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Chemotherapy Side Effects On Skin

Coping With Hair Loss

Skin conditions after chemotherapy and radiation

Hair loss can be upsetting. Talk to your care team if you’re finding it difficult to cope with losing your hair.

They understand how distressing it can be and can support you and discuss your options with you.

For example, you may decide you want to wear a wig. Synthetic wigs are available free of charge on the NHS for some people, but you’ll usually have to pay for a wig made from real hair.

Other options include headwear, such as a headscarf.

Read more about advice about cancer and hair loss.

What Do I Need To Know About Side Effects

  • Every person doesnt get every side effect, and some people get few, if any.
  • The severity of side effects varies greatly from person to person. Be sure to talk to your cancer care team about which side effects are most common with your chemo, how long they might last, how bad they might be, and when you should call the doctors office about them.
  • Your doctor may give you medicines to help prevent certain side effects before they happen.
  • Some chemo drugs cause long-term side effects, like heart or nerve damage or fertility problems. Still, many people have no long-term problems from chemo. Ask your doctor if the chemo drugs youre getting have long-term effects.

While side effects can be unpleasant, they must be weighed against the need to kill the cancer cells.

Be sure to talk to your cancer care team about which side effects are most common with your chemo, how long they might last, how bad they might be, and when you should call the doctors office about them.

Who Should Not Receive 5fu Chemotherapy

People with a deficiency of an enzyme called dihydropyrimidine dehydrogenase shouldnt receive 5FU. Because DPD helps to break down 5FU in the body, a deficiency in this enzyme can lead to life threatening complications.

5FU is also not recommended if you:

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When Do Radiation And Chemotherapy Side Effects Start

You may experience side effects within a few hours of treatment as is the case with certain chemotherapy treatments that gradually begin to improve. Or you may not experience side effects until youve completed several treatment sessions, as is sometimes the case with radiation. Talk to your healthcare provider about when youre most likely to experience side effects based on your treatment type and schedule.

How Vitamins Affect Chemotherapy Drugs

My Journey Through Topical Chemotherapy

Many people want to take an active role in improving their overall health. They want to help their bodys natural defenses fight the cancer and speed up their recovery from chemo. Most people think of vitamins as a safe way to improve health, so its not surprising that many people with cancer take high doses of one or more vitamins. But some vitamins might make chemo less effective.

More research is needed, but until more is known about the effects of vitamins on chemo, keep these points in mind:

  • If your doctor has not told you to take vitamins, its best not to take any.
  • Always check with your doctor first before starting to take a vitamin of any kind, even a simple multivitamin.
  • Ask your doctors if and when it might be OK to start taking vitamins after treatment.
  • If youre concerned about nutrition, you can usually get plenty of vitamins by eating a well-balanced diet. See Nutrition for People With Cancer to learn more about nutrition during and after cancer treatment.

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Reduced Number Of Blood Cells

Chemotherapy can reduce the number of blood cells made by the bone marrow. Bone marrow is a spongy material that is found in the middle of your bones. It makes special cells called stem cells which develop into the different types of blood cells:

  • white blood cells, which fight and prevent infection
  • red blood cells, which carry oxygen to all parts of the body
  • platelets, which help the blood to clot and prevent bleeding and bruising.

You will have regular blood samples taken to check the number of these cells in your blood .

Side effects may include:

Reduced number of white blood cells

If you have a low number of white blood cells, you are more likely to get an infection. The main white blood cells that fight infection are called neutrophils. When they are low, you are neutropenic.

Your resistance to infection is usually lowest 7 to 14 days after chemotherapy. The number of your white blood cells will then increase steadily and usually return to normal before your next cycle of chemotherapy is due. Developing an infection when you have a low number of white blood cells can sometimes be a serious complication of chemotherapy. Your doctor may prescribe you antibiotics and other medicines to take during chemotherapy to prevent an infection. These are called prophylactic drugs. Or you may have injections called G-CSF to encourage your bone marrow make more white cells.

Your chemotherapy nurse will talk to you about infection and show you how to check your temperature.

Talking With Your Health Care Team About Skin And Nail Changes

Prepare for your visit by making a list of questions to ask. Consider adding these questions to your list:

  • What skin-and nail related side effects are common for the type of treatment Im receiving?
  • Are there steps I can take to prevent any of these problems?
  • What problems should I call you about? Are there any problems that need urgent medical care?
  • When might these problems start? How long might they last?
  • What brands of soap and lotion would you advise me to use on my skin? On my nails?
  • Are there skin and nail products I should avoid?
  • Should I see a dermatologist so I can learn more about how to prevent or manage skin problems?

View Transcript

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How Cancer Drugs Can Affect Your Skin And Nails

There are many different types of drugs for treating cancer. Some can cause a variety of skin and nail changes.

Some of these side effects can be uncomfortable, painful or distressing. Changes to your skin and nails are visible and can be a constant reminder of your cancer. It can interfere with your sleep, make you feel low in mood and affect your quality of life.

But in most people, they can be managed and will clear up once treatment has finished.

Even if a drug can cause certain side effects, you might not get them. Drugs affect people in different ways. It isn’t possible to tell in advance who will have which side effects. It depends on:

  • the drug or combination of drugs you are having
  • how you react to the drug
  • how you have reacted to drug treatment in the past

Tell your doctor or nurse about any changes to your skin or nails during cancer drug treatment. They can tell you how to manage it or suggest treatments to relieve your symptoms.

Skin problems happen mostly with chemotherapy, targeted cancer drugs and immunotherapy.

Severe skin rashes can be side effects of:

  • targeted cancer drugs like tyrosine kinase inhibitors and epidermal growth factor receptor inhibitors
  • some immunotherapies

Hormone therapies can cause skin rashes and itching in some people, but this is usually mild.

Bisphosphonates very rarely cause skin problems.

Cancer drugs can also cause your skin to become:

Your doctor might treat these skin problems with a combination of:

Skin And Nail Changes

Chemotherapy: Other Side Effects

Some chemotherapy drugs may cause your skin to peel, darken or become dry and itchy. During treatment and for several months afterwards, your skin is likely to be more sensitive to the sun.

You may find your nails also change and become darker than usual or develop ridges or white lines across them. Your nails may also become brittle and dry or lift off the nail bed. These changes usually grow out. It is recommended that you avoid having your nails done at a nail salon, as this can increase the risk of infection during chemotherapy.

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Why Is It Important To Know About Chemotherapy Drugs And The Skin

Each year, 10.9 million people worldwide are diagnosed with cancer, and this incidence is rising. This increase reflects the world’s growing population and the fact that people are living longer. Chemotherapy is a crucial component to all cancer management, and with this rising cancer burden, doctors and patients alike will see an increasing incidence of chemotherapy-related skin toxicity.

Effects On Your Digestive System

Chemotherapy can affect your digestive system in different ways. Some people get constipated, other people have diarrhoea. Your hospital will have its own guidelines, but if you have four or more episodes of diarrhoea within 24 hours contact you GP or treatment team. Drink plenty of fluids to avoid dehydration.

Some chemotherapy drugs can make indigestion more likely. Some may also cause heartburn, which is a burning feeling in the lower chest.

Let your chemotherapy team know if you have any of these side effects. They can prescribe medication to help and can give you information about diet. You can also be referred to a dietitian if necessary.

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What Are Common Side Effects Of Chemo

Most people worry about whether theyll have side effects from chemo, and, if so, what theyll be like. Here are some of the more common side effects caused by chemotherapy:

  • Nausea and vomiting
  • Mouth, tongue, and throat problems such as sores and pain with swallowing
  • Peripheral neuropathy or other nerve problems, such as numbness, tingling, and pain
  • Skin and nail changes such as dry skin and color change
  • Urine and bladder changes and kidney problems
  • Chemo brain, which can affect concentration and focus
  • Changes in libido and sexual function
  • Fertility problems

Learn more about these and other problems in Managing Cancer-related Side Effects.

Common Skin Problems During Chemotherapy

My Journey Through Topical Chemotherapy

Common Skin Problems and Tips to Minimize Discomfort

Skin changes are common during chemotherapy. Knowing what to expect, when you should be concerned, and measures you can take to protect your skin can help you cope during this time. Thankfully, some of these problems are preventable and most of them go away soon after you have finished treatment.

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Decrease In Blood Cell Counts:

Why it happens: Red blood cells carry oxygen throughout your body, white blood cells help fight infection, and platelets help stop bleeding. These normal, healthy cells divide rapidly, just like the cancer cells, which is why chemo often affects these benign cells in addition to the cancer cells.

How to handle anemia :

  • Get at least eight hours of sleep each night
  • Take short naps during the day
  • Limit your activities by setting priorities of what you need to get completed for the day
  • Accept help when your family and friends offer
  • Eat a well-balanced diet that contains all the calories and protein your body needs to keep your weight up and repair tissues that have been harmed by the chemo

How to handle infections :

  • Wash your hands with soap and water
  • Carry hand sanitizer
  • Use sanitizing wipes to clean surfaces and items that you touch
  • Be gentle and thorough when you wipe after a bowel movement
  • Take good care of your skin and clean cuts right away
  • Stay away from people who are sick or crowds
  • Wash raw vegetables and fruits before eating them
  • Do not eat raw or undercooked fish, seafood, meat, chicken, or eggs
  • If you are a pet owner, have someone else clean up animal waste
  • Do not get a flu shot or other vaccine without first checking with your cancer doctor or nurse.

How to handle a low platelet count:

Your doctor or nurse will order blood tests to find out your blood counts throughout your chemo treatment.

When To See A Doctor

You should see a doctor anytime you notice any skin irritation after receiving chemotherapy treatment, especially if it lasts longer than two days. They should examine any skin that may be open or bleeding from scratching.

Show Sources

American Academy of Dermatology Association: âHow To Care For Your Skin During And After Radiation Therapy.â

American Cancer Society: âSkin Rash.â âHand-Foot Syndrome or Palmar-Plantar Erythrodysesthesia .â

Clinical Journal of Oncology Nursing: âWhen the Patient Seeks Cure: Challenging Chemotherapy and Radiation Side Effects Requiring Creative Solutions.â

DermNet NZ: âRadiation dermatitis.â

Mayo Clinic: âDrug allergy.â

National Cancer Institute: âradiation recall.â

National Center for Biotechnology Information: âAcute radiation dermatitis in breast cancer patients: challenges and solutions.â

National Comprehensive Cancer Network: âTake Precautions During Cancer Treatment in Warmer Weather.â

National Center for Biotechnology Information: âRadiation Recall with Anticancer Agents.â

OncologyPRO: Skin Changes â Papulopustular Rash.â

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Avoid Alcohol Based Products

The chemicals, including alcohol, in perfumed products like soaps, cosmetics, moisturizers, lotions, and body sprays can irritate the skin. They can also be very drying and remove the natural oils on the skin.

Use products labeled perfume-free, allergen-free, or “for sensitive skin.” Your healthcare provider may recommend gentle cleansers to clean the skin.

A Word On Egfr Inhibitors

Cutaneous Side Effects of Chemotherapies and Immunotherapies | What Providers Need to Know

Epidermal growth factor receptor inhibitors are used in the treatment of metastatic colorectal, lung, pancreatic, and head and neck cancer. These drugsâwhich include Vectibix® , Erbitux® , and othersâinterrupt tumor growth by disrupting signals sent from EGFR, a protein that helps regulate cell growth. Though potentially effective against cancer, EGFR inhibitors may also interfere with normal cells, as EGFR is present on some healthy cells, notably skin cells. This makes mild-to-severe side effects to the skin a possible complication of EGFR inhibitors. Although even mild cases can adversely affect a patientâs quality of life, severe cases can interrupt treatment and thus jeopardize a patientâs chance of receiving optimal care.

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Fu Is Most Effective When Used In Combination With Other Drugs

By itself, 5FU may not be very effective. This is because cancer cells have several mechanisms by which they can become resistant to 5FU.

5FU is far more effective when combined with other cancer drugs. For example, when 5FU is used alone for advanced colorectal cancer, the treatment response rate is

In many cases, 5FU is delivered directly into your bloodstream , which means it can reach many areas throughout the body. This is called systemic treatment.

There are several ways that you can receive 5FU intravenously. These include the following:

  • Peripheral IV line: This is a thin tube placed into a vein in your arm or in the back of your hand.
  • Central venous catheter : A CVC consists of a narrow, flexible tube called a catheter thats inserted through your chest and into a large vein near your heart. A port is used to deliver medicine into a CVC.
  • PICC line: A PICC line is a catheter thats inserted into a vein in your arm and threaded to a large vein near your heart. The end of the catheter sticks out through your skin and its opening is covered with a special cap.
  • Bolus dose : Many people on chemotherapy regimens containing 5FU get an IV bolus as a loading dose . This is followed by a connection to a home infusion system where the drug runs slowly over many hours .

Chemotherapy is given in cycles. One cycle consists of several weeks of treatment followed by a rest period that gives your body time to recover. For 5FU, youll typically have six cycles of treatment.

Feeling And Being Sick

Many people having chemotherapy will have periods where they feel sick or are sick .

Your care team can give you anti-sickness medicine to reduce or prevent this.

This is available as:

Side effects of anti-sickness medicines include constipation, indigestion, problems sleeping and headaches.

Tell your care team if your medicine does not help, or it causes too many side effects. There may be a different one that works better for you.

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What Are Common Side Effects Of Chemo And Radiation

Chemo and radiation cause similar side effects. Chemo is a general term for a wide variety of medicines used to treat cancer. Chemo’s side effects depend on the type of drug used, the dosage, and a child’s overall health. These effects are more likely to affect the whole body.

Radiation’s side effects tend to affect the area being treated. But they do still depend on the dose of radiation given, the location on the body, and whether the radiation was internal or external.

Here are some of the side effects associated with these cancer treatments, and how to manage them:


Tiredness is the most common side effect of both chemotherapy and radiation. Even the most active kids are likely to find themselves exhausted and perhaps even a little “foggy-headed” during treatment and possibly for a while afterward. This is normal. Encourage your child to scale back on activities and to rest as much as possible. When treatment is over, your child’s energy should return.


Some chemo drugs cause headaches, muscle pains, stomach pains, or even temporary nerve damage that can result in burning, numbness, or tingling in the hands and feet. If this happens, your doctor can prescribe medicines that can help. Never use over-the-counter or herbal medicines without your doctor’s OK, though, as these can interact with the chemo drugs.

Mouth, Gum, and Throat Sores

Gastrointestinal Problems

Skin Changes

Weight Changes

Hair Loss

Kidney and Bladder Problems


Blood Clotting Problems

Which Chemotherapy Side Effects Might I Get

Side effects of Chemotherapy

Your cancer doctor and specialist nurse will explain the side effects that your chemotherapy is likely to cause. The main areas of your body that may be affected by chemotherapy are areas where new cells are being quickly made and replaced. This includes the:

  • digestive system
  • lining of your mouth.

You may get some of the side effects mentioned below, but you are very unlikely to get all of them.

If you know the name of the drug you are looking for, you can use our list of chemotherapy drugs to find it. We have more information about:

  • what the treatment is

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