Noah Sinclair
Chemotherapy can cause changes to your nails, including discolouration, dryness, and brittleness. In some cases, nails may even fall off. Fortunately, nails typically grow back after chemotherapy, with fingernails taking around 6 months to regrow and toenails taking about 1.5 years. During chemotherapy, it is important to take extra care of your nails to prevent infections and other complications. This includes keeping nails trimmed and moisturized and avoiding nail-biting and corrosive cleaning products.
| Characteristics | Values |
|---|---|
| Time taken for nails to grow back | Fingernails take about 6 months to grow back, while toenails can take about 1.5 years. |
| Nail changes | Nails may become dry, brittle, discoloured, or develop grooves or ridges. In some cases, nails may fall off. |
| Prevention and care | Keep nails short and straight with smooth edges. Moisturise nails and cuticles with special nail oil, cream, or nourishing hand cream. Avoid nail polish, but if desired, use a colourless, nourishing base coat. |
| Infections | Chemotherapy can increase the risk of infections under the nail. Soak nails in a mixture of half vinegar and half water to reduce bacteria and yeast. Examine nails daily for any changes, and notify a healthcare provider if symptoms of infection occur. |
| Supplements | Biotin, a B-complex vitamin, may help strengthen fragile nails, but consult a doctor before taking any supplements as they may interfere with chemotherapy. |
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What You'll Learn
Nails grow back healthy after completing cancer treatment
Chemotherapy can cause nail problems, including discolouration, dryness, brittleness, and even nails falling off. However, there is good news: most patients' nail changes are short-term, and their nails will grow back healthy after completing cancer treatment.
It is important to take care of your nails during chemotherapy. Keep your nails short and straight, with smooth edges, to prevent ingrown nails and possible infections. Your nails will also benefit from additional moisturising to prevent dryness. You can use a special nail oil or cream, or a nourishing hand cream. Massage the cream into your cuticles, the skin around your nails, and the nails themselves. Doctors advise against wearing nail polish all the time, but you can wear it on special occasions, using a colourless, nourishing base coat so that the colour does not penetrate your brittle nails. You should also wear gloves when doing the dishes or gardening to protect your nails and reduce the risk of cuts and scratches.
Even with prevention, problems such as fungal or bacterial infections may occur, especially with chemotherapy medications that can reduce infection-fighting white blood cells. Examine your nails daily for any changes. If you develop a fever and redness, discharge, or drainage around your nails, notify your healthcare provider. You may need antibiotics or antifungal creams. Tea tree oil has been used for fungal infections, but an anti-fungal medication may be needed. Toenails can develop disorders, lines, ridges, and discolourations, and even come loose during chemotherapy. They grow more slowly than fingernails, so it can take longer for them to recover.
After chemotherapy, your nails should begin to grow back. It can take around six months for a fingernail to regrow and about a year and a half for a toenail. In the meantime, your nails may continue to bend or break more easily, and they may be thinner and more brittle.
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Fingernails regrow in 6 months, toenails take 1.5 years
Chemotherapy can have various side effects, and changes to your nails are among the most common. Research from 2020 found that 38% of people undergoing chemotherapy experienced nail-related changes. These changes can include discolouration, Beau's lines (grooves that form horizontally across the nail), and onycholysis (nails lifting and coming loose). In rare cases, nails may even fall off.
Fortunately, nails typically start to grow back after chemotherapy ends. Fingernails tend to regrow within six months, while toenails can take up to one and a half years to fully recover. During this time, it's important to take extra care of your nails to reduce the risk of infection and further complications. Keep your nails trimmed and smooth to prevent ingrown nails and infections. Avoid nail biting and activities that may cause wounds or trauma to your nails. Practicing good hand and foot hygiene is also essential, as chemotherapy can reduce infection-fighting white blood cells, making you more susceptible to infections. Soaking your nails in a mixture of half vinegar and half water can help reduce bacteria and yeast on the nail surface.
Additionally, moisturising your nails and cuticles with special nail oils or creams can help combat dryness and brittleness. Natural polyphenolic-rich herbal oils, such as PolyBalm, have been studied for their potential benefits in nail care during chemotherapy. Applying a colourless, nourishing base coat before using nail polish can also protect your nails. However, it is generally advised to avoid wearing nail polish constantly during chemotherapy. If you choose to wear nail polish, ensure it does not contain alcohol or acetone, as these can further dry out your nails.
Supplements like biotin can help strengthen fragile nails, but always consult your doctor before taking any supplements during chemotherapy, as some substances may interfere with the treatment's effectiveness. Your doctor can provide specific recommendations and strategies to manage nail changes during and after chemotherapy.
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Prevent wounds and infections during chemo
Chemotherapy targets fast-growing body cells, including those that control nail growth. As a result, patients often experience nail-related changes, such as discolouration, grooves, ridges, and nail deformities. Nails become dry, brittle, and fragile, making them prone to injury.
To prevent wounds and infections during chemotherapy, it is important to take extra care of your nails and skin:
- Keep your nails short and straight, avoiding ingrown nails and potential infections.
- Moisturise your nails and cuticles with special nail oil, cream, or nourishing hand cream to prevent dryness and strengthen your nails.
- Avoid wearing nail polish, especially nail polish that contains alcohol or acetone, as this can further dry out your nails.
- Refrain from nail-biting, as this can aggravate brittle nails and increase the risk of wounds and infections.
- Wear gloves when doing dishes or gardening to protect your nails from cleaning products and potential injuries.
- Avoid corrosive cleaning products, as they can be harsh on your nails and skin.
- Soak your nails in a mixture of half white vinegar and half water to reduce bacteria and yeast, thereby decreasing the chances of surface infections.
- Apply a steroid liquid to the edges of your nails if you experience nail fold inflammation.
- Take care of your skin by avoiding manicures and pedicures, as they may introduce bacteria and increase the risk of infection.
- If you must get a manicure or pedicure, ensure your tools are clean and sanitised to reduce the risk of infection.
- Avoid shaving or use an electric shaver to minimise the risk of accidental cuts or nicks.
- Wash your hands regularly, especially before and after preparing food and after using the restroom, to reduce the spread of germs and bacteria.
- Use soap and water or hand sanitiser with at least 60% alcohol, ensuring you scrub for at least 20 seconds, including the backs of your hands, between your fingers, and under your nails.
- Practise good oral hygiene by brushing your teeth twice a day and flossing. However, if you have bleeding gums, avoid brushing or flossing, and use a special mouthwash recommended by your dentist, usually a mixture of water and baking soda.
- Avoid people who are sick, and wear a mask when going out to reduce the risk of infection.
- Keep your environment clean and dust-free, especially in construction sites or areas with high dust levels.
It is important to note that any wounds or cuts during chemotherapy can increase the risk of infection. Therefore, always practise good wound care by keeping wounds clean and covered until healed. Additionally, be mindful of any changes in your nails during chemotherapy and consult your doctor if you experience pain or other symptoms.
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Chemotherapy drugs cause nail changes
Chemotherapy drugs can cause nail changes by targeting fast-growing cells in the body, such as those that control nail growth. Research from 2020 found that 38% of people experienced nail-related changes, with melanonychia (brown or black discolouration) being the most common side effect, affecting 84% of people. Other chemotherapy drugs that may cause nail changes include those containing taxanes (such as Taxotere and docetaxel) and topotecan.
Nail changes can occur 3-6 weeks after the start of chemotherapy, but this timeframe may vary. Changes include nails becoming dry, brittle, and fragile, as well as discolouration, the development of grooves or ridges, and nails lifting off the nail bed or falling off. Beau's lines, which are horizontal ridges, can indicate when nail growth has been interrupted. Repeated chemotherapy cycles can lead to multiple Beau's lines on multiple nails. Onycholysis refers to the separation of the nail plate from the nail bed due to toxin damage.
The appearance of nail changes can depend on the component of the nail unit involved and the severity of toxicity. The nail matrix is highly susceptible to damage from chemotherapeutic agents, leading to defective nail plate production. Typical nail matrix changes include melanonychia, leukonychia, Beau's lines, and onychomadesis.
Most nail changes are short-term and nails will grow back healthy after completing cancer treatment. Fingernails grow at an average rate of 0.1 mm per day, taking 4 to 6 months for complete regrowth, while toenails grow at 0.03 mm per day, taking 12 to 18 months. However, some nail changes may be longer-term or permanent, and in rare cases, nails may not grow back. It is important to consult a doctor if there are any concerns about nail growth or infection during or after chemotherapy.
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Doctors can advise on nail management during chemo
It is recommended to consult a doctor if you notice any nail changes during chemotherapy, as certain types of chemotherapy and targeted therapies can cause the skin around the nail to break down, leading to possible infections. Doctors can help monitor nail changes and suggest steps to manage these side effects. For instance, if nails are lifting, doctors may suggest clipping the nail back, which is a simple procedure. In some cases, surgery may be recommended to alleviate nail fold inflammation. Doctors can also refer patients to trained specialists for special treatments if required.
Additionally, doctors can provide advice on nail care during chemotherapy to prevent damage. This includes keeping nails short and smooth to prevent ingrown nails and infections. Doctors may also suggest using natural nails and avoiding nail polish, as well as moisturising the nails and cuticles to prevent dryness and brittleness.
It is important to note that nail changes due to chemotherapy can vary depending on the type of chemotherapy drug used and the individual's response to treatment. These changes can take several weeks to develop and usually go away once treatment is completed. However, in some cases, nail changes may be longer-term or permanent. Therefore, seeking medical advice is crucial for managing nails during and after chemotherapy.
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Frequently asked questions
Chemotherapy can cause nails to become dry, brittle, and fragile. Nails may also discolour, develop grooves or ridges, and may even fall off.
It takes around 6 months for fingernails to regrow, and about 1.5 years for toenails.
Keeping nails short and straight can prevent ingrown nails and infections. Nails will benefit from additional moisturising to prevent dryness. Using a special nail oil or cream can help.
Doctors advise against wearing nail polish all the time. However, using a colourless, nourishing base coat can be helpful if you wish to wear nail polish occasionally.
Pharmacies sell vitamins and supplements for stronger nails, but their effects are not always scientifically proven. Some substances may interfere with chemotherapy, so it is important to consult a doctor before taking any supplements.
