10 Hand- and Foot-Care Tips for Psoriatic Arthritis

Having psoriatic arthritis can be a challenge for your hands and feet: swollen fingers and toes, nail changes as well as foot and heel pain. Along with medications to treat your underlying disease, try these strategies to help your hands and feet feel – and look – their best.

Apply cold packs to your aching, swollen feet and hands. A bag of frozen vegetables or ice cubes in a zip-top bag can do the trick. The golden rule is 10 minutes on, 10 minutes off. Use a protective barrier, such as a towel, between the cold pack and your skin to prevent irritation.

For plantar fasciitis -- inflammation of the long, thin ligament that runs from the front of the foot to the heel and supports the arch of the foot – roll the bottom of your foot back and forth across a water bottle. Works best if the bottle is icy cold or frozen.

As many as one-third of people with psoriasis have nail fungal infections. Your doctor may order a biopsy of nail tissue to identify the type of infection. Treatment options include oral antifungals such as terbinafine (Lamisil) and itraconazol (Sporanox). Topical treatments for nail infections include ciclopirox (Penlac) and urea paste or cream.

Injury to the tissue around the nails can cause your skin disease to flare. Keep your fingernails short to help prevent scratching. Short toenails are less likely to hang on socks and irritate the nail bed. But don’t clip them so short that they bleed.

Don’t pull at or push back your cuticles (or allow it to happen at the salon). Manipulation of the cuticles can cause tiny tears in the tissue and make nail psoriasis worse. Injuring the skin around your nails could also increase your risk of infection when you are taking an immune-suppressing drug.

While sitting and soaking your hands can feel very good, keeping them in water too long can pull moisture from the skin and worsen psoriasis. When having a manicure or pedicure, limit soaking to a few minutes or consider skipping it. Moisturize well afterwards.

Nail polishes are usually safe for nails but doctors don’t recommend acrylic nails because removing them can injure the vulnerable nail plate. Colored polishes make it difficult to see changes beneath the nails that could give clues to disease activity. If you have signs of a nail infection, such as redness and swelling, skip the polish until the infection heals.

Nail changes are treated with the same oral medications used to control psoriasis, but your doctor may recommend UV light therapy, corticosteroid creams and corticosteroid injections beneath the nail.

Choosing the right shoes can help ease foot pain. Open-toed shoes or shoes with a large toe box help avoid crowding and pressure on swollen toes. High heels can push feet forward and cramp the toes. Add a cushioned shoe insert or silicone heel pad for extra support.

Fungi thrive in dark, damp places, so choose shoes made of natural, breathable materials, such as leather or canvas, and socks made of synthetic materials that wick away moisture. If you regularly wear athletic shoes, have at least two pairs and alternate between them to avoid putting on shoes still damp with sweat from the day before.