Living with follicular lymphoma may mean having to navigate a series of unexpected symptoms. Like other types of non-Hodgkin lymphoma, follicular lymphoma can cause common symptoms such as fatigue, night sweats, and swelling in the neck, armpits, or groin. However, you might not expect follicular lymphoma to affect your fingernails or toenails.

Some members of MyLymphomaTeam have reported nail changes with follicular lymphoma or cancer treatment. “My hair is gone, and some of my nails are turning blue,” one member wrote. Another said, “My nails are dying.”

Nail problems are visible symptoms that may make some people feel self-conscious. If your nails look or feel different while you’re managing follicular lymphoma, read on to learn more about five potential nail changes and what may be behind them.

1. Dark Nails

You may notice that once-healthy nails darken, particularly if you’re undergoing chemotherapy to treat follicular lymphoma. Dark color may appear along the nail bed or the entire nail. The nail bed is the area of tissue between your finger and your actual nail.

In some cases, your nails may be so dark that they look bruised. This may be a side effect of chemotherapy. The discoloration can also show up as shades of purple, blue, green, black, and brown along your nails. Most people will find that nail discolorations grow out and don’t affect their nails after they stop their chemotherapy treatments.

Nail discoloration may be a side effect of chemotherapy.

2. Nail Fold Inflammation

Depending on the type of treatment you’re receiving, you may experience inflammation where your cuticle meets your nail. This is also called nail fold inflammation. It can stem from certain chemotherapy and targeted therapy treatments. It may also lead to infections in the skin beside the nail plate — another term for the actual fingernail or toenail.

If nail fold inflammation keeps happening, your provider may suggest minor surgery for relief. During the procedure, the doctor numbs the affected toe or finger and then lifts the nail. Next, they place a chemical on the nail matrix (the tissue under the nail) so the skin and nail no longer develop irritation around the edges.

3. Beau’s Lines

Also referred to as horizontal ridges, Beau’s lines look like dents that go from one side of your nail to the other. They typically occur because the nail growth is disrupted, often due to illness or stress. In people with follicular lymphoma, Beau’s lines may form due to treatments such as radiation therapy or chemotherapy. They typically appear a few weeks after the treatment that disrupts the nail growth. If Beau’s lines become deep and severe, your doctor may refer to the condition as onychomadesis.

Beau’s lines are horizontal ridges in the nails. They usually grow out and don’t come back after lymphoma treatment is completed.

There’s no treatment for Beau’s lines, but they generally grow out over time. Once you’re no longer on the treatment that caused them, they aren’t likely to come back.

4. Nails Lifting Away From Skin

Some people being treated for follicular lymphoma may experience onycholysis, a condition in which the nail lifts away from the skin. If the nail then falls off, it can leave an environment where an infection may develop.

Onycholysis often occurs as a side effect of chemotherapy drugs, such as those in the taxane or anthracycline groups, which may be used in those with follicular lymphoma. For instance, doxorubicin is an anthracycline. This drug is often used in a combination of chemotherapy regimens that may be used to treat relapsed or refractory follicular lymphoma. Studies show that using cold therapy gloves before receiving certain chemotherapies may help reduce the risk of onycholysis.

5. Dry Nails and Cuticles

Chemotherapy may cause your nail beds and cuticles to become very dry. This can affect the toe and fingernails equally and may be irritating.

It’s important not to pick at the dry skin. Instead, keep it moisturized as much as possible to help ease any irritation. Buy a moisturizer designed for hands and fingernails, and try to apply it at least two times a day.

Tips for Keeping Nails Healthy With Follicular Lymphoma

Although dealing with nail alterations during follicular lymphoma treatment can be frustrating, there are ways to manage these symptoms.

• Don’t let your nails get too long. Cut them often, and keep them clean.
• Apply nail strengtheners to help keep your nails strong and prevent damage.
• Wear gloves to protect your nails when doing chores like gardening, washing dishes, and cleaning.
• Skip professional manicures to reduce the risk of nail infections.
• Use gentle lotions and moisturizers without strong scents or chemicals on your hands and feet.
• Apply colored, water-based nail polish to mask discolored nails, but don’t use artificial nails.
• Avoid picking at or scratching your cuticles and nails.
• Don’t wear shoes that are too tight and might press against your toenails.

If your nails become painful, begin oozing, or start to smell, contact your doctor right away. It’s important to address any potential infections or inflammation quickly.

Keeping your nails trimmed, clean, and protected can help you manage many potential nail symptoms and side effects associated with lymphoma.

Other Issues May Affect Nail Health

Many other health conditions besides follicular lymphoma and its treatments may also cause dark nails and other changes to your fingernails and toenails. These may include:

• Damage related to a nail injury
• Changes in the body during pregnancy
• The natural course of aging
• Vitamin deficiencies
• Skin conditions such as alopecia, psoriasis, and eczema
• Overuse of nail polish
• Constant exposure to moisture
• Fungal or bacterial infections
• Heart, kidney, liver, or thyroid conditions
• Poor nutrition

Always talk with your medical care team about any new or worsening nail symptoms to find the reason you’re experiencing nail issues. They can diagnose what may be affecting your nails, identify the cause, and, if necessary, refer you to a dermatologist for proper treatment.

Find Your Team

On MyLymphomaTeam, the social network for people with lymphoma and their loved ones, more than 19,000 members come together to ask questions, give advice, and share their stories with others who understand life with lymphoma.

Have you experienced changes to your nails while living with follicular lymphoma? How did you manage these issues? Share your experience in the comments below, or start a conversation by posting on your Activities page.