Originally published: December 2020

Updated: January 2022

One of the side effects that alarms most people but really, for the cancer patient, is just one more sucky thing to endure – is the threat of nail loss (read: fingernails and toenails). Chemotherapy attacks every part of your body, tip to toes.

The Good News

The nails don’t suddenly plop off, it’s a process with stages. This is really good news for the cancer patient, because it means you can take action to save your nails when the first stage begins.

The trick is to know what the early stages actually are so that you can do something about it. Knowledge is power. Don‘t let anyone tell you any different.

So here’s how nails go from healthy to falling out because of chemo:

  • Nails become yellow and brittle.
  • Toes (and/or fingers) become extremely sensitive, so that the lightest touch is painful.
  • Nails get noticeably thinner.
  • The nail bed bleeds at the corners.
  • Nails start to look brown.
  • Infections become more likely around this point.
  • Nails turn black.
  • Nails fall off completely.

Some cancer patients experience necrosis.

One day in the chemo chair, a woman going through chemo next to me explained to the Head Nurse that she had necrosis in her big right toe and that the doctor should please be informed about it as surgery would be required. I wondered how she knew that so precisely. Turned out she used to be a doctor.

Not wanting to lose my nails, I did some research on what to do about it. I also talked with a couple of nurses to see if they had any tips.

Hands and fingers, nails and toes.

Surprisingly (to me), my toes have taken more of a beating than my fingers. My fingers have experienced the typical burning sensation in the tips, becoming super brittle, thinning and yellowing. But I’ve managed to stop it getting worse. My fingers do from time to time get shaky and twitchy (from nerve damage caused by chemo), and my hand-eye coordination is at times impaired, but it’s clearly temporary.

It’s just the chemo working through that particular part of my body and causing that moment of difficulty. Other times, I can feel it in my mouth, or my brow, or my stomach. It always reveals in various side effects. On my previous chemo cocktail, I had pulsatile tinnitus for about 5-6 days at a time, every time after a session (which was once every three weeks).

It drove me nuts, but now I’m on another cocktail, and have weekly chemo sessions, the tinnitus and thrushing sound is gone. It’s a huge relief and means I can sleep much better.

NOTE of UPDATE: I’m now 100% cancer free. My last cancer treatment (EVER) was three weeks ago and I‘m doing much better. I still have a long way to go in the healing process, but I am healing.

My Toes

My toes are another matter. Some of my toenails have turned brown, I’m constantly fighting against infections, and sometimes they bleed. But I have managed to push it back – to stop the progression of decay – so that my toenails are looking and feeling pretty OK. Not great, but no longer in constant pain.

NOTE of UPDATE: These side effects have subsided. My nails are splotchy white now, and the bleeding has stopped. I still have tenderness and am still doing physical therapy exercises to recover from nerve damage.

What I do to keep my nails.

REMINDER: I’m no doctor, but everything here is an action recommended to me by a doctor either in person, or through a scientific study, or one of the nurses, or an article provided by a health organization that focuses on breast cancer. None of it is strange or risky in any way.

1. During Chemo, Wear Scuba Gear

No, I’m really not joking. You don’t need scuba gear for every kind of chemo, just the chemo all the cool kids are on. I remember when I was starting with chemo, I noticed one of the women wore these cool looking gloves and booties. I learned later that it was to protect her nails.

During chemo, I wear scuba booties that are a size too small to help cut off the circulation to my toes while the drugs are being administered. I also wear too-tight scuba gloves during chemo. The doctors recommend this as studies have shown it to help, and the scuba diving supplier gave me a huge discount because I need it for chemo and not scuba diving.

The shop where I went gives this huge discount as part of their mission, to help cancer patients. Otherwise, the stuff is super expensive. I got my stuff at half price.

2. Use Ice Packs

Every once in a while, I ice down my hands and feet to keep them cool.

If I can take the intensity of the cold, I also wear ice-booties and ice-gloves on top of everything else. And yes, I do feel the ice through the scuba gear I’m wearing. Sometimes though, I just can’t take the cold. So I have the ice on for a bit, then take it off again, back and forth as I can.

Chemo has heightened my sensitivity to temperatures and increased my general feeling of being chilled a lot of the time. But I also have extreme hot flashes where I sweat like a teenaged boy. So I’m pendulating.

3. Take Supplements

I take a LOT of supplements. If you’re on chemo, take your list of chemicals and check online to see what supplements you should avoid. You just want to be sure a supplement doesn’t hamper your chemo. But nothing I’m taking here is going to impair any kind of chemo – I’m just saying it’s good to be cautious.

For my nails, I make sure to take Vitamins E, C, D3, and K2. This also protects pretty much everything else, like teeth and nails. I think it’s also why I still have some eyebrows and eyelashes. Most chemo patients lose all of it completely and pretty early.

NOTE of UPDATE: I continue to take these supplements, plus Biotine and Zinc because I read that these can help foster nail growth.

4. Use nail polish type stuff

When you’re on chemo, you can’t get a manicure or pedicure. Nails need to be kept naked. I know this because I went to my nail salon and told my guy about the chemo I was about to face. I asked if he had any tricks. He said he would remove what was currently on my nails and see me again when I was all done with the chemo. He’s a good man and we talked a while about his dad’s struggle with cancer. So he knew all about it.

I use three different nail treatments. These are different, very different, from nail polish or anything you’d get at a salon. They’re basically an externally applied vitamin booster. All of these are from Art Deco, so very affordable. And they really work.

Hydra Nail Balm feels like a lotion and helps hydrate my nails and cuticles, which is great. It has a nice cooling effect on my nails and stops them from becoming more brittle. My nails were chipping off rather badly – like layers – until I started using this.

Intensive Nail Treatment is an oil, and it keeps my nails from splitting. Also helps my cuticles. When my toes are starting to feel sore and swollen, like they might start bleeding again, I apply this immediately and the pain subsides. So this is a must have for me.

Nail Perfecter from Art Deco is the closest thing to a polish I currently use, but it isn’t one. It’s a sealant of sorts. It’s important to keep nails dry – out of water – while going through chemotherapy. When I’m in the tub, I elevate my toes and fingers out of the water every so often. But I use this stuff to sort of keep my nails together. I don’t know how else to describe it, but I know it makes a huge difference.

5. Sports Tape

Sports tape is generally used to save sore muscles on athletes, but when my nails started to brown and bleed, lightly taping around them is a big help. The pressure (just not too much pressure) makes me feel more secure. Sports tape is best I think because it’s stretchy and breathes, not like most bandages.

The Head Nurse recommended this to me as well. To tape them up. My personal recommendation is to use sports tape.

Help to Help

What about you? Are you going through chemo or know someone going through chemo? If you have tips to share, or questions about what to do to manage chemo side effects, write below and let me know. Let everyone know! Knowledge is power. You can’t beat it if you don’t know what needs getting beat.