Nail Damage During Cancer Therapy

An Overlooked Side Effect That Deserves Attention

By Jonathan Slobom 

Nail damage is one of the most overlooked and under-treated side effects of cancer therapy. While much of the conversation surrounding the physical toll of cancer treatment focuses on more visible effects like hair loss, nail damage can be just as devastating, both physically and emotionally. The reality is that patients undergoing various forms of cancer therapy, including chemotherapy, targeted therapies, hormonal treatments, and immunotherapies, are at significant risk of developing nail problems that impact their quality of life.

Chemotherapy, particularly taxane-based therapies, is one of the primary culprits behind nail damage. By the sixth cycle of taxane-based chemotherapy, nearly 90% of patients may experience some degree of nail damage, ranging from ridges and brittleness to severe cases where nails detach entirely. This damage doesn’t just stop at being a cosmetic issue. For over one third of patients, the damage is severe enough to interfere with daily tasks—buttoning a shirt, typing, or even sleeping, as nails can catch painfully on bed sheets. These physical inconveniences can lead to emotional distress, feelings of embarrassment, and a loss of self-confidence, especially when coupled with the many other challenges of cancer treatment.

Although hair loss is widely anticipated as a side effect, many patients are not adequately informed about the potential for nail damage. This can lead to feelings of shock and frustration when it occurs, as nails are a constant visible reminder of the illness and treatment. For some, especially women, good nails are often tied to feelings of health and confidence. The loss or damage of nails becomes another blow to self-esteem during an already emotionally vulnerable time. Patients often feel the need to hide their hands and may avoid social interactions, contributing to isolation.

Research has shown that untreated nail damage can also create a significant burden for healthcare providers. When chemotherapy-induced nail damage leads to infections, additional clinician time is needed to address it. In extreme cases, severe nail damage can necessitate changes to a patient’s treatment regimen, which could potentially affect overall outcomes.

Interestingly, the issue isn’t limited to chemotherapy alone. Newer cancer therapies such as Tyrosine Kinase Inhibitors (TKIs), Selective Oestrogen Receptor Modulators (SERMs), bispecific antibodies, and CAR-T therapies are all linked to nail damage. Though less data is available on these newer treatments compared to chemotherapy, the emerging evidence is clear—nail damage is a widespread issue across various cancer treatments.

A growing number of healthcare institutions and charities are identifying the need to address this under-recognised side effect. Furthermore, the common advice to use dark or UV blocking nail varnish as a protective measure is not backed by clinical evidence. In fact, some experts warn that cancer therapy makes nails more sensitive, meaning they are less likely to tolerate the harsh chemicals found in nail varnish and remover. While nail varnish might provide temporary emotional relief by masking the damage, it does little to prevent the problem itself. Patients deserve more effective and evidence-based guidance to preserve their nail health during treatment.

Professor Rob Thomas, a leading oncologist practicing at Addenbrookes and Bedford Hospitals, recognised the significant challenges posed by chemotherapy-induced nail damage and the lack of a trusted solution. To tackle this, he gathered a panel of experts to experiment with various natural essential oils and waxes. Their collaborative efforts led to the creation of Polybalm.

Polybalm is entirely natural, free from synthetic ingredients, and provides intensive hydration to help reduce infection risk, alleviate nail pain, and create an environment for healthier nail growth during treatment. In a clinical trial, Polybalm demonstrated near-total protection for patients undergoing taxane-based chemotherapy.

Despite the prevalence of this issue, many patients are still unaware of the potential for nail damage when starting cancer therapy. It’s crucial that oncology teams provide this information early on, allowing patients to be proactive in preventing and repairing damage.

Nail damage may be an often-overlooked side effect, but it doesn’t have to be inevitable or untreatable. By raising awareness and providing access to solutions, we can significantly improve the quality of life for cancer patients. After all, every patient deserves healthy nails.

For more details, you can read about the study here: Polybalm Clinical Trial.