Skin and nail changes and cancer treatment

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science.

This page was updated on March 2, 2022.

Chemotherapy, and other types of cancer treatments, may cause changes to the skin and nails. Most of the time, the effects are more a nuisance than a cause for concern. However, some skin and nail changes caused by certain types of cancer treatments may be more serious.

Below are some skin and nail changes you may notice during cancer treatment.

  • Nail anomalies: Your nails may get streaks or grooves, or lift or break more easily. In addition, the cuticles may become swollen, red and painful, and nail infections may occur more often.
  • Changes to your skin color: Cancer treatment or tumor growth may lead to changes to skin color around certain areas of your body. For example, you may develop bruises that don’t have a clear cause or purple areas on the skin. You may also notice redness or paleness of your skin, lips and nail beds.
  • Burning and painful skin: If chemotherapy given through a vein leaks onto your skin, it may burn and feel painful. If left untreated, it may lead to an open wound. Alert your care team immediately if you feel pain or burning while receiving chemotherapy, so they may adjust your treatment.
  • Dry, itchy skin: If you have leukemia, lymphoma or multiple myeloma, you may notice your skin is dry and itchy. It’s also common to have dry and itchy skin with bone marrow transplants, chemotherapy, radiation therapy and targeted therapy.
  • Graft-versus-host disease (GVHD): This may occur after a bone marrow or stem cell transplant if the donated cells attack tissues in the body as foreign invaders. GVHD may affect various organs, including the skin, causing blisters, a rash and thickening.
  • Hand-foot syndrome: Redness, pain, swelling and tingling in the hands and/or feet are part of hand-foot syndrome. The redness may resemble a sunburn. Hand-foot syndrome may affect your ability to walk or do normal activities. Targeted therapy as well as several other treatments are associated with hand-foot syndrome.
  • Malignant wounds: Cancer that breaks the skin may cause a malignant wound. These types of wounds may be painful and become infected. They also may leak blood or fluid. Breast cancer and skin cancer have a greater association with malignant wounds.
  • Peeling skin: Radiation therapy may cause your skin to peel, itch or feel painful. The peeling skin usually starts a week or two after treatment and improves shortly after the end.
  • Pressure ulcers: Excessive, persistent pressure on a certain area of the body may lead to pressure ulcers, also called bed sores. Some areas where pressure ulcers commonly form include the heels of the feet or the tailbone.
  • Rashes: It’s possible to develop a rash as a side effect of certain treatments, including chemotherapy, immunotherapy and radiation therapy. A sudden or severe rash also may develop if you have an allergic reaction to chemotherapy. (Hives or a burning sensation also indicate an allergic reaction.)
  • Sensitivity to light (photosensitivity): Certain types of chemotherapy, radiation therapy and stem cell transplants make your skin more prone to sunburns and more sensitive to light.

8 tips to manage skin and nail changes associated with cancer treatments

  • Tell your cancer care team if you have any of the following:
    • Blistering, painful rash and you’re on immunotherapy
    • Rash near the eyes or the mouth
    • Suspected malignant wound
    • Bruises that remain for more than a week
    • Pink or red patches or rash-like areas
    • Severe itching
  • Ask your care team about products to use for dry skin. A moisturizing cream with salicylic acid, urea, ammonium or lactic acid may help dry, cracked skin. Avoid overly hot baths or showers, which may dry out the skin.
  • Practice sun safety. When you’re outside, use sunscreen that has a sun protection factor (SPF) of 30 or higher, and wear a long-sleeved shirt, pants and wide-brimmed hat. Limit your exposure to the sun when it is at its strongest, between 10 a.m. and 4 p.m. Reapply sunscreen every two hours or when you’re swimming or sweating a lot.
  • Try to stop the itch of itchy skin. Don’t use skin products with fragrances. Look for over-the-counter creams with camphor, menthol or pramoxine. Ask your care team about possibly using oral antihistamines to help treat itching.
  • Take care of your nails. There are a few ways to protect and soothe your nails during cancer treatment, including:
    • Apply cream or oils to keep the area around the nails soft.
    • If you suspect a nail infection, soak your nails at night for 15 minutes using a solution that is equal parts white vinegar and water.
    • Keep your nails short and avoid manicures and pedicures while undergoing cancer treatment.
    • Trim your nails regularly.
    • Use gloves while cleaning or doing yard work.
  • Place an air or water pad on top of your mattress to help treat and avoid pressure ulcers. See a doctor if you develop pressure ulcers, so you may treat them before they worsen.
  • Keep your skin clean and dry. This is to help avoid infection, especially if you’ve had radiation therapy. Your skin may peel or become wet due to radiation therapy, leaving it prone to a skin infection. This more commonly happens in areas such as your ears, breast or buttocks. Ask your care team for pointers on cleaning your skin or using special dressings.
  • Manage discomfort from a rash. To help soothe a rash, you may try:
    • Patting your skin dry instead of rubbing it
    • Exposing the rash to air as much as you can—don’t cover it
    • Wearing loose-fitting, cotton clothing
    • Bathing or showering in warm, not hot, water
    • Not shaving over a rash

Inform your care team if you develop a rash. There are over-the-counter treatments and prescription corticosteroid creams to help manage it.

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