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What to Know About Pedicures When You Have Psoriasis

Reviewed by Debra Jaliman, MD on April 22, 2020

If you have psoriasis, you might wonder if it’s safe for you to get a pedicure. This is a treatment for your feet and toenails. When you have one, a nail professional, or technician, may give you a foot bath, massage your feet, trim and polish your nails, and remove calluses and dead skin to make your feet feel and look better.

If psoriasis affects your toenails, a pedicure can make them look better, which can help you feel better about your appearance. But there are several things to keep in mind before you make an appointment. Here’s what you need to know.

Psoriasis and Your Feet

Psoriasis often appears as red or white scaly plaques on the skin. These plaques can appear on your hands and feet. But it can affect your fingernails and toenails, too. Signs of nail psoriasis include:

  • Dents or pits in your nails
  • Nails that crumble or flake
  • Nails that lift or separate from your fingers or toes
  • Thickening or buildup under your nails
  • Nail discoloration that’s white, yellow, or brown
  • Nails that are growing shorter or disappearing from your nail bed

It’s important to tell your dermatologist if you notice these issues or new changes (like larger patches or bleeding lesions) on your skin. Your doctor might recommend new or different treatments to ease your symptoms.

When to Skip a Pedicure

If you have psoriasis, there may be times when you shouldn’t get a pedicure. Some of the reasons to skip one include:

You have a plaque or plaques on your foot or ankle that are bleeding or raw. You soak your feet in water during a pedicure, and a salon professional may use lotions, oil, or other products on your skin. These can be painful for already-irritated plaques and can make a flare-up worse.

You have a fungal infection in one or more of your toenails. Up to one-third of people with psoriasis have fungal infections in their nails. Fungal infections thrive in damp environments, so a pedicure could make an infection worse. Your doctor can help you figure out if thickening or discoloration in your nails is a sign of a fungal infection. If it is, they can also prescribe treatment to clear it.

You have broken cuticles or other open wounds on or near your toes. Getting a pedicure when you have an open wound ups your odds of getting an infection.

The Safe Way to Get a Pedicure

Before you head to the nail salon, ask your doctor if it’s OK for you to get a pedicure. If you do get a green light, there’s a lot you can do to avoid triggering a flare-up or making nail psoriasis worse. Be sure to:

Keep soaks short or skip them altogether. Soaking your feet in water is a common pedicure practice. But keeping your feet in water for long periods of time can actually sap moisture from your skin and nails. And dry skin can make psoriasis worse. To avoid flare-ups, keep your soaks to a few minutes. Or ask your nail technician to skip the footbath and just do a polish change instead.

Keep your toenails short. Longer nails are more likely to lift from your nail bed. Shorter nails are also less likely to develop psoriasis-related buildup.

Ask the nail tech to leave your cuticles alone. Cutting or even pushing cuticles back can lead to injury or infection. That’s a problem for anyone, but when you have psoriasis, it’s extra-important because injury and infection can lead to a flare-up. (This is known as the Koebner phenomenon.)

Continued

It’s also important for a nail tech not to scrape under your nails aggressively, especially if your nail is already lifting from the nail bed. That can make the separation worse.

Choose your polish carefully. Gentle buffing or polishing of your nails can hide pitting and other symptoms of nail psoriasis. But make sure you remove the polish every month or so. That lets you check your nails for changes (like thickening or more pitting) that could be a sign that you need to change your treatment plan. If you currently have a nail infection, skip the polish altogether until your infection heals.

Apply your own moisturizer afterward. Psoriasis dries your skin and nails, but the moisturizers may have ingredients that irritate your plaques. Consider skipping it and applying a thick moisturizer or ointment that’s effective and non-irritating when you get home.

When in doubt, see someone who works with people with psoriasis. If your psoriasis is moderate to severe, it’s worth your time to look for a nail technician who has experience working with it.

If you do see someone who doesn’t have experience with psoriasis, you may feel more comfortable if you begin your pedicure by explaining that you have it. Try saying something like, “I have a condition called psoriasis, and the pitting and plaques you see are symptoms of that condition. It isn’t contagious. I’d appreciate it if you didn’t massage or use lotion on the plaques.” A quick explanation could help you feel less anxious or embarrassed -- and get a better pedicure.

WebMD Medical Reference

Sources

SOURCES:

Merriam-Webster Dictionary: “Pedicure.”

Arthritis Foundation: “10 Hand- and Foot-Care Tips for Psoriatic Arthritis.”

American Academy of Dermatology Association: “7 Nail Care Tips that Can Reduce Psoriasis,” “What Is Nail Psoriasis and How Can I Treat It?”

National Psoriasis Foundation: “Managing Nail Psoriasis,” “About Psoriasis.”

JAMA Dermatology: “Treatment of nail psoriasis: best practice recommendations from the Medical Board of the National Psoriasis Foundation.”

Piedmont Healthcare: “Are Professional Pedicures Really Safe?”

Charles E. Crutchfield, III, MD, medical director, Crutchfield Dermatology, Eagan, MN; clinical professor, University of Minnesota Medical School.

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