Nail Problems During Cancer Treatment

Coping With Fingernail Changes During Chemotherapy

older man's hand showing fingernails
What kind of nail changes occur during cancer treatment. istockphoto.com

Just as chemotherapy can cause hair loss and skin changes, your fingernails and toenails may be affected during cancer treatment as well. Usually not a serious side effect of chemotherapy, nail changes can nonetheless be annoying and understanding the changes you might expect, and things you can do to minimize your symptoms can be helpful.

What Nail Changes Might I Expect During Chemotherapy and Other Cancer Treatments?

Fingernails can become weak and brittle during chemotherapy.

They may fall off after several rounds of treatment, but this is less common. Lines, both horizontal and vertical can form and can appear lighter or darker than the rest of your nail. Fingernails are affected more than toenails and usually grow out normally again about 6 months after finishing treatment.

Chemotherapy drugs used in lung cancer that commonly cause nail symptoms include:

  • Taxotere (docetaxel)
  • Taxol (paclitaxel)
  • Adriamycin (doxorubicin)

Targeted therapies, especially EGFR inhibitors used for EGFR positive lung cancer like Tarceva (erlotinib) are also a common cause of nail conditions.

Coping with Nail Changes from Cancer Treatment

What can you do yourself to cope with and prevent problems from fingernail problems during chemotherapy?

  • Keep your fingernails and toenails trimmed.
  • Wear gloves when working. Cotton gloves can protect your hands during gardening. Consider rubber gloves when cleaning or washing dishes to keep your hands from drying out further.
  • Don't bite your nails as this increases the risk of infection. Wear cotton gloves if you are having difficulty breaking the habit.
  • Avoid manicures, pedicures, or cutting your cuticles, which could increase the risk of infection. Avoid using artificial nails.
  • In general, it is best to avoid nail polish, although some women find that using clear polish helps strengthen, and may protect their nails.
  • Some people find that soaking their hands in natural oils, such as olive oil, is helpful.
  • Wear comfortable, loose fitting shoes.

Prevention of Fingernail Symptoms During Cancer Treatment

A few studies have suggested that cooling hands and nails while receiving chemotherapy might decrease nail damage. Some cancer centers provide ice packs that individuals can use for this reason. Nail changes, however, can’t be prevented completely, and applying ice to your hands during chemo can be an uncomfortable experience.

When Should I Call?

Share with your cancer team any fingernail or toenail changes you experiencing during chemotherapy. Between visits, make sure to call with any signs of infection, such as increased pain, redness (especially around the cuticle,) fever, rapid elevation of your nail bed, or any drainage (pus) from around your nails.

Sources:

Robert, C., Sibaud, V., Mateus, C. et al. Nail toxicities induced by systemic anticancer treatments. Lancet Oncology. 2015. 16(4):e181-9.

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