Nail & Skin Disorders

The Nail Doctor

Dr. Phoebe Rich answers your questions on lupus and acetone-free removers.

I have a new client with lupus. Her natural nails are dry and splitting. Can she wear acrylics?

Dr. Phoebe Rich: Her brittle nails may not be due to her lupus. The most common nail manifestation of lupus is nail fold telangiectasias, which are dilated blood vessels around the cuticle. Brittle nails are most often caused by dehydration and it is important that your client wear gloves for wet work chores and moisturize her nails. Brittle nails can be seen in some people with anemia, which is common with lupus, so that could be a connection. Raynaud’s Syndromecan also trigger brittle nails and that could also be contributory. There is no reason that your client cannot have normal nail services including acrylic nails. The products may cause the dehydration to worsen immediately after acrylic nails are removed, but other than that, there should be no problems.

Are acetone-free polish removers more gentle on the nails than acetone-based ones?

Dr. Phoebe Rich: There’s probably not much difference. The non-acetone nail polish removers contain acetate, which is just about as damaging as acetone. It loosens the attachment of the nail cells to each other so there can be more brittleness, peeling, and chipping. It is not clear whether the various substances (aloe, lanolin, protein, etc.) added to nail polish remover do any good.

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