Breast Cancer, Chemotherapy, and Your Nails

Your fingernails reveal a lot about your health. During chemotherapy for breast cancer, you may experience problems with the nails on your fingers and toes. Understanding the causes and symptoms of nail disorders can help you care for them.


Fingernails and toenails

Nails may darken, turn yellow, become brittle, and crack easily. Six or more high-dose cycles of taxanes may cause nails to fall off. Dark or light lines (Beau's lines) may develop across the width of some of your nails.

Nails may develop a concave, spoon-like shape (koilonychia). Infections under your nails are also possible. If your nails are becoming loose, they may become quite painful. 


Because chemotherapy is very drying to your tissues, your nails can become brittle and yellow. Dry nails will break and crack easily. Koilonychia (spooning) is caused by anemia and low iron.

Beau's lines occur when you have high-dose chemo and your nails temporarily stop growing. You may develop one visible line per high dose chemo cycle.

Low-dose chemo can cause Beau's lines as well, but these will be difficult to see without a microscope.

Some chemotherapy drugs that can cause fingernail disorders include:


Chemo-related nail problems are not totally preventable. At some clinics, the nurse may bring you a dish of ice water for your hands.

Research suggests that using ice or cryotherapy, such as frozen gloves, may reduce damage to skin and nails. Ice is sometimes used for the hands and mouth during an infusion because that’s when the drugs are most toxic to your cells.


Follow these tips to promote optimal self-care for your nails:

  • Use clear polish to help keep nails strong
  • Avoid artificial nails and colored polish, especially dark colors
  • Wear gloves when washing dishes and gardening
  • Care for nails and cuticles gently
  • As Beau's lines grow beyond nail bed, cut them off
  • Increase iron in your diet
  • Cut back on or avoid caffeine
  • Try taking vitamins for hair, skin, and nails
  • Wear comfortable shoes that allow adequate room for your toes

Medical Attention

If you are having nail pain or your nails appear infected or badly discolored, tell your nurse or doctor about it. Infections can be treated with antibiotics or other medications. Pain and discoloration should be diagnosed and treated by a health care professional.

Recovery & Healing

Even if your nails disappear during chemo—or become lined or discolored—your skin and nail cells will start growing again at a healthy rate when treatment ends.

New nail tissue will push the damaged nails out of the way. Fingernails grow three times faster than toenails, so allow more time to see improvements on your toes.


Journal of Clinical Oncology. Frozen Glove Reduces Skin and Nail Damage from Docetaxel Chemotherapy.

Annals of Oncology. Annals of Oncology 14:333-337. Taxane-induced nail changes: incidence, clinical presentation and outcome. Authors: A. M. Minisini, et. al.

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