Hand-foot syndrome with chemotherapy

Hand-foot syndrome (HFS) is a common side effect of some chemotherapy drugs. It affects the palms of the hands and soles of the feet. The condition is also known as Palmar-Plantar Erythrodysesthesia.

Once you stop treatment, symptoms usually settle in 2 to 4 weeks.

It is not life threatening but you can feel very uncomfortable and unable to do some of your usual activities.

The chances of HFS and how severe it is can depend on the dose and length of treatment. 

Causes of hand-foot syndrome

The chemotherapy drugs that might cause HFS include:

• capecitabine (Xeloda)
• 5 fluorouracil (5-FU)
• liposomal doxorubicin (Doxil)
• doxorubicin (Adriamycin)
• cyclophosphamide
• docetaxel (Taxotere)

Common signs of HFS

Symptoms include:

• tingling, burning and itching on palms or soles
• redness, like sunburn
• pain and swelling
• numbness
• rash.

Signs of severe HFS

In severe cases, you may have:

• cracked and peeling skin
• blisters and ulcers on the skin
• intense pain
• difficulty walking and using hands
• nails lifting from the nail bed.

Managing hand-foot syndrome

Tell your doctor as soon as you notice the signs of HFS or if they get worse. Your doctor may do one or more of the following:

• lower your chemotherapy dose
• temporarily stop treatment until symptoms ease (usually within 2 to 4 weeks)
• prescribe steroid creams for the skin (‘topical creams’ to reduce inflammation)
• recommend pain relieving medication.

You can also do things at home to reduce how much it affects you:

• Wear loose comfortable footwear like soft shoes or slippers, to avoid rubbing, or use sheepskin inserts.
• Take cool baths or showers.
• Cool your hands and feet with cold running water.
• Apply ice pads to affected areas (but not directly on the skin) for short periods no longer than 15 minutes.
• Raise your hands and feet when sitting.
• After washing skin, pat dry and gently apply moisturiser.
• Avoid harsh chemicals such as laundry detergents.
• Create a moisture barrier with a 10% urea cream on hands and feet three times a day, and after washing your hands.
• Lather your hands and feet with a cream such as MooGoo and wear cotton gloves and socks overnight