During chemotherapy, women sometimes experience changes to their fingernails and toenails. We often hear from women who tell us that they were not provided with information on nail changes and are unsure about what to do. We hope the following information will help you to understand the issue and what you can do to help care for your nails.
What causes the changes to my fingernails and toenails?
Changes to fingernails and toenails are a side-effect of some chemotherapy drugs used in the treatment of breast cancer. The main drugs that may cause nail changes are:
- taxanes (brand names include Taxotere, Taxol, and Abraxane)
- anthracyclines (brand names include Doxorubicin and Epirubicin which are used in treatments called AC and FEC)
- Capecitabine (brand name Xeloda)
These drugs work to treat your breast cancer by stopping cell division; however this can also affect rapidly growing cells in your body, like hair and nail cells, which may result in some of the changes listed below.
What are some of the changes that may happen to my nails?
It is important to remember that not all women who are being treated with the chemotherapy drugs listed above will experience changes to their nails.
You may notice some of the following changes to your nails:
- splitting
- breaking
- peeling
- discolouration
- ridges forming along the nail
- lines forming along the nail (known as ‘Beau’s lines’)
A small proportion of women have told us that their nails have separated from their nail beds while being treated with chemotherapy. This is only temporary, and nails will grow back.
If changes to your nails do occur, they may develop during the course of your chemotherapy treatment, or once the full course of chemotherapy treatment is completed. Most of the time these changes are temporary, and they will usually grow out with the nail. However, some women have told us that ridges and lines have remained on their nails some time after completing chemotherapy.
What can I do to care for my nails?
Some women and health professionals have given us their tips to help prevent or manage fingernail and toenail changes:
- Use a nail strengthener regularly. A nail strengthener is a special type of nail polish which can strengthen the nails when applied regularly, and can be purchased from your local supermarket or pharmacy. An example of a popular nail strengthener is ‘Revitanail’.
- Use dark coloured nail polish to protect the nails from sunlight. Black, dark brown or navy blue polish are best.
- Use nail polish remover that does not contain acetone.
- Keep your nails clipped short.
- Apply moisturising cream to your nails and cuticles regularly.
- Keep your hands and nails clean to avoid infection.
- Wear protective gloves while doing household chores, particularly when washing dishes.
- Use a topical antiseptic cream on your nails if they split or break, to avoid infection. An example of a popular topical antiseptic cream is Savlon, which can be purchased from your local supermarket or pharmacy.
Can I do anything during my chemotherapy sessions to help my nails?
You may like to ask your oncologist or oncology nurse if they have frozen gloves available at the chemotherapy centre you are attending, before you begin your first session.
Frozen gloves are ice packs that you wear as gloves. They are worn before, during and after each chemotherapy session to keep your nails cold. Research has shown that, when used this way, frozen gloves can be useful in preventing or minimising nail changes.
To use them most effectively, your hands should be placed in frozen gloves at least 30 minutes before beginning your chemotherapy session, and then left on for the duration of the session and a further 30 minutes after the session is completed. You may like to replace your gloves with a freshly chilled pair half way through the chemotherapy session so that the cold temperature is maintained.
Some women have told us that using frozen gloves can be quite painful, especially the first time they are used. Taking the gloves out of the freezer some time before putting them on, and wearing thin cotton gloves underneath them, may help to reduce pain. Alternatively, you may like to reduce the total amount of time that you wear the gloves.
Who can I talk to for help?
Most nail changes that occur during or after chemotherapy are temporary, and should heal within a few weeks. However, if you experience more severe changes, or are concerned about your nails, you may like to speak with your oncologist or breast care nurse.
You may also find it helpful to talk to other women about nail changes. BCNA has an online network where you can raise issues with other women and share your experiences.
