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1. What are several changes that can occur in the nail due to toxicity from chemotherapy drugs?

  • Groves in the nail plate, (Beau’s line).
  • Separation of the nail plate from the underlying nail bed, (Onycholysis).
  • Loss of entire nail, (Onchomadesis).
  • Nail pain, thickening and/or thinning.
  • Hyper- or Hypo-pigmentation- pale or dark streaks in the nail plate.

2. Which drugs are responsible for these changes?

  • 5-FU (Adrucil) - Is a chemotherapy drug that interferes with the growth of cancer cells. It can be used to treat many types of cancers, including cancer of the colon, rectum, breast, stomach, head, and neck.
  • Adriamycin (chemical name: doxorubicin) - Adriamycin can be used to treat early-stage or node-positive breast cancer, HER2-positive breast cancer, and metastatic disease. Adriamycin is sometimes combined with cytoxan and/or 5-fluorouracil to make a cocktail of breast-cancer fighting chemotherapy drugs.
  • Bleomycin - Bleomycin belongs to the general group of medicines called antineoplastics. It is used to treat several types of cancer, including cervix and uterus cancer, head and neck cancer, testicle and penile cancer, and certain types of lymphoma.
  • Capecitabine - used to treat breast, colon, or rectal that has spread.
  • Cyclophosphamide - is used for the treatment of lymphoma, leukemias, multiple myeloma, mycosis fungoides, neuroblastoma, retinoblastoma, and cancers of the breast and ovary.
  • Daunorubicin (brand names: Cerubidine, DaunoXome) - is used to treat acute lymphocytic and myelocytic leukemias.
  • Docetaxel (Taxotere) - A drug, in the same family as taxol that is used in chemotherapy that interferes with the growth of cancer cells and helps slow the growth and spreading throughout the body. This drug affects the quick growing cells such as hair, nails, and skin.
  • Lxempra (chemical name: ixabepilone) - Ixempra is used to treat metastatic breast cancer after other chemotherapy medicines have stopped working.
  • Methotrexate - interferes with cell DNA and RNA, preventing cancer cells from multiplying and growing, and causing cancer cell death.
  • Mitoxantrone (brand name: Novantrone) – Is used to treat Prostate cancer and Acute nonlymphocytic leukemia.
  • Paclitaxel (Taxol) - A drug used in chemotherapy that interferes with the growth of cancer cells and helps slow the growth and spreading throughout the body. This drug affects the quick growing cells such as hair, nails, and skin.
  • Tamoxifen - This drug blocks the effects of estrogen on many organs such as the breast.

Note: Check out our glossary for more cancer-related terms and their meanings.

3. Is there anything I can do to prevent or help manage these changes?

  • Apply Tea Tree oil to fingernails and toe nails 2 x daily by brushing it on, then massaging on nail and around nail bed until absorbed. 
  • Keep nails trimmed short.
  • Wear a non-chemically based nail strengthener on your nails.
  • Talk to your doctor about painkillers, as some of these changes can be extremely painful.

Note:  Often nail changes disappear when the damaged nail is replaced by the growth of the new nail.

4. Is it safe to receive a professional manicure while I am undergoing cancer treatment?

It is important that you choose a technician who has experience working with clients that have a compromised immune system, and who practices the strict rules of sanitation and sterilization.

5. What is the best way to decrease the risk of infection in my nails?

  • Avoid cutting your cuticles.
  • Do not share implements, (files or clippers).
  • Avoid the use of acrylic or Gel nails. If you already have them on your natural nails, have them removed prior to beginning your cancer treatment.

6. What do I do if I notice that my nails are cracking, peeling, or chipping?

You will notice these changes due to the nail and surrounding areas becoming dehydrated. Begin by applying to the nail and surrounding area, A.M., & P.M.  You should expect to see dramatic changes with the use of this powerful product. 

7.  What should I do if I noticed my nails are becoming discolored?

There is a new product by Zoya that can correct, camouflage and prevent the discoloration of your nails and it is available in our centers and online here