Virginia Commonwealth University

VCU Massey Cancer Center

Effects on the skin and nails

The side effects of chemotherapy depend on the type of chemotherapy and the amount given. Anticipating and managing side effects can help to minimize them and provide the best possible experience for the person receiving chemotherapy.

Chemotherapy’s potential effects on the skin and nails
How can I manage skin and nail problems?

Chemotherapy’s potential effects on the skin and nails

As each person’s individual medical profile and diagnosis is different, so is his or her reaction to treatment. Side effects may be severe, mild or absent. Be sure to discuss with your cancer care team any/all possible side effects of treatment before the treatment begins.

Chemotherapy can affect both the skin and nails. It may cause an increased sensitivity to the sun as well as redness, rashes, itching, peeling, dryness or acne. Nails may become darkened, yellow, brittle or cracked, and also may develop vertical lines or ridges.

Sometimes, chemotherapy causes the skin along the vein to darken, especially in people who have very dark skin. Cosmetics or makeup may be used to cover the darkened area, but this process can be time consuming if more than one vein is affected. After treatment ends, the darkened areas often fade in a few months.

Although some side effects can be self-managed, some conditions require immediate medical attention. If you are receiving intravenous drugs, be sure that you immediately report any burning or pain to your physician. Sometimes, intravenous drugs can leak out of the vein, potentially causing tissue damage. These symptoms need to be reported to your physician right away.

Other skin and nail symptoms may indicate an allergic reaction. Consult your physician or cancer care team immediately if you develop sudden or severe itching, rash or hives or wheezing or any other labored breathing.

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How can I manage skin and nail problems?

The National Cancer Institute recommends the following strategies for reducing skin and nail problems related to chemotherapy:

Acne

  • Keep your face clean and dry.
  • Discuss with your cancer care team the use of any over-the-counter medicated creams or soaps before using them.

Itching and dryness

  • Apply cornstarch like you would using a dusting powder.
  • Take quick showers or sponge baths, not long, hot baths. Use a moisturizing soap.
  • Apply cream or lotion to your skin while it is still moist.
  • Avoid perfume, cologne or aftershave lotions that contain alcohol.

Nail problems

  • Avoid nail-strengthening products as they may bother your skin and nails.
  • Wear gloves when doing housework or working in the garden.
  • If you note redness, pain or changes around the cuticles, consult your physician or nurse practitioner.

Sunlight sensitivity

  • Avoid direct sunlight as much as possible, and especially stay out of the sun between the peak hours of 10 a.m. and 4 p.m. when the sun’s rays are the strongest. Even if you have dark skin, protect yourself from the sun.
  • Use a sunscreen lotion with a skin protection factor of 30 or higher. Zinc oxide, sold over the counter, can block the sun’s rays completely.
  • Use a lip balm with a high sun protection factor.
  • Wear long-sleeve cotton shirts, pants and hats with a wide brim (especially if you are experiencing hair loss) to prevent your skin and scalp from sunburn.

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