Lauren Cawley had a good life. She was planning her wedding and had recently started a job she loved doing nails. When her stomach started bothering her and she experienced unexpected and significant weight loss, she was concerned — but too busy to be terribly troubled. She hit her threshold when she found blood in her stool. “The doctors had no idea what it was,” says Cawley. “It took six months of testing to rule out female issues.”

With no diagnosis or treatment, her symptoms worsened. Her skin had outbreaks of eczema and psoriasis. At one point, Cawley’s reaction was so intense, her nails separated from the nail beds and fell off. Clients didn’t realize the extent of her condition because she wore gloves and long sleeves at work, both to conceal the condition and to protect herself from coming into contact with the products she used.

Finally, doctors diagnosed her condition as colitis, an autoimmune disease that results in an inflamed colon. “When I went on medication to treat the colitis, my skin condition went away,” explains Cawley, who has been a nail tech for 25 years and is now the owner of Volpe Nails in Johnson City, N.Y.


Nail tech Lauren Cawley finds her skin reacts negatively to nail products when her colitis is flaring up.

Nail tech Lauren Cawley finds her skin reacts negatively to nail products when her colitis is flaring up.

A Confusing Condition

Autoimmune diseases are baffling, painful, debilitating, and much more common than you might think — especially among women, who are affected disproportionately. A report titled “Autoimmune Diseases Research Plan” published by the National Institute of Health says more than 80 “clinically distinct” autoimmune diseases have been identified, affecting 5%-8% of the U.S. population. That’s nearly 20 million people.

“We don’t know what causes autoimmune diseases,” says Dr. Dana Lefkowitz, a family practice physician in St. Petersburg, Fla. “What we do know is that our body stops functioning correctly and the immune system starts to attack itself.” Once the immune system is activated, it’s hypersensitive to other stimuli it normally would be able to ward off, such as allergens in the air, toxins in the food we eat, and stress.

“Think about our jobs for a minute,” says Cawley. “All day long, we watch the clock and work under pressure to keep pace. We go hours without leaving the desk. When we eat, it’s often something fast and unhealthy. All day, we’re breathing in vapors and absorbing allergens through our skin.” This lifestyle can stress the body even without the addition of an autoimmune disease. But for those struggling to manage a systemic condition, the salon environment could cause their weakened body to have exaggerated reactions. “Once that switch is turned on and the immune system is activated, it will keep fighting and attacking itself — and the result is increased signs and symptoms,” says Dr. Lefkowitz.

Cawley agrees. “If I happen to have a flare-up of colitis, I find I have a reaction to the nail products,” she explains. “When I’m in remission, the allergens in the salon don’t bother me.”

Fibromyalgia-sufferer Robin Stopper invented the Wrist-Assist to raise and stabilize clients’ hands in order to ease the pain of repetitive strain injuries.

Fibromyalgia-sufferer Robin Stopper invented the Wrist-Assist to raise and stabilize clients’ hands in order to ease the pain of repetitive strain injuries.

Nail tech Robin Stopper can identify with Cawley’s struggle and her long road to a diagnosis. After 13 years of doing nails, Stopper noticed it was harder and more painful to correct clients’ hands when they invariably tried to “help” her. “It was extremely difficult to lean forward with my arms raised when I tried to guide my clients hands,” says Stopper.

Stopper’s primary care doctor referred her to a rheumatologist, who said it was fibromyalgia, another autoimmune disease. Her doctor also described the condition as a wastebasket syndrome. “In other words, doctors use that term to describe symptoms where no other diagnosis can be found,” says Stopper. “At that point, so little was known about fibromyalgia that many doctors didn’t even believe it was real.” Finally, a client who was an occupational therapist directed her to an advanced education course where Stopper learned there were ways she could reduce her pain. Eighteen years after her diagnosis, she continues to do nails as the owner of Perfectly Polished in Mount Dora, Fla.

In 2009, Ruth Windsor was fired from her job as a nail tech for missing work too often. “I didn’t know what was happening to me. There was a time in my career when I was told I had to take time off because I was working too much!” Windsor recalls. But then came the headaches, migraines, and the pain in her neck, back, and hips. “Everything hurt: My scalp hurt, my clothes were uncomfortable, even a hug from my husband could cause pain,” she says. Windsor was finally diagnosed with lupus and fibromyalgia. Through medication and lifestyle changes, Windsor was able to get back into doing nails, working as an independent contractor at Angelic Beauty Works in Dearborn Heights, Mich. Unfortunately, in 2013, the pace of work and the stress on her body caused her flare-ups to become more frequent, making it difficult to keep a consistent schedule for clients. She eventually left the salon in an effort to manage the pain.


Take Over Your Treatment

Though no cause or cure exists for autoimmune diseases, all is not hopeless. In fact, many people have learned to successfully manage and avoid flare-ups once the condition is detected. The first step of any treatment is to consult your doctor — whether your primary physician or a specialist — to determine an accurate diagnosis and, if necessary, to receive a prescription to control symptoms, including pain or inflammation.

A diagnosis of lupus and fibromyalgia eventually caused veteran nail tech Ruth Windsor to leave the industry.

A diagnosis of lupus and fibromyalgia eventually caused veteran nail tech Ruth Windsor to leave the industry.

Your next steps are up to you. “Most people aren’t going to quit their jobs, even if their autoimmune disease makes working painful,” says Dr. Lefkowitz. “So they can participate in keeping their condition under control through diet and lifestyle.”

Dr. Lefkowitz says many of the problems our body is forced to fight can be avoided. Take one condition called leaky gut. “Basically, it means our gut is broken down and ‘leaky’ due to inflammation from the foods we consume,” says Lefkowitz. “It most often happens because we eat things we shouldn’t — for example, an excessive amount of gluten or dairy, which are inflammatory foods, or processed foods, that cause the cells that line our gut to be inflamed. When the gut is inflamed, it causes leaks, allowing foreign things to be absorbed into our system that shouldn’t be there. This triggers the immune system to start fighting. When we change our diet to reduce the number of inflammatory foods we consume, the body is able to repair itself and function properly.”

“My doctors focused for years on trying to relieve my pain through medication,” says Windsor. “We also tried physical therapy, but that only increased the muscle pain. Finally, removing gluten from my diet reduced my migraines and pain.” Dr. Lefkowitz has seen how much diet can affect outcome. “I have a patient who keeps her rheumatoid arthritis under control by avoiding all dairy and gluten, and by eating organic non-processed foods so she is not exposed to the toxins or unwanted pesticides,” she says. “Not everyone is that fortunate to avoid medication, but dietary changes may be able to minimize the amount you need.”

Even techs without an autoimmune disease are likely to feel the aches and pains of sitting all day, bent over a desk and straining their eyes for precision. Our bodies aren’t designed to perform that way without offsetting the demand with exercise, ergonomics, and rest. “I notice a huge difference in my flare-ups when I’m diligent about taking care of my body,” says Cawley. She advises techs who suffer from any autoimmune disease to drink plenty of water, avoid unhealthy food, get adequate rest, step away from the desk to take quick breaks, and commit to regular exercise. “You have to be mindful of your body,” she says. “You want to do all you can to strengthen your immune system because when you are sick or tired, your immune system is positioned to overreact.”

Dr. Lefkowitz agrees. “Your body functions within a threshold,” she explains. “If you’re below that threshold, you won’t have a reaction. When you hit it, your immune system is triggered. Your best line of defense is to reduce everything that could cause inflammation — which can come from foods you eat, or from anxiety, worry, and stress — so you can stay well below the threshold.”

Exercise plays an important role in reducing physical and emotional stress. Choose an exercise routine that is more than a leisurely walk; it should incorporate stretching, strength and core work, and cardio to help keep the body functioning well.

Finally, small changes within the salon can help techs manage their symptoms. When Stopper realized how debilitating it was for her to wrestle with her clients’ hands, she developed the Wrist-Assist. Her small, mobile device raises clients’ hands and stabilizes them. “I don’t have to lean forward anymore,” she explains. “You can’t imagine how much it’s relieved the strain on my back, neck, arms, and hands.” It worked so well, Stopper patented her idea and made Wrist-Assist available for purchase ( “Many nail professionals have contacted me to say it’s relieved the pain of repetitive strain injuries,” says Stopper.


If It’s to Be, It’s Up to Me

Autoimmune diseases can wreak serious havoc in the lives of techs. In a service job, it’s essential to keep your body performing at its peak. Pain can reduce a tech’s ability to provide customer care, deliver exceptional workmanship, and perform efficiently when you multitask. It’s natural to look to a doctor as your lifeline to keep you in top shape. If you’re lucky, you’ll find an advocate in your physician so he or she will work with you to get the best results. But that’s not always the case.

“Don’t just take what your doctor says as the one-and-only treatment,” advises Windsor. “We know our body better than anyone else. Research. Seek out groups where you can speak with others who have your condition to learn what works for them. We are all unique. Find what works best for you.”

“If diet, exercise, and lifestyle aren’t components of your autoimmune treatment plan, I would suggest you consult with a doctor who specializes in functional medical in addition to your primary care doctor or autoimmune specialist,” says Dr. Lefkowitz. Functional medicine treats the whole person, rather than just the symptoms, and takes into account genetic, environmental, and lifestyle factors.

Don’t ignore the signs. Often the symptoms of an autoimmune disease are easy to dismiss: You’re tired; your stomach hurts; you have a headache. When these seemingly benign symptoms persist, call your doctor to determine if it’s a larger problem. The sooner your condition is diagnosed, the sooner you can begin to find ways to take control of your health.


Most Common Autoimmune Diseases

According to the National Institute of Health, the most common autoimmune diseases include:

> Lupus (SLE): can affect joints, skin, kidneys, lungs, heart, or brain

> Multiple sclerosis (MS): causes severe weakness, fatigue, lack of coordination, speech disturbances, and more

> Type 1 diabetes: affects the pancreas, preventing it from making sufficient insulin

> Graves’ disease and Hashimoto’s thyroiditis: inflammation of the thyroid that could lead to hypothyroidism

> Myasthenia gravis: inflammation that causes weakness of the skeletal muscles

> Rheumatoid arthritis: inflammation of the tissue surrounding the joints, causing serious inflammation and pain

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