Skin Conditions

Approved by the Cancer.Net Editorial Board, 11/2016

Cancer treatment, in addition to slowing or stopping the growth of cancer, can affect a person’s skin, hair, and nails. Often skin problems from cancer treatment are not severe, but they can be uncomfortable and noticeable. Some people struggle with the visible changes or symptoms caused by a skin condition.

Skin conditions may get better over time, but some may not go away. However, there are options for managing most skin conditions caused by cancer treatment. Relieving side effects such as skin conditions is an important part of cancer care and treatment. This is called symptom management or palliative care.

Managing skin conditions

Most of the time, prevention is the best way to manage skin problems. Let your health care team know if you have any sores, wounds, rashes, or other problems with your skin. Also, sometimes an itch, pain, or discomfort is the first sign that a skin condition is beginning. Let them know if you experience these problems, even if they are not visible.

Below is some general information on common skin conditions and how your health care team can manage them.

Rashes. Rashes can be a side effect of chemotherapy, targeted therapy, immunotherapy, radiation therapy, or stem cell transplants. People may experience a rash that looks like acne or measles. There are several ways to manage a rash based on how bad it is:

  • For a mild or a moderate rash, your doctor can prescribe drugs called corticosteroids given as a cream. Your doctor may also suggest antibiotic creams or antibiotics that are taken by mouth.

  • For a more severe rash, your doctor may prescribe corticosteroids to take by mouth and use as a cream. Your doctor may stop your chemotherapy for a short time and restart at a lower dose.

  • If these steps do not work, your doctor may refer you to a dermatologist for additional treatments.

Dry and itchy skin. Dry skin is called xerosis and itchy skin is called pruritus. It may be more common for people with cancers of the blood, such as leukemia, lymphoma, and multiple myeloma. Dry and itchy skin is also very common with chemotherapy, targeted therapy, radiation therapy, and stem cell transplants.

To treat dry skin:

  • Use a moisturizing cream at least twice a day and within 15 minutes of showering.

  • Avoid products that irritate the skin. This includes soaps, detergents, and creams with fragrance.

  • Avoid products that scratch or scrub the skin, such as sponges, bath scrubs, or loofahs.

  • Shower and bathe with warm water. Hot water can dry the skin even more.

  • When skin is very dry and cracked, use moisturizers containing salicylic acid, urea, ammonium, or lactic acid. These will soften the skin and allow for water to be retained.

To treat itchy skin:

  • Avoid fragranced skin products.

  • Use creams with menthol, camphor, or pramoxine, which are available over the counter. Or, you can use topical steroids prescribed by your doctor.

  • Try using oral medications called antihistamines. Talk with your doctor about the itching before taking any medication.

Sensitivity to light. Some types of chemotherapy, radiation therapy, and stem cell transplants may make the skin more sensitive to light. This is called photosensitivity. To protect sensitive skin from sunburns when outside:

  • Cover up with clothing or a hat, especially from 10 AM to 4 PM.

  • Use a sunscreen that is labeled as broad-spectrum (blocks UVA and UVB rays) and has a sun protection factor (SPF) of at least 15. Make sure to apply enough to cover your entire body (1 ounce or 35 mL). And, reapply every 2 hours or every hour if swimming or sweating.

Nail changes. Cancer treatments may cause your nails to lift, break, or develop light or dark streaks or grooves. The cuticle surrounding your nails may also swell and become red and painful. If your nails change from chemotherapy, your doctor may recommend that you cool your hands and feet with ice or wear cold gloves or slippers while you are receiving treatment, specifically for the drugs docetaxel and paclitaxel. The cold helps narrow the blood vessels in your hands and feet. This may help reduce the amount of these drugs that reaches the hands and feet.

To help manage any nail changes you experience:

  • Trim your nails.

  • Avoid manicures and pedicures.

  • Wear gloves for tasks such as yard work or cleaning.

  • Use oils or creams to keep the skin around your nails soft.

  • Avoid wearing shoes that are too tight.

  • If an infection is suspected, soak nails for 15 minutes every evening in a solution of white vinegar and tap water in equal amounts.

Radiation-related skin problems. When radiation therapy is used on cancer cells, it also affects healthy skin cells. This can cause the skin to peel, itch, or hurt. Skin damage from radiation treatment often starts after 1 or 2 weeks of treatment. Most often, it gets better a few weeks after treatment ends. If it becomes a problem, your doctor may change your radiation dose or schedule until the condition improves.

Corticosteroid skin creams, such as mometasone (Elocon) cream, may help prevent skin changes from radiation. But, make sure you do not apply these creams within 4 hours of radiation treatment. Tell your doctor if you see any open sores or areas where the skin is moist. This may be a sign of an infection that needs treatment with oral antibiotics.

Chemotherapy extravasation or leaks. Chemotherapy extravasation is what happens when chemotherapy given into a vein leaks onto the skin. This can cause pain or burning, and if left untreated, an open wound may develop. If you have pain or burning when you are receiving chemotherapy, tell your health care team right away. They will likely stop the chemotherapy and treat the area around the infusion with topical or injected medications. Your health care team will also show you how to care for the area at home. Then, you will receive chemotherapy through another vein or by another method.

Pressure ulcers or bed sores. Pressure ulcers are caused by constant pressure on one area of the body. They often form on the heels of the feet, the tailbone, and other parts of the body with a thin layer of fat. To prevent and treat pressure ulcers and bed sores, try using an air or water pad that lies on top of your mattress. Or, use a low-air-loss bed or air-fluidized bed. It is important to seek treatment for pressure ulcers and bed sores to reduce pain and keep them from getting worse.

Malignant wounds. When cancer breaks the skin, it can cause a malignant wound. Many types of cancer can cause these wounds, but they are most common with skin cancer and breast cancer. Malignant wounds can easily become infected and be very painful or itchy. They may leak a large amount of fluid or blood and have a very strong odor. Placing an odor absorber in the room, such as cat litter or charcoal, can help lessen the smell. Or, you can try introducing another odor, such as a burning candle, vanilla, vinegar, or coffee. Keep in mind that fragrances and perfumes can bother some patients and may cause nausea. Topical antibiotics such as metronidazole (multiple brand names) may help reduce the odor. Talk with a member of your health care team if you have a malignant wound.

More Information

Mouth Sores or Mucositis

Side Effects of Chemotherapy

Side Effects of Radiation Therapy

Self-Image and Cancer

Side Effects of a Stem Cell Transplant

Skin Reactions to Targeted Therapy and Immunotherapy