Skin Reactions

Nail Changes

Cancer treatments can alter your finger-nails and toenails in a number of different ways. You may develop a groove across the nail plate, the nail plate may separate from the nail bed underneath, or you may lose the nail entirely. You also may experience a thickening and/or thinning of the nail, the nail may develop pale or dark streaks, and the skin around the cuticles may become inflamed or painful.

Nail changes associated with chemotherapy and other cancer treatments are often difficult to avoid. However, if you have a history of nail changes, you may be given cold gloves and slippers (or ice packs) to wear during treatment if you are receiving the chemotherapy drugs docetaxel or paclitaxel. (Cold gloves and slippers have not been shown to be effective with other types of chemotherapy.) Using cold gloves and slippers shrinks the blood vessels in your hands and feet, resulting in less medication delivered to these areas.

Nail changes will often disappear when new nails replace damaged nails. When nail changes are painful or if you experience fluid draining from the area around the nails, it may indicate an infection and your doctor may prescribe antibiotics. You can typically manage less severe changes yourself by following a few simple tips:

  • Regularly trim your nails.
  • Wear gloves when you are working with your hands (such as gardening, cleaning or washing dishes).
  • Avoid manicures, pedicures or cutting your cuticles; also avoid artificial nails during active chemotherapy. This will help reduce your risk of infection. You can resume manicures and pedicures after chemotherapy has ended.
  • Use dark nail polish to help hide any discoloration, but do not change your polish frequently because nail polish removers are harsh.
  • Soak your hands in natural oils, such as olive oil, to keep the nail beds soft.
  • Wear comfortable, loose-fitting shoes as much as you can.

Several over-the-counter antibiotics, such as polysporin and mupirocin, as well as some antiseptics, such as betadine or iodine, are available that you can apply to your nails to treat changes. Soaking your fingers and toes in a solution of one part white vinegar and one part cool tap water once a day for 15 minutes is helpful as well. If your nail problems persist, you may need to see a dermatologist.

Medications associated with nail changes:

  • capecitabine (Xeloda)
  • cetuximab (Erbitux)
  • docetaxel (Taxotere)
  • doxorubicin (Adriamycin, Doxil)
  • eribulin (Halaven)
  • erlotinib (Tarceva)
  • lapatinib (Tykerb)
  • paclitaxel (Taxol, Abraxane)
  • panitumumab (Vectibix)

Inflammation Around Nails

 

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