Author: Dr Bassa Oncology

Just as chemotherapy affects your hair because of the rapidly dividing hair follicle cells, it also affects your nails.

You may see a line in the nail related to the cycle of chemotherapy. This line is not permanent and grows out with the nail, usually in about six months. There may even be multiple lines and indentations reflecting the different cycles of chemotherapy.

Your nails may become pigmented or discolored. They may become more brittle, so they won’t grow as long as they used to and may break more easily.

The area around the nail bed may become dry, and your cuticles may fray. Don’t rip or peel off the loose cuticle. Cut it carefully with a CLEAN pair of nail scissors.

The nail may actually lift off the nail bed. While this, too, is reversible, you need to be very careful, for two reasons. First, the nail is more vulnerable and may fall off. Second, because the nail is not tightly bound to the nail bed, it can become a site for bacteria to enter. So be sure to practice excellent hygiene to avoid infection.

Nail care is first-line prevention for lymphedema, a condition that develops when lymph fluid accumulates in the soft tissues of the arm, causing it to swell. If you’ve had an underarm lymph node dissection (with mastectomy or lumpectomy), you should be particularly careful of damage to the nail, such as hangnails or cuts or burns on the hands or fingers, which could lead to infection.

Tips for better nail care
Clip your nails short. Imperfections show up less in short nails.
Don’t cut your cuticles. Use cuticle remover cream or gels and push your nails back gently.
Don’t bite your nails or cuticles, particularly on the hand on the same side as your affected breast. If you have a hard time stopping, consider wearing thin white cotton gloves around the house to help you break this habit.
Massage cuticle cream into the cuticle area daily to prevent dryness, splitting, and hangnails.
Wear gloves while doing chores, such as washing dishes. Excessive exposure to water can lead to fungal infections of the nail bed.
Wear nail polish to help keep nails strong and protected from the environment (and looking nice, too). If your nails are very dry or falling off, you might want to consider a nail moisturizer instead of polish.
Dry nails can become weaker or more brittle during chemotherapy treatment. To take off polish, use non-acetone-based remover, which is less drying than acetone.
Don’t use acrylics or other nail wraps. Fake nails can trap bacteria that may cause infection.
If you have a professional manicure, bring your own instruments, regardless of how the salon cleans theirs.
Ask a professional manicurist for more information on daily home care to keep your nails healthy and strong.
Alert your doctor to any signs of inflammation or infection.

Why do some chemotherapy patients lose their hair, not just on the scalp, but also on their eyebrows, eyelashes, and the rest of their bodies?

Many of the drugs work by attacking the rapidly dividing cells in the body, and tumor cells or cancer cells are rapidly dividing cells. But there are normal cells in the body that are also rapidly dividing, and the chemotherapy drugs affect those normal cells as well, which gives us side effects. Because hair follicles divide fast, they’re also susceptible.

Some chemo drugs are more likely than others to cause hair loss, Lacouture says. Ask your doctor about the likelihood of hair loss before you start your treatment, so you are prepared and know what you may expect. After chemotherapy begins, any hair loss usually progresses quickly.

Generally, patients notice it when they wake up in the morning and they look at their pillow. They’ll see hair on their pillow, Then they’ll start brushing it and noticing that it comes out in clumps.

It is emotionally challenging for someone who is losing their hair. Once a person takes steps such as wearing a wig or cap to feel more attractive, self-esteem may improve.

If your doctor says that your hair is likely to fall out, decide before you begin chemo whether you want to wear a wig. You may want to shop before treatment to match your hair color.
The CANSA association can direct women to places that can help them with wigs. Sometimes, medical aids will also help cover the cost of a wig for cancer patients.
Hats, turbans, and scarves can also camouflage hair loss, although some people prefer to leave their heads uncovered. If you go bare-headed outdoors, be sure to use sunscreen on your scalp.
Cut your hair short. It eases the inconvenience of shedding lots of hair, but it also can reduce the emotional impact of watching your hair fall out.
Don’t perm or color your hair during chemotherapy. Those chemical treatments are already damaging to hair and can enhance hair loss. Once your chemo treatments are done and your hair has grown back, it’s OK to resume dyeing or perming hair.

With chemotherapy, hair loss is almost always temporary. But when it grows back, it may be a different color or texture. In older adults who still had hair color before chemotherapy, the new growth may be completely gray. Often, new hair is very fine and soft.