The United States saw over 1.6 million cases of cancer in 2016, according to the American Cancer Society, with a lifetime cancer risk facing about one in every two men, and one in every three women. Because of these high rates, it’s almost inevitable that you will encounter a client with cancer. In the United States, the number of those affected by cancer grows by about 50,000 each year. Each person facing a new diagnosis, along with the disease’s 15.5 million survivors, will have unique conditions and compromised health. Because of this, clients with cancer will need your special attention when caring for their nails.

There are several traditional ways to treat cancer medically, including chemotherapy, radiation therapy, immunotherapy, and integrative therapies. These methods are often effective in destroying cancer cells, but unfortunately, healthy cells are also affected negatively, including blood, skin, hair, and nail cells.

Many effects of treatment would be considered cosmetic and will affect our client’s self-image and quality of life, but some are painful and even life-threatening, like low white blood cell counts and the inability to fight infection.

Typical Manicure Protocol

Allow your client to enjoy the towel’s therapeutic warmth, ensuring that it isn’t hot.

Allow your client to enjoy the towel’s therapeutic warmth, ensuring that it isn’t hot.

Here is a step-by-step example of how you might treat a client with cancer:

Step 1: Remove nail polish with ingredient-safe polish remover, such as a soy polish remover.

Step 2: Apply lukewarm (not hot) towels to both hands and hold gently for a few minutes to soften the cuticles and allow the client to enjoy the therapeutic warmth.

Step 3: Apply warm oil, such as grapeseed, sunflower, or jojoba, and gently massage into the cuticles.

Step 4: Using a plastic cuticle pusher, gently push the cuticles back making sure not to tear or break the skin. Avoid metal cuticle pushers.

Step 5: Add more warm oil and apply gently, starting at the fingertips and then moving up to the hand and arm in a soft patting motion. Remember that clients who are at risk for lymphedema cannot have massage or sliding movements on the skin or arms where lymph nodes have been removed or radiated. 

Step 6: Remove all oil from the nails with witch hazel or white vinegar on a cotton pad.

Step 7: Apply an ingredient-safe nail polish if the client desires color.

Common Nail Symptoms

These symptoms will need special care so you help the nails instead of harm them. A nail tech’s role is to keep the client’s nails healthy and comfortable. The following conditions are often associated with cancer treatments and should be dealt with in a careful manner.

Beau’s lines often occur during chemotherapy and grow out in time.

Beau’s lines often occur during chemotherapy and grow out in time. 

> Beau’s lines are horizontal lines in the nail where the nail cells were affected by the chemotherapy during the growth cycle. They are not permanent and will grow out.

> Nails will be dry and brittle and crack or break easily.

> Cuticles will also be dry, cracked, and uncomfortable.

Cancer patients may experience onycholysis, a symptom where the nail lifts away from the nail bed.

Cancer patients may experience onycholysis, a symptom where the nail lifts away from the nail bed.

> Onycholysis is when the nail lifts away from the nail bed. It is not only painful, but it puts the client at risk for infection from trapped bacteria.

> Lymphedema is a collection of lymph fluid and swelling in the arm or leg where a client has had lymph nodes removed or radiated. The nails on that side will need special care so you don’t increase the client’s risk of infection.


How Can You Help?

Because a cancer patient’s nails will be particularly sensitive, precautions should be taken to avoid inflammation or infection.

> Do not soak in water because of the potential introduction of bacteria.

> Suggest dry manicures and pedicures while undergoing cancer treatments.

> Advise clients that they need to keep their nails clean and hydrated.

> Use lukewarm water to wash, pat dry, and apply pure oil like calendula, tamanu, grapeseed, sunflower, or a pure shea butter product.

> Do not cut the cuticles or break the skin barrier in any way. Clients with a low white blood cell count have a higher risk of infection, slower healing, and increased bleeding.

> Keep clients’ nails short to avoid the breaking and cracking of dry nails.

> Suggest they wear gloves for activities involving water or dirt to avoid bacteria and infection risk.

> Do not apply acrylics or harsh nail products during this time when nails are already compromised.

Avoid the following products or ingredients:

> Fragrances and perfumes are used to mask the scent of other ingredients, but can cause allergic reactions and contact dermatitis.

> Alcohol is used to encourage quicker drying time, but can cause additional dryness in the nails and skin.

> Formaldehyde resin is used to harden the nails and the polish, but can cause allergic reactions, skin irritations, and loss of nerve sensation.

> Acetonitrile can be used to remove artificial nails. The toxin is harmful when absorbed in the skin or inhaled and very drying to the nails. 

> Methacrylic acid is used in nail primers to help acrylic nails bond or adhere to the surface of the nail. It can be harmful if inhaled or if it comes in contact with skin or eyes.

> Methacrylate is used to harden acrylic nails and can be associated with nail damage, deformity, and contact dermatitis.

>Dibutyl Phthalates (DBP) is used to make the polish long lasting and resist chipping. It has been removed from most polishes due to health concerns.

> Toluene is used to give the nail polish a smooth and even application. It has been removed from most polishes due to health concerns.

> Camphor is used to make your nail polish shiny and glossy. It can cause allergic reactions and skin irritations.

> Parabens are used as a preservatives, blocking the nail bed from receiving natural vitamins and nutrients from the sun and air.

> Triphenyl Phosphate (TPHP) is used as a hardener and makes the polish flexible and durable. It is an endocrine disrupter, meaning it affects hormones.

So What Can You Do? Pamper clients with the basics and listen to and care for them. Your client will love her time away from the chaos of cancer and enjoy learning how to safely care for her nails during this difficult time. Keep in mind that every client will be different, so specialized training is necessary to know how to modify services and what steps would be appropriate for each client. If you are interested in cancer care training, visit

Nail Products that Give Back

Pevonia will donate 5% of all October proceeds from its RS2 Line to the National Breast Cancer Foundation. The line protects and hydrates the skin, with ingredients such as green tea and rose essential oil. It’s ideal for clients with hypersensitivity, redness, and Rosacea. In addition, the company will donate 3% of profits from all website purchases during October.

For more information, visit

Minx donates a portion of all October proceeds to Doug Schoon’s Walk for the Cure and sells pink ribbon nail wraps. Co-founder Janice Jordan’s mom has battled breast cancer for over 20 years, so the cause, she says, is close to her heart.

For more information, visit

Sheba Nails Dipcrylic Powders are sold as a Breast Cancer Awareness Kit and 100% of the product’s proceeds for the month of October are donated to the Breast Cancer Research Foundation. Sheba Nails owner Sheila Bargas had been a breast cancer survivor before she passed away this April.

For more information, visit

Londontown donates 50% of all pink polish e-commerce sales to Bright Pink, a non-profit organization focused on prevention and early detection of breast and ovarian cancer in young women.

For more information, visit

Becky Kuehn is the founder and director of education for Oncology Spa Solutions, as well as a cosmetologist and Master Esthetician based in Tacoma, Wash. For more information, visit

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