Skin and nail care

Certain cancer treatments can cause skin and nail changes due to their effects on healthy cells. While some side effects are mild and manageable, others may require medical attention. Your oncology team can help you understand what to expect based on your treatment plan.

Common skin and nail changes by treatment type

Chemotherapy

• Can damage healthy skin and nail cells while targeting cancer

Skin changes:

• Dryness, peeling, redness or itchiness

• Rash or increased sun sensitivity, making skin more prone to sunburn

• Sores on the skin or lips that are not caused by cuts or injury

• Radiation recall – skin irritation on areas previously treated with radiation therapy

Nail changes:

• Darkening, yellowing, cracking

• Red, painful cuticles

Radiation therapy (external beam therapy, IMRT, IGRT)

• Skin may look sunburned, tan, swollen or puffy

• May cause dryness, peeling, itching and color changes (redness or darkening)

Biological therapy (immunotherapy)

• May cause pain, swelling, soreness, redness, itchiness or rash at the infusion or injection site

Targeted therapy

• May cause dry skin, acneiform rash (rash that looks like acne) or nail problems

Interesting finding: Patients who develop an acneiform rash often respond better to targeted therapy drugs than those who do not.

When to call your oncologist immediately

Some skin issues can be serious and require urgent care. Contact your oncology team right away if you experience:

• Sudden or severe itching, rash or hives during or right after chemotherapy (signs of an allergic reaction)

• Painful, wet or infected sores that appear without a known cause (moist reaction). This often occurs in skin folds (ears, breasts or bottom).

• Swelling, redness, burning or pain near a surgery or procedure site or an IV or port.

Proper skin and nail care can help manage these side effects. Speak with your cancer care team about the best ways to protect your skin and nails during treatment.

Proper skin and nail care during cancer treatment can help reduce irritation, prevent infections and minimize discomfort. Your cancer care team can provide personalized recommendations based on your specific treatment plan.

Protecting your skin during cancer treatment

• Apply lotions, creams, or ointments to manage dry, itchy, swollen, or irritated skin.

• Shave less often or switch to an electric razor to reduce skin irritation.

• Avoid using heating pads, ice packs, or bandages on areas receiving radiation therapy.

When outdoors:

• Wear sunscreen (SPF 30 or higher) and SPF lip balm.

• Cover exposed skin with loose-fitting clothing and a wide-brimmed hat.

Preventing or treating dry, itchy skin

• Avoid skin care products with alcohol or perfume, including laundry detergents, as they can irritate or dry out your skin.

• Take short, lukewarm baths or showers instead of long, hot ones.

• Add baking soda, oatmeal (in a cloth or mesh bag), or bath oil to bathwater for relief.

• Use calamine lotion (Caladryl®) or witch hazel to soothe itching, but note they may dry out the skin.

• Avoid scrubbing your skin while bathing—gently pat dry instead.

• Apply fragrance-free lotion while skin is still slightly damp.

• Maintain a cool (60° to 70°F) and humid home environment—use a humidifier if necessary.

• Protect skin from cold and wind by wearing a hat and scarf in cold weather.

• Stay hydrated and eat a nutrient-rich diet to help keep your skin healthy.

• Apply a cool washcloth or ice to soothe affected areas.

• Consider acupuncture, which has helped some patients manage skin discomfort.

• Get enough rest to support overall skin health.

Preventing or treating minor nail problems

• Keep nails clean and trimmed short to reduce breakage and infection risk.

• Wear comfortable shoes to avoid pressure on toenails.

• Protect hands—wear gloves when washing dishes, gardening, or cleaning to prevent skin from splitting.

• Avoid biting nails and using fake nails or wraps, which may cause nail damage.

• Ask your oncology care team about recommended products to support nail health.

By following these preventative steps, you can help minimize discomfort and maintain skin and nail health during your cancer treatment. If you experience severe symptoms, consult your cancer care team for additional guidance.

Use only recommended skin care products

When caring for skin and nails during cancer treatment, it’s best to use gentle, fragrance-free, alcohol-free, and hypoallergenic products. Creams and ointments tend to be thicker and may provide more relief than lotions.

Recommended skin care products

• Aquaphor advanced therapy healing ointment

• Aveeno skin relief fragrance-free body wash

• Bag Balm skin moisturizer

• Neutrogena sheer zinc sunscreen SPF 50

• Renpure 100% organic coconut oil (use as a moisturizer)

• Dove sensitive skin bar (unscented)

When to use prescription medications

If your skin or nails require extra care, your oncologist may prescribe medications to help manage swelling, dryness, and itching. These may include:

• Topical therapeutic creams or ointments

• Antihistamines (to relieve itching)

• Antibiotics (if there’s an infection)

• Pain medications (for severe discomfort)

Always consult your doctor before using over-the-counter medications, as they may interfere with cancer treatment or cause unexpected side effects.

When to contact your cancer care team

It’s important to report any unusual skin or nail changes to your oncology team, especially if you experience:

• Painful skin

• Sores that won’t heal

• A rash or skin irritation

Certain skin and nail issues could lead to infection if left untreated. Your oncologist may schedule an evaluation to provide personalized recommendations and maximize your comfort.

Here are some helpful resources for more information

• National Cancer Institute – Skin and Nail Changes

• Survivorship Cancer Springboard – Skin and Nail Changes

• CancerCare – Caring for Your Skin During Cancer Treatment

• American Cancer Society – Skin Dryness