Coping with Nail Changes during cancer treatment

How does cancer treatment effect the nails?

During cancer treatment your body will experience many side effects. Some are well known, whilst other side effects like the fingernails and toenails, might come as a surprise. 44% of people receiving chemotherapy and targeted therapy drugs like radiotherapy, can affect nails on both fingers and toes. 

Nails are attached to your body by the nail bed, which receives blood and nutritions from the body. This keeps your nails healthy and allows new cells to form and grow. Cancer treatment can disrupt this cycle and stop new cells from growing. The changes can happen in the nail bed or in the nail plate itself and may be temporary or may last.

Remember that while some cancers and cancer treatment can cause changes in your nails, non-cancer conditions and medications can also cause them. It's important to talk to your doctor about all medical problems you might have and about the medications, vitamins, minerals, and supplements you are taking so your risk can be discussed and you know what to expect.

What are the side effects of chemotherapy nails? 

1. Dark areas near the cuticle of the nail (subungual lesions) You may find along the bottom edge of the nail an area that looks bruised.

2. Fissures: Small thin cracks or deep cuts or tears in the fingertips, nail plate or bed.

3. Haemorrhage: Tiny red lines in the nails that are tiny areas of bleeding under the nail plate.

4. Hyperpigmentation: This is when the skin or the nail itself becomes darker and may become permanent. 

5.  Inflammation (paronychia): Redness, and sometimes swelling of the nail bed and surrounding finger or toe, can cause infections or be a sign of an infection.

6. Lifting of the nail plate (onycholysis): This is usually a temporary condition. The nail may fall off and become a place where an infection could easily happen.

7. Nail loss: Complete loss of the nail plate. Some medications cause the nail plate to loosen entirely and be lost. This is temporary but can be painful and can increase the risk of infection.

8. Ridges or lines in the nail plate: You may notice different looking ridges or different coloured lines in the nail plate. These may happen and remain throughout treatment and will usually grow out once the nail grows completely. 

9. Koilonychia: Nails can lose their convexity, becoming flat or even concave in shape. This is caused by anaemia. 

10. Beau's Line: High does of chemotherapy may cause your nails to stop growing but this is only temporary. 

Best treatment for chemo nails

When your nails become damaged, bacteria may find a way into them, resulting in infection, which may have serious consequences if the immune system is compromised due to cancer treatment. Therefore, it is imperative that you do not let your nails get damaged before, during, or after chemotherapy treatment.  

1. Caring for your nails
- Wear protective gloves when doing household chores or gardening and wear comfortable shoes and cotton socks.
- Moisturise regularly using a hand, foot and nail cream. Maybe try using a nail-strengthening cream and massage a cuticle cream into your cuticles to help prevent dryness, splitting and hangnails. Do not cut your cuticles.

2. Nail Safety
Keep nails short and filed, to reduce any risk of breaking nails and make nail changes less noticeable. When filing your nails, draw the emery board across them in one direction only. This prevents nails splitting further. Do not go backwards and forwards with it.

3. Nail Varnish
- Try water-based varnishes which contain less harsh chemicals.
- Use dark nail varnishes to help disguise discoloured nails.
- Use nail varnish remover that does not have acetone or other harsh solvents.
- Don’t use acrylics or false nails, this can trap bacteria and cause infection.


Struggling with skin problems? Check out our blog for tips - Skincare During Cancer Treatment

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