Nail Cooling During Treatment with Taxane-based Chemotherapy

This information explains how cooling your hands, feet, or both during taxane chemotherapy can help minimize nail changes.

You may have changes in your fingernails and toenails if you are taking a class of chemotherapy medications called taxanes. Taxanes that commonly cause nail changes include:

  • Docetaxel (Taxotere®)
  • Paclitaxel (Taxol®)
  • Albumin-bound paclitaxel (Abraxane®)


You may have any of the following symptoms in your nails:

  • Discoloration in nails (dark or light)
  • Grooves or ridges
  • Brittle nails and changes in nail shape or texture
  • Nail splitting
  • Nail separation from the skin below, which may or may not be painful
  • Discharge or fluid from under the nail, which may or may not be an infection. It may be foul-smelling and painful.
  • Swelling in the tips of your fingers or toes
  • Slow nail growth
  • Growth on the side of your nails

Nail changes vary from person to person. Some people do not experience any nail changes, while others experience a wide range of symptoms. You may find that nail changes makes some of your everyday activities more difficult.

Once the taxane chemotherapy is stopped, your nails should begin to improve and eventually return to normal. This healing may take time because nail growth is a slow process. For more information about how to care for your nails while on taxanes, ask your nurse for the resource, Nail Changes During Treatment with Taxanes.

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Nail Cooling

Figure 1.

Cooling of the nails on your hands and feet during taxane chemotherapy may help to minimize nail changes. It is most effective for reducing the symptoms of nail separation from your skin.

During the nail cooling

Your nurse and other members of your healthcare team will wrap your hands, feet, or both in ice packs or ice bags, at least 15 minutes before you start chemotherapy (see Figure 1). The ice will stay on throughout your treatment, and will be removed 15 minutes after your chemotherapy ends. The ice may need to be changed during your treatment if it starts to melt. It is important to keep the ice on during the recommended time so that you can fully benefit from the cooling.

Effectiveness of nail cooling

Studies have found that people who use nail cooling have fewer changes in their nails than people who don’t. The effects vary from person to person, so it is hard to predict how this will affect you. However, nail cooling is safe and has few risks. Talk with your healthcare provider if you have any questions or concerns.

Side effects of nail cooling

Most people are able to tolerate nail cooling without any problems. Some people find the ice to be uncomfortable and too cold. It may also prevent you from using your hands and moving around during treatment. Some people stop the cooling because of these side effects.

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