Side Effects of Chemotherapy

Skin and Nail Changes

Some types of chemotherapy can damage the fast growing cells in your skin and nails. While these changes may be painful and annoying, most are minor and do not require treatment. Many of them will get better once you have finished chemotherapy. However, significant skin changes need to be treated right away because they can cause life-long damage.


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. 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.
  • Radiation recall
  • Protect the area of your skin that received radiation therapy from the sun and do not use tanning beds.
  • Place a cold, wet cloth on your skin where it hurts.
  • Wear clothes and underwear (bras, underpants, and t-shirts) made of cotton or other soft fabrics.
  • Let your doctor or nurse know if you think you have radiation recall.

Minor Skin Changes may Include

  • Itching, dryness, redness, rashes and peeling.
  • Darker veins. Your veins may look darker when you receive IV chemotherapy.
  • Sensitivity to the sun (when you burn very quickly). Sun sensitivity can also affect people who have a dark skin colour.
  • Nail problems. Your nails may become darker, turn yellow, or become brittle and cracked. Sometimes your nails will loosen and fall off, but new nails will grow back.


Changes in your skin can be caused by:

  • Radiation recall. Some chemotherapy causes skin in the area where you had radiation therapy to turn red (ranging from very light to bright red). Your skin may blister, peel or be very painful.
  • Chemotherapy leaking from your IV. You need to let your doctor or nurse know right away if you have burning or pain when you receive IV chemotherapy.
  • Allergic reactions to chemotherapy. Some skin changes mean that you have an allergy to chemotherapy. Immediately inform your doctor or nurse if you have sudden or severe itching, rashes, hives, wheezing or other trouble breathing.


Ways to manages skin changes

  • Look out for itching, dryness, redness, rashes and peeling.
  • Apply cornstarch to the affected area, as you would apply a dusting powder.
  • Take quick showers or sponge baths instead of long, hot baths.
  • Pat (do not rub) yourself dry after bathing.
  • Wash with a mild, moisturising soap.
  • Put on cream or lotion while your skin is still damp after washing. Tell your doctor or nurse if this does not help.
  • Do not use perfume, cologne, or aftershave lotion that contains alcohol.
  • Take a colloidal oatmeal bath (a power you add to bath water) when your whole body itches.



  • Keep your face clean and dry.
  • Ask your doctor or nurse if you can use medicated creams or soaps and which ones to use.


Sensitivity to the sun

  • Avoid direct sunlight. Stay out of the sun when it is at its strongest between 10 a.m. and 4 p.m.
  • Use a sunscreen lotion with an SPF (Skin Protection Factor) of 15 or higher, or use ointments that block the sun’s rays, such as those containing zinc oxide.
  • Keep your lips moist with a lip balm that has an SPF of 15 or higher.
  • Wear light-coloured pants, long-sleeve cotton shirts, and hats with wide brims.
  • Do not use tanning beds.


Nail problems

  • 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 discoloured. 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.

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