Like fingernails, toenails can develop other disorders, lines, ridges, and discolorations, and even come loose during chemotherapy.
Your nails may take on a bruised appearance, turning various shades of black, brown, purple, blue and green. Blemishes, such as horizontal and vertical lines and small indentations, may develop on your nails in response to different cycles of chemotherapy. These marks will grow out along with the affected nails.
Dark areas near the cuticle of the nail (subungual lesions): These look like bruises under the nails, and are usually along the bottom edge of the nail, near the cuticle. These kinds of color changes can be seen in nail cancer (called melanoma) and can also be a side effect of some types of drugs used to treat cancer.
Strengthen Your Toenails
Taking a biotin supplement may help strengthen fragile nails. Biotin is a B-complex vitamin, but talk to your oncologist before starting. Some vitamin supplements may interfere with chemotherapy. 3 Clear polish may also help protect toenails during treatment.
Some types of chemotherapy can cause your skin to become dry, itchy, red or darker, or peel. You may develop a minor rash or sunburn easily; this is called photosensitivity. Some people also have skin pigmentation changes. Your nails may be dark and cracked, and your cuticles may hurt.
Taxanes are one of the most common cancer chemotherapeutic agents causing nail toxicity. Most of the cases have been attributed to docetaxel after variable schedule like weekly, 3-weekly, and undefined schedules of administration or combination therapy.
Chemotherapy, especially the types with taxanes (such as Taxotere) may cause your nails to become dry, brittle and fragile. They may also discolour or develop grooves or ridges and at worst they may fall off. Whether or not you experience these side-effects depends on the type of chemo and the doses.
Avoid harsh chemicals:
Nail polish will cause your nails to dry up even faster. These chemicals can be harsh on the nails and can cause further damage during chemotherapy.
Chemotherapy and radiation therapy may cause changes in the lining of the mouth and the salivary glands, which make saliva. This can upset the healthy balance of bacteria. These changes may lead to mouth sores, infections, and tooth decay.
You may have multiple lines or indentations that mark the different cycles of chemotherapy. These spots are not permanent, and will grow out with the nail. Your nails may become thin or brittle. Your nails probably won't grow as long as they used to and may tend to break more easily.
It generally takes about 48 to 72 hours for your body to break down and/or get rid of most chemo drugs. But it's important to know that each chemo drug is excreted or passed through the body a bit differently.
Having tingling (“pins and needles”) or numbness in the hands or feet is a common side effect of some types of chemotherapy drugs. This is called peripheral neuropathy. It may last for a few months after treatment finishes or it may be permanent.
So, it is not surprising that many people feel that they age dramatically during chemotherapy. During chemotherapy, the epidermis loses its ability to hold on to moisture, which leads to fine lines in the skin's surface. In the dermis, the collagen and elastin break down, which weakens the skin's support structure.
How quickly hair regrows varies from person to person but most people will have a full covering of hair three to six months after treatment. For some people this may be patchy. Hair may be weak and fragile or softer to begin with but over time the condition and texture of hair becomes stronger.
Although rare, skin cancer, including melanoma — the deadliest form of skin cancer — can develop under and around the fingernails and toenails. While anyone can develop melanoma on their nails, it's more common in older individuals and people with skin of color.
For most people the side effects were worst in the first few days after treatment, then they gradually felt better until the next treatment. Some said the effects were worse with each successive treatment. Most side effects don't persist and disappear within a few weeks after the end of treatment.
Some cancer drugs affect the growth of skin cells or small blood vessels in the hands and feet. This causes hand-foot syndrome. Once a drug is out of the blood vessels, it damages the surrounding tissues. This causes symptoms that range from redness and swelling to problems walking.
First, don't panic. Even if your toenail falls off, it will grow back within three to six months. However, getting treatment from your trusted podiatrist can help to protect your toe while your nail grows back and prevent further infection from developing.
Onycholysis is when your nail separates from its nail bed. It often appears after an injury to your nail, but it may have other causes, including fungi. Treatment may only involve cutting away the separated nail as it grows out, or you may need to take antifungal medications or stop using certain nail products.
The most frequently cited drugs that cause photo-onycholysis are tetracyclines, psoralens, and fluoroquinolones. Medications such as chlorpromazine, chloramphenicol, and oral contraceptive pills may also cause photo-onycholysis but rarely.