Types of skin problems with cancer

Itching

Some types of cancer produce substances that cause itching. Certain treatments used for cancer can also make you itchy. This can be very distressing. There are treatments and things you can do to help control it.

Read why you may be itchy and what you can do about it

Sweating

Some cancers, as well as cancer treatment such as ​hormone therapy​, can cause sweating. Sweating can be very troublesome and embarrassing. There are treatments and things you can do to help control it.

Causes of sweating and ways to manage it

Pressure ulcers

Pressure ulcers are wounds that develop when the skin is damaged by constant pressure or friction. When you have cancer, you risk developing pressure sores if you can’t move around very well.

If your skin is very dry or sweaty, it is also more likely to get sore. But remember, there are things you can do to help prevent pressure ulcers.

The National Institute for Health and Care Excellence (NICE) guidelines say that people at risk of developing pressure sores should have a special mattress. They also say that a health professional should do an assessment to help prevent pressure sores.

Dealing with pressure sores

Treatment-related skin reactions

Some cancer treatments can cause problems with your skin. Talk to your doctor if you are concerned. You may need treatment with steroids or antibiotics.

Targeted cancer drugs

Some types of targeted cancer drugs​ are more likely to cause skin reactions. Types of targeted cancer drugs that can cause this include:

• EGFR inhibitors such as erlotinib and gefitinib

• MEK inhibitors such as trametinib and binimetinib

• mTOR inhibitors such as everolimus and temsirolimus

• BRAF inhibitors such as encorafenib and dabrafenib

Skin reactions can include a rash that often looks like acne. This type of rash mainly affects the scalp, face and upper part of the body. It might cause itching or feel sore.

Targeted drugs may cause dry skin that develops gradually. If the skin gets too dry it may crack or split. It can cause a skin condition called eczema.

Hand-foot skin reaction is another type of skin related side effect from targeted cancer drugs. This usually happens on the hands and feet. The skin reaction includes sensation changes such as burning or tingling. There might be skin colour changes such as reddening on white skin or darkening on black or brown skin. You might also get blisters.

Targeted treatments can also cause nail changes. This can include:

• brittle and dry nails

• inflammation

• loosening of the nail from the nail bed making it fall off

• nail ridges

Your hair can also be affected by these drugs. You might lose all of your hair or it may thin, but this depends on the individual drug.

Chemotherapy

Some chemotherapy drugs can make your skin dry and itchy or more sensitive to the sun. Other skin reactions include:

• areas of the skin becoming inflamed if you have had radiotherapy to the area in the past

• colour changes such as darkening of the skin

• nail changes such as your nails becoming brittle, dry, inflamed and separated from the nail bed making it fall off

Hair loss is also a common skin change with some types of chemotherapy.

Hand-foot syndrome can happen with the chemotherapy medicines capecitabine or fluorouracil (5FU). But it can also happen with other cancer drugs. It affects the palms of the hands and soles of the feet. Symptoms include:

• redness or darkening of the skin (this depends on your skin tone)

• swelling

• sores or blistering

• a tingling or burning feeling

• dryness or flaking of the skin

This is different from hand-foot skin reaction.

Read about how cancer drugs effect the skin

Immunotherapy

Immunotherapy uses the immune system to fight cancer. It works by helping the immune system recognise and attack cancer cells.

Checkpoint inhibitors are a type of immunotherapy treatment. Types of checkpoint inhibitors include:

• nivolumab

• pembrolizumab

• ipilimumab

• atezolizumab

More than half of people having these types of drugs get skin reactions. They most commonly cause a rash that has a mixture of flat and small raised bumps. The rash can be itchy or your skin might be itchy before it appears. These skin reactions are usually mild to moderate. They rarely get severe.

It is important if you are having immunotherapy treatment that you monitor your skin closely for any changes. This is because skin reactions can develop into life threatening situations if not dealt with early. Let your healthcare team know straight away if you notice any changes to your skin.

Other types of skin related reactions with immunotherapy include:

• lichenoid eruptions – small, raised bumps on the skin that can be flat topped and scaly. This rash mainly affects your trunk, arms and hands. The rash may be red, purple or a mixture of both

• an eczema type rash where the skin is dry, cracked, thickened, crusty, blistered and very itchy. Areas of skin affected might be red, grey, purple or white depending on your skin colour

• a psoriasis type skin condition that causes dry, itchy, sore and flaky skin. You might also have silvery or white scaley areas

Hormone therapy

Some types of hormone therapy can cause skin problems. Commonly these are rashes, dry skin and itching. But there might be other types of skin conditions such as:

• Stevens Johnson Syndrome

• inflammation of blood vessels in the skin which may cause a rash (cutaneous vasculitis)

Radiotherapy

Skin problems are a common side effect of radiotherapy treatment. The effects vary from one person to another and depend on:

• your skin type

• the part of the body you are having treated

• the amount of radiotherapy you have

The reaction can be mild, with just some skin colour changes. On white skin this may look:

• red

• pink

• maroon

On brown or black skin there may be darkening of the skin in the area that had radiotherapy and it can also look:

• yellow

• purple

• grey

The skin can also be tender, itchy, and the skin might be flaky.

Radiotherapy can cause more severe skin reactions making the skin break down and blister. This can be very painful.

Talk to your therapy radiographer or healthcare team if you have any skin changes. They can give you advice on how to manage it.

Read about skin radiotherapy side effects

Stem cell transplant

High dose cancer treatment such as a stem cell transplant can cause graft versus host disease. This is called GvHD for short.

In GvHD the immune cells from the donor attack your body’s own cells. It can cause a number of different symptoms, including a skin rash, which can be itchy and painful.

Coping with skin problems from GVHD

Photodynamic therapy (PDT)

PDT uses a light sensitising drug and a very bright light to destroy cancer cells.

Some light sensitising drugs make the skin and eyes sensitive to light for about 6 weeks after treatment. This means you need to avoid direct sunlight and bright indoor light for at least 6 weeks. The skin gets very sensitive and may become very red and sore if it is exposed to light during this time.

Ultraviolet light treatment

This is also known as phototherapy. It uses part of the ultraviolet (UV) light range to treat a type of skin cancer and other skin conditions such as GvHD.

After this treatment a common reaction is a type of skin rash called a polymorphic light eruption. It looks like small red or dark bumps. But in some cases, you might have larger areas of red or dark changes, or small blisters.

Phototherapy can also cause skin colour changes and itching.

Electrochemotherapy

Electrochemotherapy is a treatment that combines chemotherapy with small electrical pulses.

This treatment can cause an ulcer or breakdown of skin in the area where you have treatment. It can also cause skin colour changes..

High intensity focused ultrasound (HIFU)

HIFU is a treatment that uses high frequency sound waves. The sound waves create heat that destroys the cancer cells.

HIFU through the skin can cause a burn in the treatment area. You might also have some mild pain or discomfort.

Ulcerating tumours

Ulcerating tumours are also known as:

• fungating tumours

• ulcerating cancers

• fungating wounds

• malignant wounds

• ulcerating cancer wounds

An ulcerating tumour is when a tumour that is growing under the skin breaks through the skin's surface and creates a wound. This means the wound won’t heal. It is rare and more likely to happen with cancers that are closer to the skin such as:

• breast cancer

• head and neck cancers

• skin cancers such as melanoma

Treatment may help the wound to heal or help control the symptoms. You might have one or more of the following:

• chemotherapy

• radiotherapy

• hormone therapy

• targeted therapy

• immunotherapy

• surgery

• electrochemotherapy

District nurses will assess and cover (dress) your wound at home. Or you might see the practice nurse at your GP surgery. They can also help with problems, such as wounds that smell, which can be uncomfortable and embarrassing. There are specialised dressings which can help reduce this.

Coping with ulcerating tumours

Lymphoedema

Lymphoedema is a build up of lymph fluid in the tissues, which causes swelling. It is most likely to affect the arms and legs, but it can also happen in other body areas. The fluid build up is due to lymph vessels or lymph nodes getting blocked. This can happen when a cancer presses on them. Or following surgery to remove lymph nodes or radiotherapy to the lymph nodes.

Lymphoedema can make your skin feel tight and uncomfortable. It can also make it dry and crack easily. It helps to keep your skin moisturised. When washing an area of the body with lymphoedema, ensure the skin is thoroughly dried by air drying or gently using a towel. Don't rub it dry, as the skin will likely be delicate.

It is important not to damage or injure the affected area. For example if you have lymphoedema or are at risk of getting it:

• wear insect repellent to avoid bites and stings

• be careful when removing body hair. Using hair removal cream or an electric razor can be better than shaving, waxing and plucking. Test any creams first on another part of your body

• prevent sunburn by wearing sunscreen with at least SPF 30 and 4 or 5 stars. Use it generously, reapply regularly and use together with shade and clothing

• clean and dry any scratches, burns or cuts. Then apply an antiseptic cream and a plaster

Caring for your skin when you have lymphoedema

Skin cancer or melanoma skin cancer

This page is about the different ways cancer and treatment can affect your skin.

If you are looking for information specifically about skin cancer or melanoma skin cancer, this isn't the right section for you. 

Find out about skin cancer

Find out about melanoma skin cancer