Dry, sore and itchy skin

Some lymphoma treatments can cause side effects that affect your skin. For example, you might have dry, sore and itchy skin. In some cases, skin problems can be a symptom of lymphoma. This information gives tips to help you manage dry, sore and itchy skin.

We have separate information about coping with itching as a symptom of lymphoma and about skin lymphoma.

On this page

How might my skin be affected by lymphoma treatment?

How can I manage dry, sore and itchy skin?

How might my skin be affected by lymphoma treatment? 

Your medical team should talk to you about any side effects of lymphoma treatment you might experience.

Some lymphoma treatments can cause side effects that affect your skin. This can happen with chemotherapy, radiotherapy, some targeted treatments and donor (allogeneic) stem cell transplants. 

Young children and people who have sensitive skin before lymphoma treatment generally have a higher likelihood of having skin problems after treatment. 

Skin problems as a side effect of chemotherapy

You might get skin irritation and changes to your skin with some chemotherapy drugs. For example, dryness, itching, soreness, redness and skin peeling. You might also have changes to your skin colour (pigmentation). These issues can be more common with bleomycin, cyclophosphamide, dacarbazine, doxorubicin, methotrexate, vinblastine and Zylonta. Skin sensitivity to sunlight (photosensitivity) is an uncommon side effect of chemotherapy, although it can be more likely with certain drugs. This includes dacarbazine, fluorouracil, methotrexate and vinblastine.

Although it is uncommon, chemotherapy drugs can also trigger a side effect of radiotherapy called radiation recall.

If you notice any changes to your skin, please speak to a member of your medical team so that they can offer advice. It is often helpful to take photos of the affected area, to document any changes.

Chrisse Kirby, Haematology & Transfusion Clinical Nurse Specialist

Allergic reactions to chemotherapy

Allergic skin reactions to chemotherapy are also possible, although uncommon. The most common of these is small (up to 1 cm), red, raised rashes – this is called papular rash. 

Papular rash most often develops around 10 days after you have chemotherapy, but it can develop up to 2 to 3 weeks later. 

More severe allergic reactions can cause a sudden or severe rash, a burning sensation or hives.

If you notice a rash, tell a member of your medical team as soon as possible. Although not all rashes need treatment, it is important to seek medical attention, in case you do need treatment.

Skin problems as a side effect of radiotherapy

You might get skin changes in the area or areas of your body where you have had radiotherapy. 

Possible side effects include the skin in the area treated with radiotherapy becoming:

• dry, itchy and sore skin
• a different colour to your usual skin tone
• blistered, a bit like sunburn – this is rare and is more likely in folds of skin, such as under the breasts, in the groin or armpits.

If you have chemotherapy after radiotherapy, there is a small possibility of getting radiation recall.

While your skin is affected, avoid using any products in these areas that haven’t been prescribed to you. This includes deodorants, anti-perspirants, perfumes and fragranced moisturisers.

Radiation recall

Radiation recall is a rare side effect of radiotherapy. It causes redness and inflamed skin in the areas that receive radiation.

Radiation recall can be triggered by chemotherapy drugs after you have had radiotherapy. It can develop days, or even months, after having radiotherapy. Some of the drugs linked with radiation recall include doxorubicin, docetaxel, paclitaxel, gemcitabine and capecitabine. It can also happen with some targeted treatments. 

Usually, radiation recall is mild and goes away on its own within a couple of weeks. However, it is important to protect inflamed skin from the sun.

Will I get skin problems as a side effect of radiotherapy?

There are lots of factors that affect how likely you are to have skin problems as a side effect of radiotherapy. These are known as risk factors and include:

• age – people over the age of about 60 are at higher risk of developing skin problems (due to the skin being thinner and taking longer to recover from damage)
• skin colour – people with lighter skin are at higher risk of developing skin problems than people with darker skin
• the dose of radiotherapy you receive
• the size of the area of your body treated with radiotherapy
• having also had treatment with chemotherapy (which can lead to radiation recall)
• having had a lot of steroids, for example for other conditions such as arthritis or eczema.

Following a healthy lifestyle can also help your overall health and wellbeing. This includes eating a balanced diet and not drinking a lot of alcohol.

How long do skin problems go on for after radiotherapy?

Skin reactions are usually at their worst a few days after finishing radiotherapy treatment. Your skin then starts to heal. 

Speak to a member of your radiotherapy team if you have cracked or broken skin in the treated area. They can sometimes offer a gel to apply that can help to soothe your skin and to help prevent infection.

Side effects of targeted treatments

Some targeted treatments and immunotherapies cause skin problems such as soreness, rash, dryness and itching (pruritis). This can include rituximab, ibrutinib, brentuximab vedotin and bortezomib.

Will I get skin problems as a side effect of a targeted treatment?

The treatment type you have can affect your likelihood of developing skin problems. As with other treatments, if you have had skin reactions to medication in the past, your risk might be higher. Having a skin condition such as psoriasis or eczema can also increase the risk. Speak to your medical team for advice about your individual situation.

Side effects of donor (allogeneic) stem cell transplant

A common complication of a donor (allogeneic stem cell transplant) is graft-versus-host disease (GvHD). GvHD can cause symptoms such as skin rashes, changes in skin colour, raised areas of the skin, skin thickening or hardening, and a feeling of tightness in the skin. Sunlight can worsen rashes caused by GvHD, so it’s important to protect your skin from the sun.

Back to top

How can I manage dry, sore and itchy skin?

Your medical team is best-placed to give you advice about how to manage skin problems. We give some tips below that you might like to talk to them about. 

It is important to mention any skin conditions to your medical team. If necessary, they can involve dermatology specialists to help manage any skin issues you are experiencing.

Chrisse Kirby, Haematology & Transfusion Clinical Nurse Specialist

You might also find the patient information leaflets available on the British Association of Dermatologists website helpful.

General tips to help manage skin problems

Leading a healthy lifestyle and managing stress can help your overall sense of wellbeing. This can help to make symptoms of lymphoma and side effects of treatment feel more manageable.

Below, we give some ideas you might find helpful in managing skin problems in relation to temperature, bathing or showering, skincare and other lifestyle tips. There are also some tips to help with sun sensitivity (photosensitivity).

Temperature

Hot and cold temperatures can dry your skin and worsen skin irritations and itchiness. This can also be the case with sudden changes in temperature.

It is a good idea to avoid:

• high temperatures, both indoor and outdoor – including water that you bathe or shower in
• being out in strong winds.

Bathing or showering

To minimise irritation and drying out your skin: 

• ask your doctor about suitable soaps, deodorants, moisturisers, shampoos and any other skincare products
• avoid perfumes and fragranced products
• avoid spending a long time in water – keep the temperature warm instead of hot
• avoid using fragranced products and those that contain alcohol (such as wet wipes and antibacterial hand gel) and if you can, wash your hands using a fragrance-free soap or emollient
• use a coconut or oat-based product in the bath, to help moisturise your skin – ask a member of your medical team about natural-based products that are suitable for you
• pat your skin dry with a towel instead of rubbing it
• moisturise soon after you get out of the bath or shower, while your skin is still damp – you could use a water-based emollient cream
• let your hair dry naturally or pat it with a towel rather than rubbing – if you use a hair dryer, keep it on a low temperature setting.

I have a body-temperature shower or bath rather than a hot one. It really helps.

Ashley, diagnosed with skin lymphoma and affected by skin irritation

Skincare

There are things you can do to help lessen skin dryness and irritation:

• drink plenty of water throughout the day
• consider using a humidifier (which release water vapour or steam into the air) to hydrate your skin
• use a suitable fragrance-free moisturiser frequently (around three to four times) throughout the day
• if you wear make-up, speak to your doctor about suitable products: those labelled ‘hypoallergenic’ (designed to cause fewer irritations) might be suitable if your skin is not broken
• use a cool (not freezing) compress to soothe painful skin.

Ask your doctor if they can prescribe or recommend an anti-itch moisturiser. You might have to try a few different ones before finding one that works well for you. If one moisturiser doesn’t help, see if your doctor can suggest something else.

Chrisse Kirby, Haematology & Transfusion Clinical Nurse Specialist

Lifestyle

To minimise skin irritation, you could try the following tips:

• wear loose-fitting clothes made of soft, natural fabrics like bamboo, cotton or linen
• keep your fingernails short to reduce scratching itchy skin
• eat a healthy diet and drink plenty of water to help keep your skin healthy
• find ways to relax, manage stress and get restful sleep – taking care of your overall emotional wellbeing can help to manage physical symptoms
• if you shave, use an electric razor rather than wet shaving, to lower the risk of skin irritation and to avoid shaving cuts
• avoid hair removal methods such as waxing, threading and hair removal creams
• while you’re having treatment and for a while after, avoid hair dyes, perming and chemically straightening – once your medical team advise that it’s safe for you to use these, do a patch test in case your skin has become sensitive to these products – this is even more important if you have skin irritations
• avoid chlorine.

Avoiding scratching is easier said than done, but habit reversal can be really effective. Individual itches don’t tend to last, so sitting on your hands and counting to 30 should mean that the itch has gone, you haven’t scratched and therefore haven’t damaged the skin and made it more itchy.

Ashley, diagnosed with skin lymphoma and affected by skin irritation

To help with sensitivity to sunlight (photosensitivity)

Sun safety is important for everyone. If your skin has become more sensitive to sunlight, you can take steps to minimise irritation and further damage in the following ways:

• protect your scalp by wearing a hat or high factor (SPF 50) sun cream when you are out in the sun
• use a high factor (SPF 50) sun cream and reapply it frequently, especially if you are swimming or sweating
• avoid the sun when it is at its strongest (11am to 3pm during summer months in the UK)
• avoid using sunbeds
• if your photosensitivity is severe, ask your doctor if a steroid treatment is suitable for you and if they can prescribe one.

Cancer Research UK has more information about sun safety.

Back to top