Nail Changes

Other possible causes

There are a few other reasons your nails might change.

Certain cancers

Some cancers, especially skin cancers, can show up as nail changes. For example, some melanomas may appear as a thin, dark line or a bruise under the nail.  

For pictures of melanomas under the nail, see Skin Cancer Image Gallery. 

Other medicines or treatments

Remember that while some cancers and cancer treatment can cause changes in your nails, non-cancer conditions and medications can also cause them. It's important to talk to your health care team about any medical problems you might have. Also make sure they know all the medications, vitamins, minerals, and supplements you are taking.

With this information, you and your health care team can discuss your risk and what to expect.

Treatments

The treatment for nail changes depends on what signs or symptoms you’re having. Not all nail changes need to be treated. Most changes are short-term and improve after cancer treatment ends.

Always talk to your doctor or cancer care team before starting or stopping any new medicine, supplement, or treatment.

For pain or swelling

While most nail changes aren’t painful, nail inflammation or infection can cause pain or swelling. Your health care team might suggest daily vinegar nail soaks (equal parts white vinegar and water). Over-the-counter medicines such as non-steroidal anti-inflammatory drugs (NSAIDs) can also help relieve your symptoms.

For nail weakness, splitting, or ridges

For minor, non-painful nail changes like weakness, splitting, or ridges, you can use a water-soluble nail lacquer or a prescription nail polish to protect your nails from damage. Biotin (a dietary supplement) may also be prescribed to strengthen your nails.

For infected nails

If you have a nail infection, your health care team might prescribe antibiotics, antifungals, steroid ointment, NSAIDs, or other medicines.

For nailbed lifting (onycholysis)

If you have nailbed lifting with pain, you might need to have that nail removed surgically to relieve the pain.

Tips for preventing and managing nail changes

It may not be possible to prevent nail changes during cancer treatment, but there are steps you can take to manage minor nail changes, and to avoid making them worse.

Protect your hands and feet:

• Check your hands and feet every day to look for changes in your nails.
• Avoid excessive or prolonged pressure, friction, or injury to your nails.
• Wear protective gloves or shoes during activities that could damage or injure your hands or feet.
• Wear socks and shoes that aren’t too tight.

Use gentle soaps and skin-care products:

• Avoid skin-care products and lotions that have harsh chemicals, strong perfumes, or fragrances. These can be irritating.
• Wash your hands and nails with soap and water instead of hand sanitizer, which can sometimes irritate skin or nails.

Take extra care when trimming or polishing your nails:

• Keep your nails trimmed short, but don’t cut or trim your cuticles (due to risk of infection).
• Don’t get professional manicures or pedicures.  
• Don’t use nail polish removers or hardeners.
• Use a water-soluble nail lacquer or ask about a prescription nail polish if you have weak, brittle, or splitting nails.

Consider using cold packs if your chemo includes a taxane:

• If you are taking a taxane (especially docetaxel), consider applying cold packs to your nails for 15 minutes before the infusion, during the infusion, and for 15 minutes after the infusion. This may prevent nail lifting. Talk to your nurse or doctor first.

It’s important to tell your health care team as soon as you notice any expected or unexpected changes to your nails. Preventing and avoiding injuries to your nails is an important part of keeping them as healthy as possible.

Learn more

• Managing Cancer-related Side Effects
• Hair, Skin, and Nail Changes