Nail and Skin Changes

Updated 
August 31, 2015

Normal, healthy skin and nails appear smooth and have a consistent color. During breast cancer treatment, you may notice a number of changes to your skin and nails.

In most cases, nail and skin problems get better within a few weeks to several months after you stop the treatment that causes them. Still, when you have nail and skin problems, they can be upsetting to see and may cause discomfort. We will help you understand why you might have these side effects, and what you can do to manage them. 

What Are the Symptoms of Nail and Skin Changes?

Symptoms of Skin Changes May Include:

  • Redness
  • Rash
  • Thin or fragile skin
  • Peeling or blistering skin
  • Itching
  • Pain, soreness or burning
  • Dryness
  • Acne
  • Increased sensitivity to the sun
  • Darkening or color changes of your skin

Symptoms of Nail Changes May Include:

  • Painful, thin, brittle or cracked fingernails and toenails
  • Nail blemishes such as lines or small indentations
  • Ragged or dry cuticles
  • Darkening or color changes of your nails
  • Nails that lift off the nail bed

While most of these side effects are not serious, be sure to tell your doctor right away if you develop any signs of an allergic reaction, such as severe itching or rash, swelling or burning near your IV site. Also, call your team if you see signs of infectioninfo-icon, such as skin or nails that look red, feel painful or are warm to the touch.

What Causes Nail and Skin Changes?

Chemotherapyinfo-icon, radiationinfo-icon, and some hormonal and targeted therapies can all cause nail and skin changes. Other issues that result from treatment—injury, irritation, infectioninfo-icon and vitamin deficiency—can also affect the health of your nails and skin.

Chemotherapy works well at killing fast-growing cells like cancer cells. But some other, healthy cells in our bodies are also fast-growing. Those include the cells that help skin stay soft and nails to grow. Chemotherapy can make your skin more sensitive and reduce the oil your skin makes, causing dryness.

Chemotherapy medicines that may cause nail and skin changes include:

Radiation can cause a gradual, sunburn-like skin reaction on the area being treated. Because radiation affects nerveinfo-icon endings in your skin, it can cause your skin to feel more sensitive to touch.

The hormonal therapy tamoxifen, as well as the targeted therapies lapatinib (Tykerb) and everolimus (Afinitor) can cause nail and skin changes as well.

How Can I Avoid Nail and Skin Changes or Manage Them if They Occur?

Tips to Prevent Skin Changes or Lessen the Symptoms if You Develop Them

  • Ask your team to help you manage skin reactions by giving skin care tips, prescribing medicineinfo-icon or recommending salves, such as pure aloe.
  • Avoid hot baths. Apply lotions and creams while your skin is damp.
  • Use mild, unscented soaps.  Avoid any skin products containing alcohol and lotions with scents or perfumes, as they can further irritate the skin.
  • Avoid direct sun as much as possible. Wear long sleeves, pants and hats when outside. Use sunscreen and lip balm with an SPF of 15 or higher.
  • Eat a healthy, balanced diet and drink 8-10 glasses of fluid a day.

Tips to Prevent Nail Changes or Lessen the Symptoms if You Develop Them

  • To protect your nails, keep them trimmed and clean.
  • Wear gloves when doing household chores, gardening or cleaning.
  • Avoid cutting or removing your cuticles. Instead, use a good moisturizer or massage them with natural oils such as olive oil or vegetable oil.
  • Polish your nails to make them strong, but do not use artificial nails as they can increase your risk of infectioninfo-icon.
  • Look for roomier shoes if your toenails become painful.
  • If your nails lift off, keep them clean and protected.  You can use a bandage to protect them from any traumainfo-icon. Talk to your providers.
  • If you go to a dermatologist, a skin doctor, make sure to explain that you are getting breast cancer treatment. Nail changes can look like fungus, and you don’t want to get an anti-fungal treatment if you don’t need it.

If you have metastaticinfo-icon breast cancer, learn more about ongoing treatment and nail and skin changes.