I have frequently heard patients with breast cancer complain of drainage, brittle nails, or nails falling off while undergoing chemotherapy. Are there any evidence-based practices for managing changes to nails during chemotherapy? — Mina Duca, RN, BSN, OCN

Several evidence-based practices are reported to help prevent/relieve damage to nails caused by chemotherapy.  

·     • Wear rubber gloves when doing household chores such as washing dishes or using cleaning products to protect your hands. Also, wear gloves while doing any outside chores such as gardening.

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·     • Be cautious when getting a manicure or other cosmetic nail treatments. If you choose to get a manicure, bring your own nail care implements. Avoid having acrylic nails or wraps applied because bacteria can grow behind the synthetic nail or wrap and possibly cause an infection.

·     • Nail polish is safe to wear unless a nail is cracked or falling off. Use a nonacetone remover to take off nail polish.

·     • Monitor your cuticles. Hang nails may develop. Use cuticle cream to keep them moisturized. Do not cut, pull, or tear away dry cuticles or hang nails. —Rosemarie Tucci RN, MSN, AOCN