Caleb Foster
Chemotherapy can cause changes to your fingernails and toenails, including discolouration, changes in texture, and increased brittleness. While nail changes are usually temporary, they can last long after treatment ends or even become permanent. Certain types of chemotherapy are more likely to affect your nails, including chemotherapy drugs that contain taxanes. During chemotherapy, it's important to take extra care of your nails to prevent infection and reduce discomfort.
| Characteristics | Values |
|---|---|
| Effect on Nails | Chemotherapy can affect the texture and appearance of nails |
| Nail Colour | Nails may turn dark, yellow, or display over-pigmentation |
| People with darker complexions may notice the colour changes more | |
| Nails may also appear bruised | |
| Nail Strength | Nails may weaken, thin, or reduce in strength, leading to breakage |
| Nail Growth | Nail growth may be disrupted, leading to horizontal ridges (Beau's lines) |
| Nails may grow into the skin | |
| Nail Shape | Koilonychia, or "spoon nails," are nails that rise at the ends, appearing "scooped out" |
| Nails may start to lift off the nail bed | |
| Nail Bed | Nail beds may become painful and sensitive |
| The skin around the nail bed may become dry or cracked | |
| Nail Care | Keep nails short, clean, and moisturised to reduce the risk of infection |
| Avoid biting or picking at nails and cuticles | |
| Use cuticle cream to prevent dryness, splitting, and hangnails | |
| Avoid artificial nails and professional manicures |
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What You'll Learn
Chemotherapy can cause nail discolouration, including black nails
Chemotherapy can have several effects on the fingernails, toenails, and nail beds. While nail changes are usually temporary and return to normal within a few months of stopping treatment, it is still important to inform your healthcare provider as soon as you notice any changes.
To prevent and treat nail discolouration and other side effects of chemotherapy, it is recommended to keep your nails clean and short, wear protective gloves when cleaning or gardening, and avoid biting or picking at your cuticles or nails. You can also massage cuticle cream into your cuticles and nails to prevent dryness, splitting, and hangnails. If you notice any signs of infection, see a physician right away.
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Nail thinning and reduced strength, leading to breakage
Chemotherapy can have several effects on the fingernails, toenails, and nail beds. One of the most common changes is nail thinning and reduced strength, which can lead to breakage. This can be caused by certain chemotherapy drugs, such as those containing taxanes, including Docefrez, Taxol, Onxal, Oraxol, and Taxotere.
Nail thinning and reduced strength can make nails more prone to breakage and splitting. This can be managed by keeping nails clean, short, and well-moisturized. It is recommended to use fragrance-free creams or ointments, especially thick ones, to keep the hands and feet moisturized. Cotton gloves can be worn after applying moisturizers or when doing physical activities to protect the nails.
To prevent further nail damage, it is important to avoid biting or picking at the nails and cuticles. Protective gloves should be worn when doing activities that could damage the hands or nails, such as cleaning or gardening. It is also advised to limit the amount of time the hands are submerged in water and to avoid professional manicures or artificial nails, as these can trap bacteria and cause infections.
In some cases, a doctor may recommend using a hydrating nail solution or a water-soluble nail lacquer to prevent nail breakage and splitting. For those receiving taxane treatments, cold packs can be applied to the nails before, during, and after the infusion to prevent nail lifting. Additionally, biotin supplements may be prescribed to strengthen the nails.
While most nail changes due to chemotherapy are temporary and improve after treatment ends, it is important to monitor any changes and consult a healthcare provider for guidance on managing these side effects.
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Dry or cracked skin around nails or cuticles
Chemotherapy can cause changes in the appearance, texture, colour, and health of your nails. Dry or cracked skin around your nails or cuticles can be a side effect of chemotherapy. Here are some ways to manage this condition:
Keep Nails Clean and Short
It is important to maintain proper hand hygiene and keep your nails trimmed to avoid accidentally tearing them. Wash your hands and nails with soap and water instead of hand sanitiser, which can sometimes irritate the skin or nails.
Wear Gloves
Protect your hands and nails by wearing gloves when cleaning or gardening. This will help prevent your nails from becoming dry and cracked.
Moisturise
Use recommended creams or lotions to prevent your skin from becoming dry and itchy. Colloidal oatmeal baths can also help reduce itching. Moisturising is crucial in preventing and treating dry skin.
Avoid Manicures and Pedicures
It is advisable to avoid professional manicures and pedicures during chemotherapy. Do not cut or trim your cuticles as this may increase the risk of infection.
Treat Nail Problems
If you experience nail problems, ask your nurse or doctor to recommend products that can help. For weak, brittle, or splitting nails, consider using a water-soluble nail lacquer or prescription nail polish.
It is important to note that not all nail changes are related to chemotherapy. Some nail changes can be caused by non-cancer conditions, treatments, or medications. Always consult your healthcare team if you notice any nail changes or have any concerns.
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Nails may lift off the nail bed
Chemotherapy can have several effects on the fingernails, toenails, and nail beds. Nail changes are usually short-term and temporary, but some changes can last long after treatment ends or can even be permanent.
Some patients may experience nail lifting or onycholysis, where the nail falls off the nail bed. If you are taking a taxane drug, such as docetaxel, applying a cold pack to the nails for 15 minutes before, during, and after the infusion may help prevent the nail from lifting. It is important to talk to your doctor or nurse before trying this method.
If a patient's nails are lifting, a doctor may suggest clipping the nail back. This is not a painful procedure, but it may look unusual. A small surgery can also be performed to alleviate nail fold inflammation. The entire finger or toe is numbed, and then the lateral edges of the nail are split and pulled away. A chemical is then used to remove the matrix, or the tissue under the nail, so that the nail does not grow back on the lateral edges.
If you are experiencing nail lifting, it is important to protect your nail bed while you wait for a new nail to grow. Keep your nails clean and short, and wear protective gloves when cleaning or gardening to prevent infection.
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Increased risk of nail infections
Chemotherapy can cause changes to your nails, including changes in colour, texture, and thickness. These changes may increase your risk of developing nail infections. This is partly because chemotherapy weakens your immune system, making it less able to fight off bacteria and other invaders.
Nail infections can be serious if your immune system is compromised from chemotherapy. If you have lymphedema, a nail infection can worsen the condition. Chemotherapy can also cause nail thinning or reduced strength, leading to breakage, which may further increase your risk of developing nail infections.
To reduce your risk of infection, it is important to keep your nails clean, short, and well-maintained. You should also avoid biting or picking at your nails and cuticles. If you have the habit of biting your nails, you can buy thin cotton gloves to wear around the house to help you break this habit.
Additionally, it is recommended to wear protective gloves when cleaning or gardening to avoid exposure to bacteria and other potential sources of infection. It is also important to avoid artificial nails and professional manicures, as these can trap bacteria and cause infections. If you notice any signs of infection, such as redness, swelling, or pain, it is crucial to seek medical advice from your doctor.
While most nail changes during chemotherapy are temporary and resolve after treatment, it is important to prioritize nail care and hygiene to reduce the risk of infection and maintain nail health throughout your treatment journey.
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Frequently asked questions
While chemotherapy can cause changes in the colour of your nails, it is unlikely that they will turn black. People with darker complexions may notice colour changes more than those with lighter complexions. Nails may look bruised, turning a few colours, and can develop ridges or become brittle.
Chemotherapy can cause nail thinning or reduced strength, leading to breakage. It can also cause painful nail beds, dry or cracked skin around the nails or cuticles, and discolouration or over-pigmentation.
It is important to keep your nails clean and short to reduce the risk of infection. You should also wear protective gloves when cleaning or gardening. Avoid biting or picking at your cuticles or nails, and use cuticle cream to prevent dryness, splitting, and hangnails.
Yes, nail changes can also be caused by non-cancer conditions, treatments, and medications. It is important to discuss any nail changes with your healthcare provider to determine the underlying cause and appropriate treatment.
Most nail changes from chemotherapy are temporary and will return to normal within a few months of stopping treatment. However, it is important to note that some changes may last long after treatment ends or can even be permanent.
