We look at what might happen to your finger and toenails when you have chemotherapy and how you can help prevent the changes

When you think about the side effects of chemotherapy, hair loss and nausea are probably what first come to mind.

But many are unaware that chemotherapy agents can also adversely affect the nails.

Nail changes during chemotherapy

So how does chemotherapy affect your nails? Nails – both on the fingers and toes – may darken, turn yellow, become brittle, and crack easily.  Beau’s lines (dark or light lines) may develop across the width of some of your nails.

The area around the nail bed may become dry, and your cuticles may fray. Nails may develop koilonychia (also known as spooning – when nails lose their convexity, becoming flat or even concave in shape). Infections under your nails are also possible and there are cases where your nails will fall off completely.

The nails can look bruised and can turn black, brown, green or blue in colour during chemotherapy. People who have darker complexions usually have more obvious nail colour change

Why does chemotherapy cause nail changes?

Because chemotherapy is very drying to your tissues, your nails can become brittle and yellow. Dry nails will break and crack easily. Koilonychia is caused by anaemia and low iron.

Beau’s lines occur when you have high-dose chemo and your nails temporarily stop growing.

Which chemo drugs affect the nails?

Some chemotherapy drugs that can cause fingernail disorders include:

  • Taxanes (Taxol, Taxotere, Docetaxel)
  • Doxorubicin (Adriamycin)
  • 5-fluorouracil (5Fu)
  • Bleomycin

Preventing chemo nails

Unfortunately, there is no way to completely avoid chemo-related nail problems. Though, some nurse may bring you a dish of ice water for your hands. Research suggests that using ice or cryotherapy, such as frozen gloves or slippers, may reduce damage to skin and nails.

Tips to help save your nails during chemo:

  • Wear gloves while doing chores, such as washing up as exposure to water can lead to fungal infections of the nail bed.
  • Experiment with nail polishes in darker shades to cover up discolourisation
  • If you’d like to wear nail polish, consider using a water-based polish. Conventional nail polishes may contain chemicals to harden them that are considered toxic.
  • To take off polish, use a remover that doesn’t contain acetone, ethylacetate, or other harsh solvents. There are gentle removers specifically for water-based nail polish.
  • Try vitamins for hair, skin, and nails. (Please note, you should always talk to your doctor before starting any supplements/ vitamins)
  • Use cuticle remover cream or gels and push your nails back gently rather than cutting them.
  • Massage cuticle cream into the cuticle area daily to prevent dryness, splitting, and hangnails.
  • As Beau’s lines grow beyond the nail bed, cut them off
  • Increase iron in your diet
  • Alert your doctor to any signs of inflammation or infection
  • Evaux EvoNail Nail Repair Solution is perfect for soothing brittle or tender nails, nail ridges, split nails and yellowed or blackened nails.
  • Try to cut back on or avoid caffeine
  • Use a gentle nail oil like the Defiant Beauty Nail Oil to keep your nails moisturised
  • Wear comfortable shoes that allow adequate room for your toes
  • Don’t use acrylics nails or other nail wraps. Fake nails can trap bacteria that may cause infection.