These are my nails. I am sharing them because when I was going through chemotherapy, I searched the internet desperately for honest information about what treatment does to your body, and so often what I found felt sanitised or clinical. So here they are, in all their glory, at various stages of my treatment journey.
Nail changes are one of those side effects that tends to get a brief mention in the leaflets and then not much more. But for many people going through chemo, they become something you think about every single day. They can be painful, they can feel exposing, and they can make even the simplest tasks feel harder than they should.
So let us talk about it properly.
What actually happens to your nails during chemotherapy
Chemotherapy targets fast-dividing cells, and nail cells are among them. The drugs slow down or disrupt nail growth, which can cause a whole range of changes. You might notice banding or lines across the nail, known as Beau's lines, which mark the points in your treatment cycle where growth paused. You might see discolouration, yellowing, browning, or a greenish tinge if infection has crept in under the nail.
In some cases nails can turn black. This can happen when bleeding occurs beneath the nail plate, or as a direct toxic effect of certain chemotherapy drugs on the nail bed. It looks alarming, and I will not pretend otherwise, but it is a known side effect and worth telling your oncology team about if it happens to you.
Nails can also become thin, brittle, ridged, or very dry. The skin around the nail bed often peels and cracks. And in some cases nails lift away from the nail bed partially or completely, a condition called onycholysis, which can be sore and leaves the nail vulnerable to infection.
What you are seeing in my photos is all of this. Different stages, different fingers, different degrees of change. Some nails came through relatively unscathed. Others took a real battering.
The yellowing and banding visible here are typical of chemotherapy-related nail changes.
You search the internet for honest information and so often what you find feels sanitised. "ese photos are the reality. And the reality is survivable.
You might think you have got away with it. I did.
This is something I really want to flag, because nobody warned me and I wish they had. I got to the end of my chemotherapy and my nails looked okay. Not perfect, but okay. I genuinely thought I had dodged that particular bullet.
I had not.
My nails did not start to show the signs of chemotherapy damage until after I had finished radiotherapy, which was a full month after chemo had ended. So if you are sitting there at the end of your treatment thinking you have escaped the nail changes, please do keep an eye on them. The damage can be delayed. The effects of chemo on your nails can take weeks to become visible as the compromised nail growth slowly makes its way to the surface. Do not be caught off guard the way I was.
How long does it actually take?
I want to be really honest with you here, because I think the timeline is something people are often not prepared for. My last thumbnail took a full year to repair. A whole year. And even now, a year on from that, my nails are still not fully back to what they were before treatment. One year out and we are still on the journey.
I am not saying this to frighten you. I am saying it because I think you deserve the truth rather than a vague reassurance that things will go back to normal quickly. They might. For some people recovery is faster. But for others it is a slow, patient process, and knowing that in advance means you can stop measuring yourself against an unrealistic timeline and just let your body do what it needs to do at its own pace.
My last thumbnail took a full year to repair. One year out and my nails are still not fully back to what they were. Be patient with yourself and with your body.
What helped me
There is no magic fix, and I want to be upfront about that. Your nails will largely go through what they go through, and your job during treatment is mostly damage limitation and keeping infection at bay. But there are things that genuinely make a difference.
Practical ways to protect and support your nails
- Keep nails short and clean. Longer nails are more likely to catch, lift, or tear, and a nail that rips when it is already compromised is really painful.
- Wear gloves for anything wet or chemical. Washing up, cleaning, gardening. Prolonged contact with water softens already weakened nails and increases the risk of infection getting underneath a lifted nail.
- Use a good nail oil daily. Something with jojoba or vitamin E keeps the nail bed and surrounding skin hydrated and reduces the cracking and peeling around the cuticle. Morning and night, and any time your hands feel dry.
- Use a nail strengthener. Look for formulas free from formaldehyde, toluene, and DBP. These create a protective layer over weakened nails while they recover.
- Wear dark nail polish. There is evidence that dark colour may help reduce the severity of nail changes by limiting light exposure to the nail bed. And practically speaking, it covers the discolouration and makes your hands feel a little more like yours again.
- Always use acetone-free nail polish remover. Standard acetone removers are incredibly drying and will strip what little moisture your nails have left. This is not optional. It is one of the most important swaps you can make.
- Tell your oncology team if anything changes significantly. Pain, swelling, complete nail loss, or signs of infection around the nail bed should always be raised with your team. What looks cosmetic can sometimes need medical attention.
And after treatment?
Be patient with yourself and with your nails. This is a marathon, not a sprint. Keep oiling, keep strengthening, protect them from water and chemicals, and give them the same gentle care you would give any other part of your body that has been through something hard.
You are not alone in this, and your nails are not a small thing. They are part of your body, part of your story, and they deserve care.
If you are going through treatment right now, I see you. These things are hard and they are real and you are doing brilliantly, even on the days it does not feel like it.
WITH LOVE, HANNAH X