Chemotherapy & Nail Care
What to expect, how to look after your nails during treatment and practical information.
Cancer treatment can affect much more than your hair. Chemotherapy and some other cancer therapies can also cause changes to your fingernails and toenails.
Beyond the obvious cosmetic impact of this nail damage, daily tasks that we take for granted such as doing up buttons, typing and even sleeping can be significantly impacted. The area around the nails, including the nail bed, can become very painful, and damaged nails and surrounding skin can become prone to infection.
With very little information about chemotherapy-related nail damage, many misunderstandings have crept into common knowledge regarding how best to protect your nails.
This resource brings together practical information about why nail changes can occur, what to look out for and some simple ways to care for your nails before, during and after treatment.
You'll also find information about Polybalm®, including its ingredients and how it can be used as a potential protection for nails during chemotherapy.
Why Nail Changes Happen
Why can cancer treatment affect your nails?
Your nails are constantly growing. New nail is produced in the nail matrix, which sits underneath the cuticle. Because the cells involved in nail growth are active and continually dividing, some cancer treatments can interfere with this process.
Chemotherapy has long been associated with nail changes, while some targeted therapies, immunotherapies and hormonal therapies can also affect the nails in different ways.
How often does cancer treatment affect the nails?
New research published in The Journal of Cancer Nursing Practice (2026) shows that up to 90% of patients can experience nail damage depending on their therapy, yet only 11% receive any advice or support. As many as 7% reported interruption to their cancer therapy as a direct result of nail toxicities.
of patients can experience nail damage, depending on their treatment.
reported that nail damage significantly affected their quality of life.
reported emotional distress specifically associated with nail damage.
Nail damage can make everyday tasks such as doing up buttons, typing and sleeping difficult. Damaged nails may catch on bedding, become painful or leave the surrounding skin vulnerable to infection.
The highly visible nature of fingernails can also leave people feeling self-conscious, with nail changes serving as a frequent reminder of their cancer treatment.
What Does Chemotherapy Nail Damage Look Like?
Splitting, peeling or cracking (Onychoschizia)
Nails may feel drier, weaker or more prone to splitting.
Ridges or Texture Changes (Beau’s lines)
The surface of the nail may become uneven.
Discolouration (Melanonychia)
Some treatments can alter the appearance of the nail.
Tenderness and Infection (Paronychia)
The nail or surrounding area may become sensitive, painful and in some cases infected.
Separation and Detachment (Onycholysis)
In some cases, the nail can begin separating from the nail bed leading to complete detachment.
Bleeding under the nails (Subungual hematoma)
The nailbed begins to bleed, potentially leading to Onycholysis.
If You've Ever Lost a Nail, You'll Know How Much They Matter
It's only when they're gone...
Have you ever trapped a finger in a door or dropped something heavy on your toe and ended up losing a nail? You'll know just how painful even the simplest everyday activities can become.
We rarely give our nails much thought, but they protect the delicate tissues and nerve endings in our fingertips and toes. They also help us grip objects and sense fine textures.
For people undergoing chemotherapy
Nail damage is an often overlooked side effect of cancer treatment. Nails can become tender, brittle or discoloured and in some cases may lift away from the nail bed or fall off entirely.
This can be extremely uncomfortable, affecting everything from getting dressed to walking. And because nails grow so slowly, the effects can continue long after treatment has finished.
Fingernails
To grow back completely
Toenails
To grow back completely
Because existing nail damage must gradually grow out as new nail is produced, protecting nails before and during chemotherapy is particularly important. Taking preventative steps may help reduce nail damage and the discomfort associated with it.
Practical Nail Care
How can I look after my nails during treatment?
As your nails are more vulnerable during cancer treatment, small changes to your everyday routine can help protect them from additional physical or chemical stress.
Click each card to learn more.
Keep nails manageable
Keep nails relatively short and gently smooth rough edges with a fine-grit emery board.
Protect your hands
Wear comfortable protective gloves when doing activities such as cleaning, washing dishes or gardening.
Give your toes some room
Choose comfortable shoes with a wide toe box and avoid unnecessary pressure on your toenails.
Be gentle around the cuticle
Avoid cutting or damaging the cuticle and surrounding skin.
Dry carefully
After washing, bathing or swimming, dry your hands and feet thoroughly, including between your fingers and toes.
Protect loose nails
If a nail begins to lift, protect it from catching rather than pulling or picking at it.
What Should I Avoid?
Select each heading to learn more.
Manicures & pedicures
Avoid unnecessary trauma to the nail or cuticle. If you do visit a salon, make sure equipment is appropriately sterilised.
Acrylic, gel & shellac nails
Artificial nails and their application and removal processes can place additional physical and chemical stress on the nail.
Nail polish & remover
Polishes and removers can contain solvents that may further dry already vulnerable nails. Polish can also make it more difficult to see changes occurring underneath the nail.
Pulling at loose nails
Don't pull or pick at a nail that is separating from the nail bed.
Highly concentrated essential oils
Avoid applying undiluted essential oils directly to vulnerable skin around the nail.
Biotin supplements
Talk to your healthcare team before taking biotin supplements, as high doses can interfere with some laboratory tests.
When Should I Talk to My Healthcare Team?
Nail changes can sometimes be dismissed as cosmetic, but they can become painful and there are preventative steps you can take to minimise the risk of damage.
Talk to your oncology or healthcare team if you experience changes that concern you, particularly:
- Significant or increasing pain
- Redness or swelling
- Discharge or an unpleasant smell
- Bleeding
- Significant separation of the nail from the nail bed
- Changes that may indicate infection
Your healthcare team is best placed to assess changes to your nails and advise you on appropriate care.
Evidence-Based Nail Care
A nail balm for use as part of your nail-care routine.
Initially recommended by the New Zealand Breast Cancer Foundation, when we first came across Polybalm® what stood out to us was the evidence behind the product.
Developed in the UK by Professor of Oncology Robert Thomas, Polybalm® is an intensive nail balm made from a carefully formulated blend of natural oils, waxes and butters. It has been clinically tested in people undergoing chemotherapy and is used and recommended in hospitals in the UK and internationally.
We were struck by how few options were available here in New Zealand for people looking for a product specifically developed with cancer treatment-related nail care in mind. The combination of the research behind Polybalm® and that gap in the New Zealand market is what led to us working with Polybalm® directly to have the product stocked here in New Zealand.
Polybalm® can be applied to the nails, cuticles and surrounding skin as part of a regular nail-care routine. Each pack contains two tubes, one for fingers and one for toes, to help reduce the risk of cross-contamination.
What's in Polybalm®?
A carefully balanced blend of natural oils, waxes and butters, precisely formulated by Professor Thomas to ensure each ingredient is used at an appropriate concentration for nail care.
Polybalm contains a blend of:
- Unrefined shea butter (Butyrospermum parkii)
- Organic beeswax (Cera alba)
- Extra virgin, cold-pressed olive oil (Olea europaea)
- Wintergreen leaf (Gaultheria procumbens)
- Organic cocoa seed butter (Theobroma cacao)
- Lavender flower (Lavandula spica)
- African sage (Tarchonanthus camphoratus)
- Eucalyptus leaf (Eucalyptus globulus)
The oils are steam extracted from each plant and then gently blended, avoiding overheating to prevent damage to the phytochemicals.
How do I use Polybalm®?
Apply twice daily
Apply a small amount morning and evening. Reapply after bathing, showering or swimming.
Apply around the whole nail
Massage a small amount over the nail, cuticle and skin surrounding the nail.
Apply to fingers and toes
Follow the application instructions for both fingernails and toenails.
Keep the tubes separate
Each pack contains two tubes: one marked for fingers and one for toes.
How much do I need?
Each Polybalm® pack contains:
1 × tube for fingers + 1 × tube for toesWhen used according to the supplied directions, one pack is designed to last approximately one month.
Buy Polybalm®What's Polybalm® like?
Texture
Designed to absorb quickly without leaving nails feeling excessively greasy.
Aroma
Polybalm has a mild, natural aroma, with eucalyptus and lavender among its more noticeable scents.
Packaging
Each pack contains separate tubes for fingers and toes.
Pharmacist Support
Going through cancer treatment can mean being given an enormous amount of information all at once. If you have a question about Polybalm, its ingredients or how my other customers have found using Polybalm, please do get in touch.
Nicola Johns
Pharmacist, The Probiotic Store
Get in touch
Frequently Asked Questions
Select each question to see the answer.
Can chemotherapy affect my nails?
Yes. Chemotherapy can affect the way your nails grow and may cause changes such as dryness, brittleness, ridging, discolouration, tenderness or lifting of the nail from the nail bed. The type and extent of nail changes varies depending on the treatment and from person to person.
Can both my fingernails and toenails be affected?
Yes. Cancer treatment-related nail changes can affect both fingernails and toenails. Some people notice changes in their fingers first because they are more visible, while others notice their toenails first because of the pressure placed on them when walking.
How long do nails take to grow?
Nails grow slowly. A fingernail typically takes around 4–6 months to grow from the base to the tip, while a toenail can take around 8–12 months. This means changes to the nail can take time to fully grow out.
What should I do if my nail starts lifting?
Don't pull or pick at a nail that is lifting, as this can damage the exposed nail bed underneath. Protect the nail from catching on clothing or bedding with a breathable dressing and keep the area clean and dry. If the nail is painful, significantly separated or you notice signs of infection, speak with your healthcare team.
Can I wear nail polish during chemotherapy?
You may choose to wear nail polish, but it is worth being aware that polish and removers can place additional stress on already vulnerable nails and can make it harder to see changes developing underneath. Nail polish can also interfere with some clinical monitoring, including pulse oximeter readings, so you may be asked to remove it during treatment.
Can I have a manicure or pedicure?
Extra care is recommended with manicures and pedicures during cancer treatment because small cuts or damage around the nail can increase the risk of infection. Avoid cutting the cuticles or using sharp tools around the nail and make sure any equipment used is appropriately sterilised.
What is Polybalm®?
Polybalm® is an intensive nail balm made from a carefully balanced blend of natural oils, waxes and butters. The formulation was developed by UK oncologist Professor Robert Thomas, with each ingredient used at a considered concentration. It is designed to be applied to the nails, cuticles and surrounding skin as part of a regular nail-care routine.
How often do I apply Polybalm®?
Polybalm® should be applied at least twice a day. Applying it in the morning and evening can make it easier to remember. The usage instructions also recommend reapplying after bathing, showering or swimming.
Where do I apply Polybalm®?
Apply a small amount to each nail, paying particular attention to the cuticle, the skin just behind it and the folds at the sides of the nail. Gently massage the balm into the nail and surrounding skin.
Why are there two tubes of Polybalm®?
Each pack contains two separate tubes: one for your fingernails and one for your toenails. Keeping them separate is intended to reduce the risk of cross-contamination between the fingers and toes.
How long does one pack of Polybalm® last?
Each pack contains two tubes, one for fingers and one for toes, and is designed to last approximately one month when used according to the directions.
Shop Polybalm
Polybalm®
Intensive nail balm made from natural oils, waxes and butters.
Each pack contains separate tubes for use on fingers and toes.
Shop Polybalm®Further Information About Polybalm and Nail Health
- UK patient experiences with Polybalm
- Clinical Study of Polybalm, Breast Cancer Research and Treatment, Volume 171
Disclaimer: The information on this page is intended as general educational information and is not a substitute for individual medical advice. Cancer treatments and their side effects vary. If you experience new, painful or concerning changes to your nails during treatment, speak with your oncology or healthcare team.
