This section has been reviewed and approved by the PLWC Editorial
Hand-foot syndrome is a side effect of some types of chemotherapy that
causes redness, swelling, and pain on the palms of the hands and/or the soles
of the feet. Hand-foot syndrome occurs when small amounts of chemotherapy
leak out of the capillaries (small blood vessels) in the hands and feet.
Once out of the blood vessels, the chemotherapy damages the surrounding
tissues. Although less common, hand-foot syndrome can also occur on other
areas of the skin, such as the knees and elbows.
The following chemotherapy may cause hand-foot syndrome:
- Capecitabine (Xeloda)
- Cytarabine (Cytosar-U)
- Floxuridine (FUDR)
- Fluorouracil (5-FU)
- Idarubicin (Idamycin)
- Liposomal doxorubicin (Doxil)
In mild to moderate hand-foot syndrome, the following symptoms may
occur on the palms and/or soles:
- Redness (resembling a
- A sensation of tingling
Symptoms of severe hand-foot syndrome include the following:
- Cracked, flaking, or
- Blisters, ulcers, or
sores on the skin
- Severe pain
- Difficulty walking or
using the hands
If you develop severe hand-foot syndrome, your doctor may reduce your chemotherapy
dose or alter your chemotherapy schedule. If necessary, your doctor may
temporarily stop your chemotherapy until your symptoms improve.
The following medications may be used to treat hand-foot syndrome:
- Oral or topical (applied
to the skin) corticosteroids to reduce inflammation
- Topical dimethyl sulfoxide
(RIMSO-50) to help reduce leakage of chemotherapy from the
- Vitamin B6 (pyridoxine [Nestrex]) to help reduce symptoms
- Over-the-counter pain
relievers, such as acetaminophen (Tylenol), to help relieve pain
Management and prevention
Management and prevention of symptoms focuses on avoiding friction and
heat, which make the symptoms worse. The following suggestions may help
you manage symptoms and prevent hand-foot syndrome from becoming worse:
- Avoid prolonged exposure
of hands and feet to hot water when washing dishes or bathing.
- Take cool showers or
- Avoid exposure to
sources of heat, including saunas, sitting in the sun, or sitting in
front of a sunny window.
- Avoid activities that
cause unnecessary force or friction on the feet, such as jogging,
aerobics, and long walks.
- Avoid contact with harsh
chemicals used in laundry detergents or household cleaning products.
- Avoid the use of rubber
gloves to clean with hot water, as rubber traps heat against your
- Avoid using tools or
household items that require you to press your hand against a hard
surface, such as garden tools, knives, and screwdrivers.
Other things you can do to help manage symptoms of hand-foot syndrome
- Cool your hands and feet
with ice packs or cool compresses for 15 to 20 minutes at a time.
(Avoid applying ice directly to the skin.)
- Elevate your hands and
feet when sitting or lying down.
- Carefully pat your skin dry
after washing or bathing-try not to rub your skin with a towel.
- Gently apply mild skin
care creams to keep your hands moist. Avoid rubbing or massaging
lotion into your hands and feet, as this creates friction.
- Wear loose,
well-ventilated shoes and clothes.
PLWC: Managing Side Effects