Treatment Side Effects - Skin Changes and Rashes

Some treatments for blood cancer may cause changes to the skin, including rashes and other irritations. Skin may become dry, itchy, peeling, or red, or the skin may be more sensitive to sunlight and prone to burning. Some patients also experience changes to their nails. Nails may become yellow, dark, or cracked. Most skin and nail reactions to treatment are temporary and tend to go away once the treatment is finished, although it may take nails weeks to months to appear normal again.^1-3

What causes changes to the skin and nails during blood cancer treatment?

Many of the treatments used in blood cancer can cause changes to the skin and nails, such as:

• Chemotherapy targets fast growing cells, which includes skin and nail cells. Skin can peel or become dry, itchy or red, and some patients develop a rash. Others experience sensitivity to sunlight, increasing the risk of sunburn.
• Targeted therapy can create dry skin, a rash, or nail problems.
• Immunotherapies can cause itchy skin.
• Radiation therapy can cause skin to become red, dark, or dry and peeling on the area where the radiation is focused.¹

When skin problems become serious

Some skin changes can be signs of a more serious complication. People who are undergoing treatment for blood cancer should contact their healthcare professional if they experience any of the following:

• Sudden or severe itching, hives, or rash, which may be signs of an allergic reaction
• Sores on the body that are painful, wet, or infected
• Pain or burning during intravenous (IV) chemotherapy infusion
• Worsening rash or rash with other symptoms like pain and itching²

Caring for your skin during blood cancer treament

In addition to discussing any skin changes with their doctor, patients can reduce the effect of treatment on their skin by using strategies such as:

• Drink plenty of fluids, at least two liters daily. Hydration is critical for skin health (check with your doctor if you have a fluid restriction).
• Use moisturizers, especially after showering or bathing when skin is still moist.
• Take baths or showers in warm, not hot, water.
• Gently pat skin dry with a towel instead of rubbing.
• Use sun protection, including sunscreen, hats, long sleeves and pants, and avoid tanning.
• Use skin products (including soaps and lotions) that are alcohol-free, fragrance-free, and hypoallergenic to minimize irritation.
• Carefully manicure fingernails and toenails.
• Wear protective gloves during dish-washing or gardening.
• Wear gloves in cold weather to protect skin from extreme weather conditions.
• If spending a lot of time lying or sitting down, prevent pressure sores by shifting weight or changing position regularly.
• Avoid using heating pads or ice on areas receiving radiation therapy.
• Use an electric shaver rather than a razor.
• Keep room temperature cool and humid.
• Wear loose clothing and fabrics that don’t irritate the skin.
• Ask doctors or nurses for recommendations on skin products as well as any products to avoid. For example, patients may be asked not to use antiperspirants or powders while receiving radiation therapy.^1,2