Nail Changes

What are nail changes?

There are several types of nail changes which may occur in patients receiving chemotherapy. The most common of these skin reactions seen, particularly in dark-skinned persons, is hyperpigmentation (darkening). Vertical or horizontal bands, or general darkening. Drugs in which these skin reactions been known to occur include:

• Bleomycin, cyclophosphamide, daunorubicin, doxorubicin, fluorouracil, hydroxyurea, aminoglutethimide, busulfan, cisplatin, dacarbazine, docetaxel, idarubicin, ifosfamide, melphalan, methotrexate, mitomycin and mitoxantrone.
• This hyperpigmentation generally grows out with the nail.

Other nail changes include:

• Beau's lines (horizontal depressions of the nail plate). These skin reactions can occur a few weeks after a course of chemotherapy.
• Mees' lines (white horizontal discoloration of the nail plate involving the entire nail width).
• Leukonychia (white horizontal discoloration involving partial nail width).
• Onycholysis (The separation or loosening of a fingernail or toenail from its nail bed).
• Onychodystrophy (A malformation of the nail).

All of these skin reactions are temporary and eventually resolve once the drug causing the change is stopped and the affected nails grow out (this may take weeks to months).

Things you can do to manage nail changes:

• Nails should be trimmed and kept clean.
• Gloves should be worn for housecleaning and gardening to minimize damage and prevent infection.
• Nail polish and imitation fingernails should not be worn until the nails have grown out and returned to normal.

Drugs that may be prescribed by your doctor for skin reactions:

• Antibiotics may be necessary to treat infections in the nail beds.

Notify your doctor or health care provider if:

• You suspect an infection of the nails.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website about skin reactions and other medical conditions is meant to be helpful and educational, but is not a substitute for medical advice.