Skin Care During Treatment With Targeted Therapies

This information will help you manage skin problems that can develop while taking targeted treatments for cancer.

Targeted treatments cause fewer side effects than chemotherapy. However, they can lead to skin problems. These skin problems are most often seen with the following targeted medications:

  • Erlotinib (Tarceva®)
  • Cetuximab (Erbitux®)
  • Panitumumab (Vectibix®)
  • Lapatinib (Tykerb®)

Skin Changes

You may have none, some, or all of the following symptoms:

Acne-like rash on the face, chest, and upper back

  • The rash can cause mild discomfort with itching, or can cause more severe pain that stops you from doing your usual activities.
  • In most patients, the rash is mild to moderate and will not affect your daily life.
  • It may look like acne, but it is not. It will not improve with antiacne medications.
  • The rash will usually appear within the first few months of treatment.

Dry, scaly skin and itching on the scalp, trunk, arms, and legs

  • The dryness will appear as cracks on your fingertips and heels.
  • Dry skin and itching can be uncomfortable enough to disrupt sleep.
  • This usually appears after 2 months of treatment.

Painful swelling in the fingernails or toenails

  • This may make it hard to pick up small things such as a pen or a fork. You may have trouble buttoning your clothes or putting on shoes.
  • This usually appears after 4 months of treatment.

Hair curling or hair loss on the scalp

  • This may include increased hair growth on the face, eyebrows, or eyelashes.
  • This usually appears after 4 months of treatment.
  • Symptoms usually go away when the dose of the medication is lowered or when treatment is stopped. The skin will begin to heal after a few weeks.
  • If you wish to remove any hair, we recommend doing so through threading. We do not recommend waxing because it can cause an infection.
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Managing Your Symptoms

Tell your doctor or nurse as soon as you begin to have any of these symptoms. Do not stop taking your medications unless your doctor or nurse tells you to. Follow the suggestions below to help you manage:

  • During the first month of treatment, stay out of the sun or use a sunscreen with an SPF of at least 30. It should protect you against both UVB and UVA sunlight.
  • If you are taking erlotinib, always take the pill on an empty stomach (at least 1 hour before or 2 hours after eating).
  • Makeup is safe to use, but avoid those with many ingredients. Stop using them if they cause redness and itching.

Use the table below to find possible treatments for your symptoms.


Possible Treatments

Dry skin

  • Over-the-counter moisturizers (Vanicream®, Eucerin®, Aquaphor®)
  • Ointments or creams rather than lotions

Very scaly areas

  • Over-the-counter AmLactin® cream

Cracks in the fingertips

  • Creams or ointments containing zinc oxide (Desitin® regular or Maximum Strength®)

Itchy skin

  • Over-the-counter creams (Sarna Ultra cream®) or oral medications (Benadryl®)
  • Prescription medications applied to the skin or taken by mouth. (Most anti-itch tablets cause drowsiness, so you may want to take them at night)

Red, inflamed skin

  • Prescription creams containing corticosteroids

Itching on the scalp

  • Prescription solutions or foams that contain corticosteroids

Inflammation around fingernails
or toenails

  • Prescription medications, including topical antibiotics (silver nitrate applied weekly)
  • Wear soft shoes
  • Avoid activities that could injure the fingers or toes
  • If there is any sign of infection (pain, redness, secretions), soak fingers or toes every evening in a solution of white vinegar diluted in an equal amount of tap water

Increased hair growth on the face

  • Use electric razors instead of chemical hair removers
  • Use threading to remove hair. Avoid waxing because it can cause an infection
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If you have any questions or concerns, talk with a member of your healthcare team. You can reach them Monday through Friday from 9:00 am to 5:00 pm at ____________________. After 5:00 pm, during the weekend, and on holidays, please call____________________. If there’s no number listed, or you’re not sure, call 212-639-2000.

Skin Care During Treatment With Targeted Therapies
Printed on May 24, 2015, 7:03 am