Chemotherapy finger alterations: Anticipated modifications and methods for handling them
In the course of undergoing chemotherapy treatment, it's not uncommon for individuals to experience changes in their nails. These alterations can range from subtle to severe and may include discoloration, ridging, brittleness, weakening, onycholysis (nail separation), and increased vulnerability to infections.
These changes occur due to chemotherapy agents, particularly those targeting rapidly dividing cells, affecting the nail matrix where new nail forms. Taxanes, such as paclitaxel and docetaxel, and anthracyclines are known to be particularly harsh on nails.
While these changes can be concerning, there are strategies to minimize nail damage and discomfort. First and foremost, gentle nail care is crucial. This includes keeping nails trimmed and clean, avoiding nail varnish, manicures, or pedicures that may traumatize nails.
Protection is another key factor. Wearing gloves during activities like washing dishes or gardening can prevent mechanical trauma and infections. Regular moisturization, especially around cuticles and nail edges, helps maintain nail hydration and flexibility. Some products, like Polybalm®, are specifically formulated for cancer patients.
For those at risk of developing hand-foot syndrome—a condition characterized by redness, swelling, and pain around the nails and on the palms and soles—preemptive measures include the application of urea-based moisturizers, avoidance of irritating agents, and use of appropriate footwear.
Early dermatology consultation is essential for emerging severe skin or nail reactions, including infections or immune-related effects from newer targeted or immunotherapies.
It's important to note that chemotherapy may cause partial or full nail loss in a small percentage of people. In rare cases, nails may not grow back after chemotherapy. If this happens, it's advisable to contact a doctor for further guidance.
The time frame for nail changes to appear varies, typically occurring 3-6 weeks into treatment, but this can differ from person to person. Fortunately, these changes usually resolve once the treatment has finished, although it may take around 6 months for a fingernail to regrow, and about 1.5 years for a toenail.
Different types of chemotherapy drugs can cause varying nail changes. For instance, Beau's lines, grooves that form horizontally across a person's nail, can be a result of chemotherapy treatment. If a person is taking a taxane drug such as docetaxel, applying a cold pack to the nails before, during, and after the infusion may help to prevent the nail from lifting.
In conclusion, supportive nail care focusing on protection, hydration, and avoiding trauma is key during chemotherapy treatment to reduce the incidence and severity of nail changes. If any nail changes are noticed during treatment, it's best to contact a doctor for advice and management strategies.
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