When cancer treatments fight cancer cells, they can also affect healthy cells. This can result in certain side effects including skin changes. Side effects of the skin commonly occur with two cancer treatments: external beam radiation therapy and new targeted therapies.

External Beam Radiation Therapy

With external beam radiation therapy, high-energy radiation rays from outside the body are used to kill and shrink cancerous tumors. The radiation is targeted at a specific area of the body. This therapy usually consists of daily treatments over several weeks.

Skin side effects, such as the following, do not usually appear until about the third week of treatment and may continue after finishing treatment:

  • The skin at the treatment area may become red, dry, and tender like a mild to moderate sunburn.
  • The skin may also become very itchy, which is a condition called pruritus.
  • In some cases, the skin may even darken, swell, blister, or peel away.
  • If the skin becomes moist or cracked, you are at risk for an infection.

If side effects become too severe, your radiation oncologist may stop or delay treatment to allow your skin to rest.

Targeted Therapies

Targeted therapies focus on or “target” a specific type of cell or molecule. Common types of targeted therapy drugs attack the epidermal growth factor receptor (EGFR) to stop cancer cells from continuing to grow. Because EGFRs are also important to normal skin cell growth, this may cause skin side effects.

The most common skin side effects with targeted therapies are rashes, dry and itchy skin, hair loss, redness, and inflammation around fingernails and toenails. These side effects most commonly appear after the second or third treatment.

The following are targeted therapies (drugs) that commonly cause skin changes:

Drug

Type of Cancer

Erlotinib, Gefitinib, Cetuximab, Panitumumab Colorectal, Head and Neck, Lung, Pancreatic
Sorafenib, Sunitinib Kidney, GIST, Liver
Ipilimumab Melanoma
Vemurafenib Melanoma
Everolimus and Temsirolimus Kidney, Pancreatic

Source: American Society of Clinical Oncology

How can I manage my skin side effects?

First, always tell your healthcare team about any skin changes you notice. Some side effects can be easily managed with prescription creams or oral medications. Here are some tips to help take care of your skin while undergoing cancer treatment:

Avoid irritants.

  • Use unscented bath and household products including soap, shampoo, lotion, detergent, and dryer sheets.
  • Do not use bath products containing alcohol. Alcohol dries the skin, making irritation worse.
  • If your facial skin is affected, avoid using makeup, or switch to a sensitive skin brand.
  • Always wear gloves when cleaning, and avoid skin contact with cleaning products.
  • Do not shower or bathe with extremely hot or extremely cold water.
  • Stay out of the sun, or wear protective clothing and sunscreen if you must be outside.
  • Do not use tanning beds.
  • Do not use chlorinated pools or hot tubs.

Let your skin rest.

  • Do not scratch or pick at your skin.
  • Do not pop blisters.
  • Wash skin with care.
    • Use a mild, fragrance-free soap.
    • Do not scrub the skin.
    • Let warm (not hot) water gently run over the affected area.
  • Do not wear tight clothing over the affected areas.
  • Do not use adhesive bandages.

Moisturize.

  • Keep skin well moisturized.
    • Use petroleum-based skin protectants or unscented lotions.
    • Look for moisturizers specifically for sensitive skin.
    • Ask your doctor which over-the-counter moisturizer is best for you.
  • Use a humidifier while you sleep, and keep the temperature cool.
  • If you are having radiation treatment, do not apply moisturizers right before treatment. It’s better for your skin to be clean and clear during actual treatments.

Watch for signs of infection.

  • Signs of infection include:
    • swelling, redness, or warmth
    • cloudy drainage or pus instead of clear
    • fever
    • bad smells
  • Tell your doctor immediately if you notice signs of infection. You may need an antibiotic. If left untreated, infections can become very serious and spread to other parts of the body.