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Nails: short, clean, no cuts

Germs collect under the nails, and small injuries around a nail can turn into infection during neutropenia. Some chemotherapy medicines make nails brittle, dark or ridged.

Last updated: ~1 min read
Hands holding a nail file
Figure 1.Shorten nails with a file

01Short answer

Keep nails short and clean, and clean under them with a soft brush. Filing them straight with a soft emery board is safer than cutting, especially when platelets are low. Do not cut or push back cuticles; moisturise them instead. Do not bite or pick your nails. Salon manicures and pedicures, false nails and gel polish are not recommended during treatment; ask your team once your counts recover. Wear gloves for housework. Tell your team about redness, swelling, pain or pus around a nail. Nail tools are personal; do not share them.

02Simple explanation

Short, clean.

Do not cut: file.

Cuticles: do not cut.

Salons: ask.

03Scientific explanation

NCI: treatment can cause nail changes; keeping nails short and clean and wearing gloves for housework are recommended.

NCI: chemotherapy can lower neutrophils, platelets and red cells, which raises the risk of infection, bleeding and fatigue.

04What happens in the body?

Paronychia

Inflammation around a nail can spread quickly during neutropenia.

Polish

Ordinary polish and acetone-free remover are usually fine; ask your team.

Neutrophils

The first defence against infection; when they are low, hygiene matters most.

Platelets

Help blood clot; when they are low, protect yourself from injury.

05Daily protection: four steps

Wash, protect, check, report.

Wash — Hands and personal hygiene.1WashHands and personal hygiene.
Protect — Against injury and infection.2ProtectAgainst injury and infection.
Check — Temperature and skin.3CheckTemperature and skin.
Report — Tell your team about changes.4ReportTell your team about changes.
HygieneClean hands.
TemperatureThe 38 °C threshold.
ProtectionYour team's rules.

06Key points at a glance

TopicIn brief
ParonychiaInflammation around a nail can spread quickly during neutropenia.
PolishOrdinary polish and acetone-free remover are usually fine; ask your team.
NeutrophilsThe first defence against infection; when they are low, hygiene matters most.
PlateletsHelp blood clot; when they are low, protect yourself from injury.

07Key terms

Cuticle
The thin skin at the base of the nail.
Emery board
A tool for filing nails.
ANC
Absolute neutrophil count.
Thrombocytopenia
A low platelet count.

08Key points

  • Keep short.
  • File.
  • Tell us.
  • Wash your hands.
  • 38 °C: call.

09Frequently asked questions

My nails have darkened.

This can be caused by medicines; tell your team.

A nail is lifting.

Cover it and tell your team.

What should I watch every day?

Temperature, bleeding, tiredness and the catheter site; tell your team about any change.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. My nails have darkened.

  2. A nail is lifting.

  3. What should I watch every day?

My questions

12Sources

  1. National Cancer Institute. Skin and Nail Changes during Cancer Treatment
  2. National Cancer Institute. Infection and Neutropenia during Cancer Treatment
  3. National Cancer Institute. Bleeding and Bruising (Thrombocytopenia) and Cancer Treatment
  4. National Cancer Institute. Anemia and Cancer Treatment
  5. World Health Organization. World Hand Hygiene Day
  6. MedlinePlus (U.S. National Library of Medicine). Peripherally inserted central catheter — flushing
  7. ICUsteps. Guide to intensive care: effects on your body
  8. National Cancer Institute (NCI). Support for Caregivers of Cancer Patients
  9. American Cancer Society. Caregivers and Family
  10. Macmillan Cancer Support. Support with cancer and anxiety
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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