Quick Links
Resources
About MyLungCancerTeam
Powered By
Medically reviewed by
Article written by
Many people with lung cancer experience skin rashes as side effects from treatments such as radiation, chemotherapy, targeted therapy, immunotherapy, or stem cell transplantation. Different kinds of skin reactions can occur, depending on the specific treatment. Rashes may be managed both in a clinical setting and at home.
MyLungCancerTeam members have shared their experiences with rashes and lung cancer treatment. “I have a rash from chemo that kind of burns like a bad sunburn,” a member said. Another member responded, “I just got a rash from the chemo, too … just on my head and neck. Itches like crazy! It’s annoying, but nothing I can’t deal with.”
A third member wrote, “I have just been on immunotherapy every four weeks. I have been very lucky in that I only experience fatigue and, every once in a while, a rash.”
It’s important to recognize which type of rashes are common and can be treated at home and when they’re severe and require medical care. In some cases, urgent medical treatment may be needed for serious rashes.
Various treatment options for lung cancer can affect the skin in a variety of ways. Be sure to talk to your oncologist before treatment to discuss potential skin rashes.
As many as 95 percent of people who undergo radiation, also known as radiotherapy, experience changes in their skin, known as radiation dermatitis. Radiation exposure can cause inflammation at the site of treatment due to reactions in skin tissue and the skin barrier.
Radiation dermatitis that appears within 24 hours of treatment is usually caused by a dilation (narrowing) in blood vessels in the skin and often goes away in a few days. More sustained reactions may occur if exposure to radiation has affected hair follicles and deeper layers of the skin. Acute reactions may appear weeks or months after treatment due to higher doses of radiation that cause deeper skin injuries.
In rare cases, chronic radiation dermatitis may develop months or years after treatment when skin tissue does not heal. Skin folds can increase the risk for acute reactions because they trap moisture, which can absorb more radiation.
More than 90 percent of people who have chemotherapy for non-small cell lung cancer with newer targeted therapy drugs experience extensive skin dryness. Targeted therapy increases the risk for skin reactions, such as follicular rash (in hair follicles), itching, pain, and infection. Follicular rash is also known as acneiform rash and resembles acne.
Acneiform rash from targeted therapy is caused by an inflammatory response to chemotherapy drugs that target the epidermal growth factor receptor, which can cause an overproduction of cells that are associated with cancerous tumors. Around 8 percent to 12 percent of cases are severe.
Having radiation therapy prior to some standard chemotherapy or targeted therapy drugs is a risk factor for a condition called radiation recall, which can resemble radiation dermatitis. Radiation recall occurs in approximately 9 percent of cases and may cause skin reactions that range from mild to severe.
Immunotherapy drugs work by activating the immune system to target cancer cells. Side effects occur when these drugs cause the immune system to attack healthy cells. Rashes and itching are the most common side effects in skin. Mouth sores and hair loss can also occur.
Rashes that occur after a stem cell transplant can be an indication of acute graft-versus-host disease, a potentially serious complication in which donor cells attack host cells, which can first show up in the skin.
Rashes after a stem cell transplant can also be due to a viral infection, which occurs in 60 percent to 70 percent of cases. Additionally, skin rashes may occur due to side effects from drugs that are used in the treatment of people who have had a stem cell transplant.
If you develop a rash after treatment for lung cancer, be sure to discuss the symptoms with your oncology team and determine if you need to see a dermatologist. There are several common types of rash that commonly occur with treatment. Severe symptoms are an indication that immediate medical care is needed, particularly if the eyes or mucous membranes (e.g., mouth, eyelids, nose) become affected.
Symptoms from radiation dermatitis typically occur in the area of the body where radiation treatment has occurred. Mild to moderate symptoms include:
More serious symptoms include moist peeling of skin outside of folds, easy or spontaneous bleeding, or thick skin sores. If any of these symptoms occur, seek immediate medical care.
Radiation recall symptoms may be similar to radiation dermatitis. Acute symptoms that require urgent care include:
Acneiform rash from targeted chemotherapy is sometimes called papulopustular eruption and looks like acne. It most commonly occurs on the face, chest, upper back, and scalp, but it can affect other parts of the body. The rash tends to develop in the first week after treatment with targeted chemotherapy drugs and usually decreases after two weeks, although it can persist for months.
Symptoms include:
Acneiform rash that covers more than 30 percent of the body or appears infected requires urgent medical care.
Rashes from immunotherapy have a range of symptoms that commonly occur on the arms and chest, including:
More serious symptoms include blisters that break and create open sores.
Discuss treatment options for rashes with your doctors, particularly if any skin is open or bleeding. Your doctor may advise oral or topical medications. You may be prescribed corticosteroids to help prevent rashes from some chemotherapy drugs.
Talk to your health care team about appropriate soaps, moisturizers, and sunscreens for your rash.
Recommendations for managing mild rashes include:
It’s essential to maintain any recommended treatment plan to avoid more serious complications and to improve your quality of life.
Caring for skin during and after treatments is a topic of discussion on MyLungCancerTeam. “I completed three months of radiation with minimal pain, minimal burns,” a member wrote. “I learned that with radiation treatments, it’s best not to put any type of lotions on the areas that will be treated. The lotions, oils, etc., will heat up. I only put Aquaphor on my skin lightly on weekends in the areas that were focused with radiation.”
“My rash has made its way to my stomach and back!” another member wrote. “Guess it’s working its way down and out. I just take things one day at a time and know that it will all work out.”
MyLungCancerTeam is the social network for people with lung cancer and their loved ones. On MyLungCancerTeam, more than 6,000 members come together to ask questions, give advice, and share their stories with others who understand life with lung cancer.
Are you living with lung cancer and have questions about rashes? Share your experience in the comments below, or start a conversation by posting on your Activities page.
Richard LoCicero, M.D. has a private practice specializing in hematology and medical oncology at the Longstreet Clinic Cancer Center, in Gainesville, Georgia. Review provided by VeriMed Healthcare Network. Learn more about him here.
Joan Grossman is a freelance writer, filmmaker, and consultant based in Brooklyn, NY. Learn more about her here.
