Nail Changes During Treatment

This information describes nail changes that you may have while taking chemotherapy or other anti-cancer treatments and how to help manage them.

Chemotherapy and other cancer treatments may cause nail changes. Some examples of these treatments are:

  • Docetaxel (Taxotere®)
  • Cetuximab (Erbitux®)
  • Paclitaxel (Taxol®)
  • Erlotinib
  • Albumin-bound paclitaxel (Abraxane®)
  • Pertuzumab (Perjeta®)
  • Capecitabine (Xeloda®)
  • Osimirtinib (Tagrisso®)
  • Pegylated doxorubicin (Doxil®)
  • Panitumumab (Vectibix®)
  • Gemcitabine (Gemzar®)
  • Methotrexate
  • Fluorouracil (Adrucil®)
  • Cisplatin (Platinol®)
  • Hydroxyurea (Hydrea®)
  • Ibrutinib (Imbruvica®)
  • Bleomycin (Blenoxane®)
  • Doxorubicin (Adriamycin ®)
Back to top

Nail Changes

For some treatments, the risk of developing these types of changes are high. For others, the risk is much lower. Your healthcare provider will talk with you about the treatments you’re taking and your risk for developing nail changes.

You may have any of the following nail changes in some or all of your nails:

  • Changes in the color of your nails (dark or light)
  • Nails that break more easily, are more brittle or split
  • Changes in nail shape or texture, such as grooves or ridges.
  • Nail separation from the skin below. This may or may not be painful.
  • Discharge or fluid from under the nail that may smell bad, be painful, or both. This may be an infection.
  • Swelling in the tips of your fingers or toes (with or without redness).
  • Pain around the fingers or toenails.
  • Slowed nail growth.
  • Nails that grow into your skin.
  • Growth on the side of your nails or opened skin around the nail.

These nail changes can involve your nail plate, nail bed, the area around or under your nail, or all these areas (see Figure 1).

Figure 1. Nail anatomy

Figure 1. The parts of your nail

These changes may prevent you from doing your usual activities. It may be hard to pick up small things such as a pen or a fork. You may have trouble buttoning your clothes. Some people have trouble walking.

It takes about 6 months to regrow a fingernail and up to 1.5 years to regrow a toenail. Most new nails will look normal. However, for some people, the new nails may regrow abnormally. Your healthcare provider will speak with you about this.

Back to top

Managing Your Symptoms

Tell your healthcare provider as soon as you begin to have any symptoms of nail changes. They can give you tips and medications to help.

Follow some general suggestions below to manage these symptoms.

Do not:

  • Take hot baths or soak your hands or feet in hot water or hot tubs.
  • Wash dishes by hand. If you must, wear Latex-Free rubber gloves.
  • Wear tight-fitting gloves, socks, pantyhose, or shoes.
  • Do anything that would cause friction or pressure on your nails, such as walking or running long distances or wearing tight-fitting shoes.
  • Bite or peel your nails.

Do:

  • Ask your healthcare provider if you can place cold packs on your hands and feet while you’re getting chemotherapy. If you can, start using them 15 minutes before each chemotherapy infusion starts and keep them on until 15 minutes after the infusion is finished.
  • Keep your hands and feet well-moisturized with fragrance-free creams or ointments. Try thick creams or ointments, such as:
    • Eucerin®
    • Aquaphor®
    • Vaseline®
    • Bag Balm®
    • Udderly Smooth®
    • Cetaphil®
    • CeraVe®
    • Vanicream®
    • Vaseline® Intensive Care
  • Wear soft, padded shoes or slippers, even when you are at home, such as Tempur-Pedic® slippers.
  • Wear soft, cushioned, cotton socks with all your shoes.
  • Wear cotton gloves after applying moisturizers, when carrying objects, or doing physical activities.
  • Keep your nails short with smooth edges. You can trim them using a nail clipper and file.
  • Speak with your healthcare provider about your nail health and ask if you can get manicures or pedicures.

If you notice your nails are lifting from the nailbed underneath, try soaking your fingers, toes, or both in a mixture of equal amounts white vinegar and tap water for 15 minutes every night. Call your healthcare provider if you have any signs or symptoms of infection.

Back to top

Call Your Healthcare Provider if You Have:

  • A fever of 100.4 °F (38 °C) or higher
  • Chills
  • Any of the following symptoms around or under your nail(s):
    • Skin that is warm, hot, or hard to the touch
    • Drainage
    • Bleeding
    • A bad smell
    • Swelling
    • Pain or discomfort
    • Redness
  • Any questions, concerns or problems
Back to top

Tell us what you think

Tell us what you think

Your feedback will help us improve the information we provide to patients and caregivers. We read every comment, but we're not able to respond. If you have questions about your care, contact your healthcare provider.
 

Questions Yes Somewhat No

Last Updated