Nails and nail care

Good nail-care is important in order to prevent infection. Avoidance of infection is particularly important whilst receiving chemotherapy when one’s natural defense, the immune system, is compromised. Also in the setting of previous under arm surgery, to remove the glands that drain the lymphatic fluid from the breast, one is at risk for developing lymphoedema (accumulation of fluid in the soft tissues of the arm). Good nail care to avoid infection is a first line prevention for lymphoedema.

Changes you may notice:

  • Brittle and dry nails may occur which are prone to breaking easily.
  • Cuticles may fray.
  • The nail will not grow as fast as it would have prior to the introduction of chemotherapy.
  • Multiple horizontal lines may develop along the nail. In medical terminology these lines are called “Beau’s lines”. Each line represents a cycle of chemotherapy. They are not permanent and will grow out with the nail usually in about six months.
  • Taxane-based chemotherapies, commonly used in breast cancer management, are known to cause nail discoloration and brittle nails. The nail can lift away from the nail bed and in a small proportion of women some nails may fall off. The nail will regrow.


The following are key tips to maintain good nailcare:

  • Keep your nails short.
  • Don't cut your cuticles.
  • Avoid biting your nails or cuticles.
  • Use protective gloves while exposed to washing dishes/gardening to avoid developing a fungal nail infection.
  • Massage cuticle cream into the nails on a regular basis
  • Nail polish will give added strength to the nail. However, use non-acetone-based remover to remove polish as it is less drying than acetone-based removers.
  • Avoid fake nails, acyrlics or nail wraps that can increase your risk for developing infections
  • If going for a manicure bring your own manicure set with you again to reduce the risk for infection.
  • Attend your doctor if you notice redness or cream discoloration under or around the nail bed.


External Links



Taxane-induced nail changes: incidence, clinical presentation and outcome.
Minisini AM, et. al.
Annals of Oncology 2003;14:333-337.

Nail toxicity induced by cancer chemotherapy.
Gilbar G, et al.
J Oncol Pharm Pract. 2009;15(3):143-55