Nail Changes

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During treatment for breast cancer you may notice some changes in the color or thickness of your fingernails or toenails or changes around the nail bed.

  • Your nails may look bruised -- turning black, brown, blue, or green. People with darker complexions notice the color change more.
  • You may develop blemishes on your nails such as a horizontal or vertical line, or small indentations. These marks reflect the timing of chemotherapy. You may have multiple lines or indentations that mark the different cycles of chemotherapy. These spots are not permanent, and will grow out with the nail.
  • Your nails may become thin or brittle. Your nails probably won't grow as long as they used to and may tend to break more easily.
  • The nail can lift completely off the nail bed or fall off in some cases. If the nail is not tightly bound to the nail bed, it can be a site for bacteria to enter and cause infection.
  • The nail bed may become dry and you may have frayed cuticles.
  • You may develop ingrown nails on your fingers or toes.

The following treatments for breast cancer can cause nail changes:

Managing nail changes

If you’re experiencing nail changes, your risk of infection may increase. A nail infection can be serious if your immune system is compromised from chemotherapy. If you have lymphedema, a nail infection can make it worse.

The following tips can cover up any nail blemishes and help keep your nails free from infection:

  • Keep nails trimmed and clean to reduce the risk of infection.
  • Wear gloves when gardening or housecleaning to avoid infection.
  • Paint your nails to hide blemishes and increase nail strength. Make sure to use a nail polish you’ve used before to decrease the risk of having an allergic reaction.
  • Remove nail polish with a non-acetone-based remover -- it can be less drying than an acetone-based remover.
  • Don’t bite or tear at your nails. This habit can put you at risk for infection. Buy thin cotton gloves that you can wear around the house to help you break this habit.
  • Don’t pick at your cuticles if you have dry skin around the nail bed or frayed cuticles.
  • Use a cuticle remover cream or gel to keep cuticles tidy. You can push your cuticles back gently using a wooden cuticle stick.
  • Massage cuticle cream into the nail area to prevent dryness, splitting, and hangnails.
  • Limit the time your hands are in water. Excessive exposure to water can lead to fungal infections in the nail bed.
  • Avoid professional manicures. If you must have your nails done in a shop, bring your own sanitized instruments.
  • Do not use artificial nails. Artificial nail adhesives have chemicals that may cause an allergic reaction, such as swelling or inflammation. Fake nails also can trap bacteria that may cause infection.
  • If you develop an ingrown toe or fingernail, try soaking it in warm water and putting some antibiotic cream on the area. If the area is still painful or there is pus or redness that seems to be spreading, call your doctor immediately.
  • Tell your doctor if you have any signs of inflammation or infection. If you’re having pain or draining fluid from your nail, call your doctor immediately.

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