Fingernails damaged by chemo

kimberly1981

GROSS PICTURE AND CONTENT WARNING! I have found so much helpful info on these boards for other side effects that I wanted to post about my experience with almost losing my fingernails from chemo (taxotere) in case anyone else experiences this horrific side effect. My oncologist said I would lose them all but I searched everywhere to find something to prevent that (because it was my worst nightmare) but only found bits and pieces of info - and most of it said my nails would definitely fall off.

For starters - this is not a side effect everyone experiences, but using cold packs on your fingernails and toenails while you are getting taxotere (and other chemos with this side effect) may help prevent it. I iced the first two rounds, and then stupidly assumed it wasn't doing anything and skipped it on the 3rd round, and then resumed for rounds 4-6. When my nails grew out enough I could see exactly where the 3rd round happened and it had caused enough damage that they all started to raise and weep and some turned black. It was incredibly painful and I was barely able to do anything with my hands for months - you don't realize how much you use your nails until the smallest touch can make them pull off.

I managed to keep mine from falling off by:
1. Soaking them in Epsom salts for at least 20 minutes twice a day - you can do this in a bowl, but it was easier to do it in a bath. In a bowl, I think I did teaspoon of Epsom salts to 3 cups of lukewarm water and in a bath about 1/4-1/2 cup Epsom salts. I also tried a 1:3 and 1:2 vinegar/water mixture, but it didn't work for me.

2. After they've been soaking for a bit, if there is any fluid build up underneath the nail, keeping your finger under the water press down on the top of the nail to get it to come out. It might hurt a bit, but push down hard enough that it comes out - if you let it stay under the nail it builds up, turns purple (see middle finger below), and the pressure becomes unbearable. Once it comes out, the pain subsides a lot.

3. After you're done soaking them, pat dry and put a couple of drops of tea tree oil (anti-fungal and anti-bacterial) inside each nail (from the top of your finger between your finger and the top of the nail - like the place dirt and gunk gets stuck)

4. Use finger gauze if you can find it to keep them safe - especially while you sleep. I would cut a piece about the length of my finger then pull it down just to the mid-knuckle, fold over the extra backwards to provide cushion on the nail, and medical tape it around to hold it in place. Be careful not to do it too tight or to get it stuck on the nail if it oozes.

5. If you can bare it, keep your nails as short as possible. Clean any nail clippers you use with alcohol first and make sure to hold your nail down before you start cutting. If the pain isn't too bad, you can also use a nail file to help

For a timing perspective -

Round of chemo that did the damage - October 8, 2020

Reddish patches appeared at the bottom of my nail - Early November 2020

Bottom right pic - December 20, 2020

Bottom middle pic - December 28, 2020

Bottom left pic - January 4, 2021

Middle right pic - January 17, 2021

Middle middle pic - January 20, 2021

Middle left pic - April 6, 2021

Top pic - May 1, 2021

I started soaking them in mid-December, but didn't figure out the "get the goo out" step until late December and that made things so much better. Once you get the goo out, you will have to be very careful not to catch your nail on anything - basically the goo is your nail bed dying so your nail will only be attached to the new nail bed growth.

I'm very sorry if you find yourself on this thread because you are experiencing this, but hopefully this will help! Of all the shitty side effects, this was the one that almost broke me but it's 5 months since the worst of it and my nails are almost completely back to normal. Best of luck to anyone who needs it!

Rmayfair2011

Thank you for posting this!! I recently started feeling the effects of nail pain from Taxol and was looking for other people's experiences.

I started Taxol in late February. Used the frozen gloves every time and even had 3 different weeks where treatment was skipped til the following week due to covid vaccines and one scheduling error. I think that's helped me a lot in having minimal side effects!

I had no nail symptoms at all until I skipped the frozen treatment for my next to last treatment, which was round #11 thinking I've been fine so far so why not skip (silly me, don't do that!! Lol) and within a week I noticed some nail sensitivity and vertical lines. For my last treatment I used the frozen gloves of course but I have since had more pain and sensitivity and now I'm starting to see the red spots at the base of some of the nails.

I've read that UV light can make things worse and I've been in the sun a lot so that probably hasn't helped..

I didn't know that this would be one of the symptoms. I knew there could be the paralysis and tingling but didn't think about the nails and that part was missed in the initial side effect consultation so I've been a bit surprised!

I have read that some people lose the nails but I'm hopeful that I can keep them and this part will just grow out like your experience!

Thank you again for sharing your experience, it's been helpful and comforting!

WC3

Isn't it strange? I didn't lose any finger nails during chemotherapy but one of my big toe nails stopped growing after mildly irritated the toe accidentally. Or rather it stopped growing out. It started to look enflammed and began to weap at the base near the cuticle and I thought it was infected but I realized months later when a "ledge" became visible near the cuticle that while it was not growing out it was thicking and this pushed the cuticle up abnormally. The "ledge" was the difference in thickness between the old nail and new nail when it started growing again.

DutchieGirl

I am two years past chemo and I’m happy to say that my fingernails did quite well. A few ridges but not bad. My toenails, on the other hand, weren’t so lucky. And this has happened more recently. There are three toenails that are not flat, they’re lumpy, and they look like they’re not going to hang on. I decided to put a fake nail over top so that the new nail can grow out flat. That’s my hope anyway! I call chemo the “gift that keeps on giving”!

kimberly1981

Rmayfair2011 - I'm sorry you find yourself in a similar situation and hope it doesn't get worse than it is now. If you start seeing the reddish color creep up your nail or feel pressure underneath - start soaking them! When mine reached the black stage it was so incredibly painful and gross I considered going to a doctor to have them surgically removed. Ack!!

WC3 - Oh my, what a nightmare! Has it gone back to normal yet?

DutchieGirl - 2 years later?! That's absolutely unfair.

WC3

Rmayfair2011:

Yes but it took well over a year to grow out enough such that I could clip the last remaining bit of the ledge off.

Gonetruckin

The only mention in my side effect literature about nail problems says absolutely don’t soak or use hot water but I’m having all the symptoms you describe. My big toenail may be too far along but I’m going to try to “release the goo” and hope for the best. Do you use warm water with the epsom salt

kimberly1981

Gonetruckin - I think you aren't supposed to hot baths or showers soon after chemo. I assume because as it's coursing through your body still if you increase the circulation to your nails, it's more likely to cause damage there. I think that's why the ice works - it limits the circulation of the blood with the chemo to your nails.

The real damage on mine started after I'd finished my last round of chemo and I didn't start soaking until probably 2 weeks post. I would do warm, but not hot water with the epsom salt. Best of luck!