Cancer Treatment: Skin/Nails and Chemotherapy

The side effects of chemotherapy depend on the type of chemotherapy and the amount given. Anticipating and managing side effects can help to minimize them and provide the best possible experience for the person receiving chemotherapy.

Chemotherapy's potential effects on the skin and nails

As each person's individual medical profile and diagnosis is different, so is his or her reaction to treatment. Side effects may be severe, mild, or absent. Be sure to discuss with your cancer care team possible side effects of treatment before the treatment begins.

Chemotherapy can affect both the skin and nails. It may cause an increased sensitivity to the sun as well as redness, rashes, itching, peeling, dryness, or acne. Nails may become darkened, yellow, brittle, or cracked, and may also develop vertical lines or ridges.

Sometimes, chemotherapy causes the skin along the vein to darken, especially in people who have very dark skin. Cosmetics or makeup may be used to cover the darkened area, but this can take a lot of time if more than one vein is affected. After treatment ends, the darkened areas often fade over time.

Although some side effects can be self-managed, others require immediate medical attention. If you are receiving intravenous (IV) drugs, be sure that you immediately report any burning or pain to your doctor. Sometimes, intravenous drugs can leak out of the vein, potentially causing tissue damage. These symptoms need to be reported to your doctor or nurse right away.

Other skin and nail symptoms may indicate an allergic reaction. Tell your doctor or cancer care team immediately if you develop sudden or severe itching, rash or hives, wheezing, or any other labored breathing.

How can I manage skin and nail problems?

The National Cancer Institute recommends the following strategies for reducing skin and nail problems related to chemotherapy:

Acne:

• Keep your face clean and dry.
• Discuss with your doctor the use of any over-the-counter medicated creams or soaps before using them.

Itching and dryness:

• Apply cornstarch like you would using a dusting powder.
• Take quick showers or sponge baths, not long, hot baths. Use a mild, moisturizing soap.
• Pat skin dry instead of rubbing it.
• Apply cream or lotion to your skin while it is still moist.
• Shave less often or stop shaving if it irritates your skin.
• Avoid perfume, cologne, or aftershave lotions that contain alcohol.

Nail problems:

• Avoid nail-strengthening products as they may bother your skin and nails.
• Keep nails clean and short.
• Check with your cancer care team before getting a manicure.
• Wear gloves when doing housework or working in the garden.
• If you note redness, pain, or changes around the cuticles, consult your doctor.

Sunlight sensitivity:

• Avoid direct sunlight as much as possible, and especially stay out of the sun between the peak hours of 10 a.m. and 4 p.m. when the sun's rays are the strongest. Even if you have dark skin, protect yourself from the sun.
• Use a sunscreen lotion with a skin protection factor (SPF) of 15 or higher. Zinc oxide, sold over the counter, can block the sun's rays completely.
• Use a lip balm with a high sun protection factor.
• Wear long-sleeve cotton shirts, pants, and hats with a wide brim (especially if you have hair loss) to prevent your skin and scalp from sunburn.

If you develop a rash or have sudden severe itching, call your doctor. Ask your health providers what other symptoms require an immediate call to the office. Try to remember that as difficult as skin and nail problems can be, most do go away after treatment.

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