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Chemotherapy and Your Nails

Caring for Your Nails and Toenails During Chemotherapy

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Updated November 08, 2010

When people start chemotherapy, they are often surprised by the effects some chemotherapy drugs can have on their nails and toenails. Nails can become brittle, dry, discolored, develop lines or ridges, and may even fall off. This is true for both fingernails and toenails.

Nail damage is a common side of chemotherapy drugs belonging to the taxane group, like docetaxel and paclitaxel, and the anthracyclines (adriamycin, for example). Taxane groups are chemotherapy drugs that work by stopping cell division, thus stopping the growth of tumors.

How to Prevent Nail Damage and Infection

There are several things you can do to help prevent and relieve damage to nails caused by chemotherapy:

  • Protect hands with rubber gloves. When doing household chores like dishes or using cleaning products, use rubber gloves to protect hands and nails. The skin around the nail and cuticles can become dry during chemotherapy. Cleaning products may cause burning and may aggravate the condition. Remember to also wear gloves if you do any outside chores, such as gardening.

  • Be cautious when getting a manicure or other cosmetic nail treatments. If you choose to get a manicure from a professional manicurist, bring your own nail implements. Although implements are sanitized at the salon, you should always bring your own to avoid possible infection.

    Avoid getting acrylic nails or wraps because bacteria can grow behind the synthetic nail or wrap, possibly causing infection.

    Nail polish is safe to wear unless a nail is cracked or falling off. Many women wear polish to cover discoloration and lines. Nail polish may even strengthen the nail. When removing nail polish, use a non-acetone remover. Acetone-based removers can be harsh on fragile nails.

  • Monitor your cuticles. Cuticles may become dry and ragged. Hang nails may develop. Use cuticle cream to keep them moisturized. To remove dry cuticles, use a cuticle remover. Do not cut, pull, or tear away dry cuticles or hang nails.

If you cuticles become painful or inflamed, talk to your doctor.

Keep nails cool during chemotherapy sessions. Studies show that keeping the nails and toenails cool during chemotherapy sessions -- a treatment known as cryotherapy -- can help to reduce damage. By keeping the nail areas colder than that rest of the body, the chemotherapy drugs do not reach the nails as easily and will not cause as much cell damage. This also works for the scalp and mouth. In clinical trials for nail damage, cryotherapy was done using a special frozen glove. But it is common to see people dipping their fingers in ice water during treatment or even keeping frozen vegetable bags on their hands. These tactics often come from the advice of other patients, but some people do seem to find success.

Sources

Florian , Scotté, Jean-Marc Tourani, Eugeniu Banu, Michel Peyromaure, Eric Levy, Sandrine Marsan, Emmanuelle Magherini, Elisabeth Fabre-Guillevin, Jean-Marie Andrieu, Stéphane Oudard. "Multicenter Study of a Frozen Glove to Prevent Docetaxel-Induced Onycholysis and Cutaneous Toxicity of the Hand." Journal of Clinical Oncology 2301 July 2005 4424-9. Accessed 19 March 2007.

  • Minisini, A. M. , A. Tosti, A. F. Sobrero, M. Mansutti, B. M. Piraccini, C. Sacco and F. Puglisi. "Taxane-induced nail changes: incidence, clinical presentation and outcome." Annals of Oncology Vol 14, No 23 July 2003 3333-337. Accessed 19 March 2007.

    "Will My Skin and Nails Be Affected?." 06 June 2006. American Cancer Society. Accessed 19 Mar 2007.

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