Skin Reactions

Hand-Foot Syndrome

Hand-foot syndrome is a common condition among cancer patients. It is characterized by pain, swelling and tightness or redness of the palms of the hands or the soles of the feet, with or without painful blisters or calluses.

If you receive intravenous chemotherapy and experience hand-foot syndrome, your health care team may decide to cool your hands and feet while they are administering the treatment to help prevent this side effect from happening. You can also change how you perform some of your daily activities, use creams or ointments and take pain medications to help relieve some of the symptoms (Table 1).

Medications associated with hand-foot syndrome:

  • axitinib (Inlyta)
  • capecitabine (Xeloda)
  • cytarabine (Cytosar)
  • daunorubicin (Cerubidine)
  • docetaxel (Taxotere)
  • doxorubicin (Adriamycin, Doxil)
  • paclitaxel (Taxol, Abraxane)
  • pazopanib (Votrient)
  • regorafenib (Stivarga)
  • sorafenib (Nexavar)
  • sunitinib (Sutent)
  • vemurafenib (Zelboraf)

If hand-foot syndrome causes serious limitations in your daily activities, your health care team may decide to temporarily stop treatment and continue it at a later time, or you may be given a different medication altogether. Your doctor may also prescribe other drugs to help you manage this side effect.

Table 1. Ways to manage hand-foot syndrome

Options Suggestions
Changing your daily activities
• Avoid extended exposure to hot water during activities such as bathing and washing dishes.
• Take short showers or baths in lukewarm water.
• Use a hand and foot moisturizer with urea every day during chemotherapy.
• Avoid putting pressure on the soles of the feet and palms of the hands, especially
  during the first month. This includes avoiding long walks, jogging, aerobics,
  jumping, gardening, household work that involves chopping food, and using tools such as screwdrivers.
• Wear cotton or leather gloves when using your hands for sports, hobbies or working, and wear thick cotton socks when walking or running.
• Do not walk barefoot; use soft slippers or shoes with a rubber sole.
• Use moleskin or Molefoam padding for your feet when areas rub against shoes. Use adhesive patches containing lidocaine (Lidoderm) for painful areas.
Cooling procedures
- Place ice packs on the palms of your hands or the soles of your feet for 20 minutes at a time. If you are receiving an intravenous chemotherapy, such as paclitaxel, docetaxel or doxorubicin, place your palms and soles over ice packs during the duration of each infusion.
Creams or ointments
• Gently apply moisturizing creams containing urea (Eucerin with urea), ammonium or lactate acid (Lac-Hydrin or Am-Lactin), or salicylic acid (Cerave SA). Do not rub them on vigorously.
• For painful areas, your doctor may prescribe creams or ointments containing
  corticosteroids, such as clobetasol or fluocinonide, to decrease pain and
  inflammation, or containing anesthetics, such as lidocaine or benzocaine, to numb
  the painful areas.
• If the skin becomes thick or calluses form, your doctor may prescribe creams with prescription-strength exfoliants containing urea, ammonium lactate or salicylic acid.
Pain relief
• Use over-the-counter acetaminophen, such as Tylenol.
• Check with your doctor if you require stronger medications, including codeine-
  related medications or nonsteroidal anti-inflammatory drugs, such as ibuprofen,
  naproxen and celecoxib.
• No vitamins have been shown to help with hand-foot syndrome.