Isla Bennett
Cancer treatments such as chemotherapy, radiation therapy, targeted therapy, and immunotherapy can cause changes to your nails. These changes include discolouration, ridges, splitting, and slowed growth. In some cases, nails may even fall off during treatment. However, most nail changes are temporary, and nails typically grow back healthy after completing cancer treatment. To promote nail health during and after cancer treatment, it is recommended to keep nails trimmed, clean, and moisturized, and to avoid injuries and infections.
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What You'll Learn
Nails may grow back slowly or not at all
While most nail changes are temporary and nails grow back healthy after cancer treatment, some changes can last long after treatment ends or can even be permanent. Chemotherapy can disrupt the growth cycles of new cells in your body, affecting the keratin-rich cells that make up your nails. This can result in nails becoming thinner and more brittle, bending or breaking more easily, and not growing as long as they used to. In some cases, nails may fall off during chemotherapy and will not reattach to the nail bed, requiring protection of the nail bed while waiting for a new nail to grow.
The time it takes for nails to regrow depends on whether they are fingernails or toenails. Approximately 6 to 12 months after finishing treatment, your natural fingernails will start to regrow, while it can take up to a year and a half for toenails to regrow. During this period of regrowth, it is important to treat your nails with care, keeping them clean, trimmed, and free of infection to promote stronger and quicker growth. Soaking nails in a solution of equal parts white vinegar and water can help to reduce bacteria and yeast, thereby lessening the chance of surface infections.
In some cases, nail changes may be longer-term. Certain chemotherapy drugs, such as taxotere and fibroblast growth factor receptor (FGFR) inhibitors, can cause the cuticle to break down next to the nail, leading to painful and inflamed skin that is more susceptible to infection. If left untreated, infections can become painful, wet, and infected, a condition known as a moist reaction. While rare, onycholysis, or damage to the tissue in the nail bed, can also occur during chemotherapy, causing nails to loosen and potentially fall off.
If nail changes are severe or persistent, medical interventions may be necessary. Small surgeries can be performed to alleviate nail fold inflammation by removing the matrix, the tissue under the nail, to prevent the nail from growing back on the lateral edges and reducing friction between the skin and the nail. In some cases, it may be decided to completely remove the nail and kill the matrix, resulting in the nail not growing back at all. While this may seem drastic, it can be preferable to living with painful and problematic nails.
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Nail infections are common after radiation
While most nail changes are temporary and nails grow back healthy after cancer treatment, some changes can last long after treatment ends or can even be permanent.
To prevent infections, it is recommended that patients with nail fold inflammation soak their nails daily in a mixture of half white vinegar and half water. This helps to decrease the amount of bacteria and yeast and lessens the chance of surface infections. Patients can also apply a steroid liquid at the edges of the nail to help it absorb into the skin.
It is important to note that patients should avoid getting manicures or pedicures and should not cut or trim their cuticles due to the risk of infection. Instead, keeping nails trimmed short and using a water-soluble nail lacquer or prescription nail polish can help protect nails from damage.
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Chemotherapy can cause nail inflammation
Changes to your nails are a common side effect of cancer treatment, including chemotherapy and radiation therapy. Chemotherapy drugs can affect the texture and appearance of your nails, and may cause nail inflammation.
Chemotherapy can disrupt the growth cycles of new cells in your body, particularly the keratin-rich cells that make up your skin and nails. This can result in nails that are thinner and more brittle, which may lead to nail inflammation. Certain types of chemotherapy drugs, such as taxotere, are more likely to cause nail problems. These problems can begin at any time after starting chemotherapy but usually appear after the first few infusions.
Nail inflammation can cause pain and swelling, and may increase the risk of infection under the nail. It is important to treat nail inflammation promptly to prevent further complications. Treatment options for nail inflammation caused by chemotherapy include:
- Soaking your nails in a solution of equal parts white vinegar and water, which helps to reduce bacteria and yeast and decrease the chance of surface infections.
- Applying a steroid liquid to the edges of the nail to help reduce inflammation and promote absorption into the skin.
- Practicing good nail care, including keeping nails trimmed, clean, and free of infection.
- Using a water-soluble nail lacquer or prescription nail polish to protect your nails from damage.
- Taking over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) to relieve symptoms.
It is important to monitor your nails for any changes during chemotherapy treatment and to notify your healthcare team if you experience any side effects. They can offer strategies and recommendations to ease discomfort and promote nail health.
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Nails may grow back thicker and painful
While most nail changes are short-term and nails grow back healthy after cancer treatment, some patients may experience longer-term side effects, such as a random nail that grows back thick and painful. Chemotherapy can disrupt the growth cycles of new cells in the body, affecting the keratin-rich cells that make up the nails. This can result in nails becoming thinner, more brittle, and prone to bending or breaking easily, which can cause pain when performing everyday tasks.
Certain chemotherapy drugs, such as taxotere and fibroblast growth factor receptor (FGFR) inhibitors, can cause nail problems. These issues may include nail ridging, which is typically the least aggressive side effect and often doesn't require treatment. However, if the nails become painful, it is important to address the symptoms. This can be done by removing the nail to see if it grows back normally. If it doesn't, a small surgery can be performed to remove the nail and kill the matrix, preventing the nail from growing back.
To alleviate nail inflammation, a procedure can be done to numb the finger or toe, split and pull away the lateral edges of the nail, and use a chemical to remove the matrix. Additionally, patients can soak their nails in a solution of half white vinegar and half water to reduce bacteria, yeast, and the chance of surface infections. Over-the-counter medicines like non-steroidal anti-inflammatory drugs (NSAIDs) can also help relieve symptoms.
During chemotherapy, it is important to care for your nails to promote healthy regrowth. Keeping nails trimmed, clean, and free of infection can help prevent issues. Applying cold packs to nails before, during, and after infusions may also help prevent nail lifting. While nail changes typically start sooner with chemotherapy than with other treatments, they usually improve within a few months of stopping treatment.
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Nail changes can be permanent
While most nail changes are short-term and nails grow back healthy after cancer treatment, some nail changes can last long after treatment ends or can even be permanent. Chemotherapy can disrupt the growth cycles of new cells in your body, and the keratin-rich cells that make up your nails can be especially affected. This can lead to nails becoming thinner and more brittle, and they may not grow as long as they used to. Chemotherapy can also cause nail inflammation, which can be treated with a small surgery to remove the matrix, the tissue under the nail, so that the nail doesn't grow back on the lateral edges.
Certain types of chemotherapy drugs, such as taxotere and fibroblast growth factor receptor (FGFR) inhibitors, can cause the cuticle to break down next to the nail. This can lead to nail infections, which are more common if nails are cracked or open. Nail infections can cause pain and swelling, and may require treatment with antibiotic or antifungal medication. It is important to keep nails clean, trimmed, and free of infection during chemotherapy to promote healthy nail growth and reduce the risk of infection.
In some cases, nails may not grow back at all after chemotherapy. This can occur if the nail bed is damaged, a condition called onycholysis, which is damage to the tissue in the nail bed that keeps the nail in place. Onycholysis is usually painless but can lead to discomfort and infection if other conditions are present. While there is no way to completely prevent nails from falling off during chemotherapy, keeping nails trimmed and clean can help reduce the risk of infection and promote healthy nail growth.
Radiation therapy can also cause nail changes, such as the skin on the treated area becoming dry, red, blistered, or peeling. These changes may be mild, but they can also be more severe, such as in the case of a moist reaction, where the skin becomes painful, wet, and infected. It is important to note that nail changes can vary depending on the type of treatment and individual factors, and it is always best to consult with a healthcare professional for specific advice and treatment options.
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Frequently asked questions
Radiation therapy can cause the skin on the treated area to become dry, red, swollen, and itchy. It may also lead to skin peeling, blistering, and soreness. While these side effects may affect the nails, they usually don't prevent nail regrowth. Most patients' nails grow back healthy after completing cancer treatment, although it can take up to a year and a half for toenails to fully regrow.
Keeping your nails trimmed, clean, and free of infection is essential during radiation therapy. You should also avoid manicures and pedicures, as these can increase the risk of infection. Soaking your nails in a mixture of equal parts white vinegar and water can help reduce bacteria and yeast, thereby lessening the chance of surface infections.
Nail changes during cancer treatment can vary, but common side effects include nail thinning, reduced strength, and breakage. Nails may also become darker, cracked, or discoloured, and you may experience painful nail beds or cuticles. These changes are usually temporary and improve after treatment ends.
While you may not be able to completely prevent nail changes, there are steps you can take to minimise their impact. Keeping your nails trimmed, clean, and free of infection is essential. You should also avoid manicures and pedicures, as these can increase the risk of infection. Additionally, speak with your healthcare team about any expected or unexpected nail changes.
It's important to consult your healthcare team if you experience any nail changes during or after radiation therapy. They can suggest treatments such as daily vinegar nail soaks, over-the-counter medications, or prescription nail polishes to protect your nails. In some cases, minor surgery may be recommended to alleviate nail fold inflammation and prevent nail regrowth in affected areas.
