Onycholysis

Last Modified: September 14, 2008

Dear OncoLink "Ask The Experts,"

I went thru 8 rounds of Taxotere & Xeloda for breast cancer, and finished the last treatment almost 90 days ago. I have the discolorations in my finger & toe nails, and my finger nails are somewhat loose. I keep my nails cut low for fear they may get pulled off. I have experienced some drainage in the finger nails, but that has stopped. I am also experiencing some soreness in the finger nails. Is there something I can do to help with that, such as soaking them or some type of cream? Please advise.

Nancy Zieber, RN, MSN, CRNP, Oncology/Hematology Nurse Practitioner, responds:

The nail discoloration and lifting or loss of nail from bed, also known as onycholysis, is caused by Taxotere. We advise band-aids around the fingers where the nail is lifting so it is not pulled off by activity. Some patients have said that Tea Tree Oil, found in health food stores, is helpful. Apply one drop to each nail daily, or try soaking your fingers in it once a day. It should clear within a few months post treatment.

Here are some tips to dealing with nail changes:

Avoid cutting cuticles; this can be a source of infection. Use a cuticle cream instead. If you need to cut your cuticle, be sure to clean the clipper before using it.
Artificial fingernails can harbor bacteria and lead to infections, so you should not use them.
Nails absorb water and expand, but then contract as they dry out. The more they expand and contract, the weaker they become, so wear gloves to protect your nails when doing housework or gardening.
Keep your hands moisturized and your nails cut short.
You may want to use nail polish to give your nails extra strength and cover imperfections.
Soaking your nails in or massaging the nail with oil, such as vegetable or olive oils, helps to replace moisture lost from water exposure. These natural oils lack the alcohol- containing fragrance that is often found in commercial nail products.
If your nails break or lift off, try to keep them clean and protected. Covering the nail with a band-aid can protect it from trauma. Clean with soap and warm water and apply an antibiotic ointment twice a day.
If the nail or nail bed appears infected (there is redness, swelling, warmth to the touch), inform your healthcare team.