Chemotherapy and Your Nails

Just as chemotherapy affects your hair because of the rapidly dividing hair follicle cells, it also affects your nails.

You may see a line in the nail related to the cycle of chemotherapy. This line is not permanent and grows out with the nail, usually in about six months. There may even be multiple lines and indentations reflecting the different cycles of chemotherapy.

Your nails may become pigmented or discolored. They may become more brittle, so they won't grow as long as they used to and may break more easily.

The area around the nail bed may become dry, and your cuticles may fray. Don't rip or peel off the loose cuticle. Cut it carefully with a CLEAN pair of nail scissors.

The nail may actually lift off the nail bed. While this, too, is reversible, you need to be very careful, for two reasons. First, the nail is more vulnerable and may fall off. Second, because the nail is not tightly bound to the nail bed, it can become a site for bacteria to enter. So be sure to practice excellent hygiene to avoid infection.

Nail care is first-line prevention for lymphedema, a condition that develops when lymph fluid accumulates in the soft tissues of the arm, causing it to swell. If you've had an underarm lymph node dissection (with mastectomy or lumpectomy), you should be particular careful of damage to the nail, such as hangnails or cuts or burns on the hands or fingers, which could lead to infection.

Tips for Better Nail Care

• Clip your nails short. Imperfections show up less in short nails.
• Don't cut your cuticles. Use cuticle remover cream or gels and push your nails back gently.
• Don't bite your nails or cuticles, particularly on the hand on the same side as your affected breast. If you have a hard time stopping, consider wearing thin white cotton gloves around the house to help you break this habit.
• Massage cuticle cream into the cuticle area daily to prevent dryness, splitting, and hangnails.
• Wear gloves while doing chores, such as washing dishes. Excessive exposure to water can lead to fungal infections of the nail bed.
• Wear nail polish to help keep nails strong and protected from the environment (and looking nice, too). If your nails are very dry or falling off, you might want to consider a nail moisturizer instead of polish.
• Dry nails can become weaker or more brittle during chemotherapy treatment. To take off polish, use non-acetone-based remover, which is less drying than acetone.
• Don't use acrylics or other nail wraps. Fake nails can trap bacteria that may cause infection.
• If you have a professional manicure, bring your own instruments, regardless of how the salon cleans theirs.
• Ask a professional manicurist for more information on daily home care to keep your nails healthy and strong.
• Alert your doctor to any signs of inflammation or infection.

For more information on care of hair, skin, and nails during treatment, be sure to read our Ask-the-Expert conference transcript on “No Hair, New Hair, Skin Care.”