Skin and nail care through breast cancer treatment

Breast cancer treatments often affect the skin and nails. Chemotherapy can make skin dry, itchy, more sensitive to the sun, and sometimes darker, especially on the face, hands, feet, knuckles and nails, which is common on brown skin. Some chemotherapy medicines cause redness, tenderness and peeling on the palms and soles, known as hand-foot syndrome. Nails may become brittle, ridged, discoloured or develop dark lines, and occasionally lift from the nail bed or become infected. Radiation causes skin reactions in the treated area, from pinkness or darkening to dryness, itching and, less often, peeling. Hormone therapy can cause dry skin and thinning hair, and some targeted medicines cause acne-like rashes or nail fold soreness. Most of these changes are temporary and improve after treatment, although darkening can take months to fade. Simple daily habits help a great deal: gentle, fragrance-free cleansers, regular moisturising, sun protection, keeping nails short and clean, wearing gloves for household work, and avoiding very hot water. Tell your team promptly about painful, blistering, weeping or infected skin or nails, as early treatment helps you stay comfortable and keep up with cancer treatment.

Why it happens

Treatments affect rapidly dividing cells in the skin and nails, and some medicines increase sensitivity to sunlight.

Skin darkening on brown skin

Darker patches on the face, knuckles, tongue or nails are common in Indian patients and usually fade gradually after treatment.

Infection risk

Low white cell counts make cracks and nail infections more serious, so good hygiene matters.

Nails can become fragile and prone to infection. A few habits help.

Keep nails short and clean

Trim straight across with clean clippers and file gently.

Do not cut cuticles

Pushing back or cutting cuticles can let infection in.

Wear gloves

Use gloves for washing dishes, cleaning, gardening and handling raw food.

Moisturise nails

Rub moisturiser or oil into nails and cuticles daily.

Nail polish and cooling

Some centres suggest dark nail polish or cooling gloves during certain chemotherapy to reduce nail damage. Ask your team.

Avoid salon manicures during low counts

Skip salon manicures and pedicures when infection risk is high.

Skin in the area treated with radiation needs special care, because reactions build up over the course of treatment and usually peak around the end or a week or two after.

Washing

Wash the area gently with lukewarm water and a mild soap, and pat dry with a soft towel. Do not scrub or use loofahs on treated skin.

Moisturising

Use the moisturiser recommended by your radiation team, and ask before applying anything else, including home remedies, oils or aloe products, especially just before a session.

Clothing

Wear loose, soft cotton tops and a soft bra without underwire, or no bra if more comfortable.

Heat, cold and shaving

Avoid hot water bottles, ice packs and shaving the armpit on the treated side with a blade during treatment.

Sun

Keep treated skin covered from the sun during treatment and for at least a year afterwards.

When to call

Report blistering, weeping, broken skin, severe pain or signs of infection promptly, so the team can advise on dressings.