A person undergoing chemotherapy may experience changes in their fingernails and toenails. These nail changes can affect the color or texture of their nails.

Cancer cells grow and multiply rapidly. Chemotherapy drugs target fast-growing cells, helping to slow or prevent the growth of cancer cells.

Chemotherapy drugs may also target fast-growing body cells, such as cells that control hair or nail growth. This can result in a person developing certain side effects affecting their nails.

Read on to learn more about how chemotherapy can affect a person’s nails, as well as how to manage any changes.

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Research from 2020 into the side effects of chemotherapy found that 38% of people had nail-related changes.

Chemotherapy can cause a variety of changes in a person’s nails. How a person’s nails change may vary on the basis of:

  • the type of chemotherapy drug they are receiving
  • the toxicity of the chemotherapy drug
  • how long a person has chemotherapy

Color changes

The 2020 research found that melanonychia was the most common nail-related side effect, affecting 84% of people. Melanonychia is when nail discoloration appears brown or black. In some cases, it can appear as a vertical line down the nail.

A 2019 study found that, out of 129 people receiving chemotherapy, 54% experienced color changes in their nails.

Chemotherapy may cause a person’s nails to turn:

  • black
  • brown
  • blue
  • green
  • white

People who have darker complexions may notice these changes in nail color more than people with lighter complexions.

Additionally, a person may develop Lindsey nails, which is when nails are half white and half red-brown.

Nail weakness and thinning

Chemotherapy can cause a person’s nails to become thin and brittle. They may break easily or split.

Nail loss

Chemotherapy may cause a person’s nails to lift from their nail bed. A loose nail can allow bacteria to enter the nail, causing infection.

The Leukemia & Lymphoma Society notes that chemotherapy may cause partial or full nail loss in a small percentage of people.

Beau’s lines

Beau’s lines are grooves that form horizontally across a person’s nail. They indicate periods when something has interrupted a person’s nail growth.

A 2018 case study noted that Beau’s lines were fairly common in people who had received chemotherapy.

Other nail changes

Other possible nail changes due to chemotherapy include:

  • pain around the nails
  • slowed nail growth
  • ingrown nails
  • growth on the side of the nails
  • swelling at the fingertips or tips of toes
  • dry nail bed, which is the area underneath the nail
  • frayed cuticles

Learn more about chemotherapy side effects.

There are various kinds of chemotherapy medications that a doctor can recommend. The type of drug may depend on:

  • the type of cancer a person has
  • where the cancer is
  • the size of the cancer
  • if it has spread to other parts of the body
  • how the cancer affects bodily functions and a person’s overall health

The American Cancer Society states that a person who is on more than one chemotherapy drug that causes nail changes may experience more severe side effects.

Examples of chemotherapy drugs that may cause nail changes include:

  • bleomycin
  • capecitabine
  • cyclophosphamide
  • dacarbazine
  • doxorubicin
  • idarubicin
  • methotrexate
  • docetaxel
  • paclitaxel
  • mitoxantrone
  • idarubicin
  • daunorubicin

Learn more about chemotherapy drugs.

Research from 2020 found that the time from the start of chemotherapy to when a person starts to develop nail changes was 3–6 weeks.

However, the time it takes for a person to experience nail changes may vary. A person’s doctor can help them to monitor nail changes and advise on any steps they can take to manage changes such as nail loss.

A person may use the following methods to manage nail changes due to chemotherapy:

  • Keep nails short and clean.
  • Strengthen nails by using water-soluble nail lacquer or prescription nail polish.
  • Wear gloves during house and garden work to prevent infection.
  • Avoid biting, tearing, or picking at nails or cuticles.
  • Wear loose-fitting shoes.
  • Do not get professional manicures or use artificial nails.
  • Avoid pressure on the nail bed.
  • Speak with a doctor about taking biotin, a dietary supplement, to strengthen nails.

A person’s doctor can provide more advice on ways to manage nail changes during chemotherapy.

Nail changes due to chemotherapy generally go away over time once the treatment has finished.

After a person finishes chemotherapy, their nails should begin to grow. It can take around 6 months for a person to regrow a fingernail. A toenail can take about 1.5 years to regrow.

However, the nails will not grow back in rare cases. A person should contact their doctor if their nails do not regrow or if they have concerns about the way a nail is growing.

A person may use management methods, such as wearing gloves, to help reduce their chances of developing an infection. These methods may also help to protect and strengthen a person’s nails.

If a person is taking a taxane drug such as docetaxel, applying a cold pack to the nails for 15 minutes before, during, and after the infusion may help to prevent the nail from lifting.

Chemotherapy can cause a person to develop certain nail changes. Color changes are the most common form of chemotherapy-related nail change. Other nail changes include nail weakness, nail loss, and Beau’s lines.

The type of nail change a person has can depend on the type of chemotherapy drug a doctor uses to treat them. These changes can take several weeks to develop. They generally go away in time once treatment is over.

A person may use certain methods to help strengthen and protect their nails during chemotherapy. It is best for a person to contact their doctor if they notice any nail changes while receiving chemotherapy.