Some chemotherapy drugs can cause hand-foot syndrome, also known as palmar-plantar erythrodysesthesia. It happens because chemotherapy drugs have a tendency to concentrate in the palms of the hands and soles of the feet. Ask your doctor if hand-foot syndrome is a side effect you're likely to experience.

You may notice redness, tenderness and possibly peeling of the palms and soles. They can tingle, become numb, or they can dry and peel. Hand-foot syndrome can be uncomfortable and can interfere with your ability to carry out normal activities.

How to prevent hand-foot syndrome

• Apply a moisturizer to hands and feet liberally and often, especially in all creases.
• Avoid exposure of hands and feet to heat such as hot water. Bathe or shower in warm water. Soak hands and/or feet in basins of cold water 3 to 4 times per day if possible.
• Avoid activities that cause rubbing of skin surfaces or even slight pressure on hands, such as vigorous washing, gripping tools or appliances, typing, playing musical instruments or driving. Do not apply tight dressing or adhesive tape to skin, such as Band-aids.
• Sit or lie on padded surfaces. Raise legs whenever possible with cushions.
• Place a pillow between knees or wear pyjamas, if rubbing of legs occur during sleep.
• Avoid any unnecessary walking, jogging or vigorous exercise.
• Wear loose fitting clothes and loose fitting shoes with cushioned soles.

Tell your healthcare team if you notice that your palms or soles become red or tender. Chemotherapy treatments may need to be interrupted or the dose adjusted to prevent worsening of hand-foot syndrome.

What you can do

If you get hand-foot syndrome, there are things you can do to relieve the symptoms.

• Keep hand and feet cool. Placing the palms or bottoms of your feet on an ice pack or a bag of frozen peas when possible may be very comforting. Alternate on and off for 15-20 minutes at a time.
• Apply lotions. Avoid vigorous rubbing to palms and soles when applying moisturizers. If blistering and ulceration develop, use only gentle emollient moisturizers on your hands and feet, as directed by your physician. Topical wound treatment may also be prescribed by your doctor.
• Ask your doctor about the following medications:
• Pain relievers: Over-the-counter pain relievers such as acetaminophen may be helpful to relieve the discomfort.
• Vitamins: Taking Vitamin B6 may be helpful in preventing and treating hand-foot syndrome.
• Corticosteroids: If you are receiving chemotherapy infusions every 3 to 4 weeks, your doctor may prescribe a corticosteroid to treat your hand-foot syndrome.

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