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Side Effect: Nail Changes

What are nail changes from cancer or chemotherapy?

Nail changes in patients with cancer can be caused by an underlying condition (such as diet or cancer), cancer treatment, infection, or radiation exposure. The exact mechanism behind these changes from chemotherapy is not fully understood, but it is thought to be related to the effect of chemotherapy drugs on rapidly dividing cells in the nail matrix and nail bed.

What do nail changes from chemotherapy look like?

Nail changes can occur in fingernails, toenails, or both. Some common nail changes include:

Nail Changes


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What types of chemotherapy treatments cause nail changes?

Chemotherapy drugs that are associated with nail changes include:

How do you prevent nail changes from chemotherapy?

Preventing nail changes during cancer treatment can be challenging, however some strategies include:

How do you treat nail changes from chemotherapy?

Some nails changes are not harmful or painful and just affect appearance. These usually do not need treatment and generally resolve once cancer treatment has completed. This includes nail discoloration, ridges or lines across the nail, thickening, pitting, and slow nail growth.

Biotin (vitamin B7) is a dietary supplement that may help to strengthen nails that are brittle. Nail lacquer or prescription nail polish can also protect splitting or delicate nails. Ask your doctor if biotin, nail lacquer, or nail polish are safe before using.

Some types of nail changes are more serious, painful, or involve an infection and require treatment. Some treatments include:

If you have any nail changes, let your doctor know as soon as possible.

References

1. American Cancer Society. Nail Changes. Accessed September 22, 2023.

2. Alzahrani MF, AlJasser MI. Nail changes during chemotherapy. New Eng J Med. 2018;379:1561.

3. Capriott K, Capriotti J, Pelletier J, Stewart K. Chemotherapy-associated paronychia treated with 2% povidone-iodine: A series of cases. Cancer Manag Res. 2017;9:225-228.

4. Chu N-S, Wu I-C, Chen L-T, Chin Y-Y. Beau’s lines in nails: An indicator of recent docetaxel and 5-FU use. Kaohsiung J Med Sci. 2018;34:181-183.

5. Cubero DIG Abdalla BMZ, Schoueri J, et al. Cutaneous side effects of molecularly targeted therapies for the treatment of solid tumors. Drugs Context. 2018;7:212516.

6. Dasanu CA, Alvarez-Argote J, Lippman SM, Plaxe SC. Longitudinal thumbnail fissures due to erlotinib therapy for lung cancer. J Oncol Pharm Pract. 2018;24:299-231.

7. Lacouture M, Sibaud V. Toxic side effects of targeted therapies and immunotherapies affecting the skin, oral mucosa, hair, and nails. Am J Clin Dermatol. 2018;19(Suppl 1):31-39.

8. Lacouture ME, Anadkat M, Jatoi A et al. Dermatologic toxicity occurring during anti-EGFR monoclonal inhibitor therapy in patients with metastatic colorectal cancer: A systematic review. Clin Colorectal Cancer. 2018;17:85-96.

9. Štulhofer Buzina D, Martinac I, Ledić Drvar D, et al. The most common cutaneous side effects of epidermal growth factor receptor inhibitors and their management. Acta Dermatovenerol Croat. 2015;23:282-288.

Created: October 14, 2023 Updated: October 14, 2023