood vessels dilate and become visible at the skin’s surface, this occurs. Spider veins are another name for it. It’s also linked to autoimmune diseases like lupus and scleroderma.


Spider veins can be treated with laser therapy or surgery, but if you have spider veins at the bottom of your nails, you should also seek treatment for the underlying issue.


Psoriatic arthritis vs. RA


Unlike some nail changes induced by psoriatic arthritis, RA nail changes do not have a negative impact on your quality of life. Psoriatic arthritis is an autoimmune disease that affects the skin and joints, as well as the nails. According to one study, up to 80% of persons suffering with psoriatic arthritis acquire these lesions.

Psoriatic arthritis can also create longitudinal ridges, splinter hemorrhages, and pitting in the nails.


Other signs and symptoms


Although changes in the nails may be a sign of RA, there are also more serious RA symptoms that can have an influence on your overall health, such as:

  • swollen, tender, red, and stiff joints on one or both sides of your body
  • fatigue
  • weakness
  • slight fever
  • weight loss
  • shortness of breath

When you have untreated RA or when you have a flare, your symptoms may get worse.




Your doctor will prescribe a treatment plan to help you manage your RA, which may include addressing the nail abnormalities if they are caused by immune system overactivity. If you see changes in your nails that aren’t responding to your RA drugs, speak with your doctor about alternate therapy choices.

Treatments for RA differ from person to person. The following are some of the drugs used to treat RA:

  • disease-modifying anti-rheumatic drugs (DMARDs)
  • biologics

Along with the medicines indicated by your doctor, lifestyle changes such as exercise, rest, and dietary changes may help minimize flares and RA symptoms.

When should you seek medical help?

RA is a long-term illness that necessitates medical attention. Changes in your nails, as well as other symptoms, could indicate the presence of the disease. Discuss your symptoms with your doctor, especially any that impact your nails.


In conclusion


Changes in your nails may indicate RA or another condition. You should consult a doctor about them, as well as any other symptoms you are experiencing.

RA is a chronic condition that necessitates medical treatment to alleviate symptoms and improve quality of life.