Posttreatment Lung Cancer Rash: Photos and Tips To Soothe | MyLungCancerTeam

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Posttreatment Lung Cancer Rash: Photos and Tips To Soothe

Medically reviewed by Richard LoCicero, M.D.
Written by Joan Grossman
Updated on April 16, 2024

Many people with lung cancer experience skin rashes as side effects from treatments such as radiation, chemotherapy, targeted therapy, or immunotherapy. Different kinds of skin reactions can occur, depending on the specific treatment. Some rashes may be managed at home, while more serious skin issues might require treatment in a doctor’s office or even urgent medical care.

MyLungCancerTeam members often discuss 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.

Causes of Rashes With Lung Cancer Treatment

Treatment options for lung cancer can affect the skin in a variety of ways. Lung cancer itself may also lead to skin symptoms. In some cases, lung cancer can spread to the skin. Since rashes can have a variety of causes related to lung cancer, be sure to talk to your oncologist to discuss any new or changing skin issues.

Rashes From Radiation Therapy

As many as 95 percent of people who undergo radiation (also called radiotherapy) experience skin problems 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 narrowing in blood vessels in the skin and often goes away in a few days. Longer-lasting reactions may occur if exposure to radiation has affected hair follicles and deeper layers of the skin. Skin reactions may also be delayed — appearing 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 doesn’t heal properly. Skin folds can increase the risk for acute reactions because they trap moisture, which can absorb more radiation.

Rashes From Chemotherapy and Targeted Therapy

More than 90 percent of people who have chemotherapy for non-small cell lung cancer (NSCLC) with newer targeted therapy drugs experience extensive skin dryness.

Targeted therapy increases the risk for a rash in the hair follicles that causes itching, pain, and infection that may resemble acne. Drugs that target the epidermal growth factor receptor, called EGFR inhibitors, can cause an inflammatory skin response. Around 8 percent to 12 percent of cases are severe.

Having radiation therapy prior to 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 and Skin Rashes

Immunotherapy works 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.

Symptoms of Skin Rashes

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 types of rashes that commonly occur with treatment. If you experience severe symptoms — especially on your eyes and eyelids or inside the mouth or nose — seek immediate medical care.

Radiation Dermatitis

Symptoms from radiation dermatitis typically occur in the area of the body where radiation treatment was directed. Mild to moderate symptoms include:

  • Redness or discoloration
  • Dry peeling or shedding of skin
  • Moist peeling in skin folds
  • Skin feeling dry, warm, or tight
  • Itching
This instance of radiation dermatitis in a person’s armpit was caused by radiation therapy for breast cancer. Symptoms of this type of rash include discoloration and peeling. (Medical Images)

More serious symptoms include moist peeling of skin outside of folds, bleeding easily or without known cause, or thick skin sores. If any of these symptoms occur, seek immediate medical care.

Radiation recall symptoms may be similar to radiation dermatitis. Seek urgent care if you develop:

  • Increasing pain
  • Swelling
  • Pustulent eruptions
  • Ulcerations or open wounds
Symptoms of radiation recall that require urgent care include pustulent eruptions and open wounds. (CC BY-NC-ND 3.0 NZ/DermNet)

At MyLungCancerTeam, members sometimes talk about their postradiation rashes. One shared, “The itching continues from my radiation rash.” Someone else commented, “It seems my skin is really sensitive to treatment, and the itchy rash will continue till treatment ends.”

Acne-Like Rash

A rash from targeted therapy can look 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 clears after two weeks, although it can persist for months.

Symptoms include:

  • Small, red or purple bumps or papules
  • Pus-filled bumps
  • Itching
  • Pain

If this rash covers more than 30 percent of the body or appears infected, it requires urgent medical care.

Targeted chemotherapy can cause a rash that looks similar to acne. This type of rash resembles an acne outbreak and most commonly occurs on the face, chest, upper back, and scalp. (Science Photo Library)

Immunotherapy Rashes

Rashes from immunotherapy have a range of symptoms that commonly occur on the arms and chest, including:

  • Redness or signs of irritation
  • Itching
  • Swelling from fluid buildup
  • Changes in skin color
This image shows a rash induced by the immunotherapy drug pembrolizumab. Rashes from immunotherapy drugs are characterized by skin discoloration, itchiness, and swelling from fluid buildup. (CC BY-NC-ND 3.0 NZ/DermNet)

More serious symptoms include blisters that break and create open sores.

Some MyLungCancerTeam members have experienced rashes while taking immunotherapy treatment — some of them severe. One member shared, “I had immunotherapy, but it gave me a rash all over my body. So they stopped it to see if the rash gets better.”

Another reported, “The rash started within a month of my first infusion. It affects my face, chest and back. It's dry, red, and itchy, and sometimes raises red bumps.”

A member taking a different immunotherapy said, “I have a red rash on my arms and legs, but it’s not itchy.”

Treating Skin Rashes

Skin care is an important part of your cancer care. Discuss treatment options for rashes with a health professional, 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 the following:

  • Clean the skin with warm water, mild soaps or cleansers, and soft cloths.
  • Rinse the affected area with care and gently pat it dry.
  • Moisturize dry skin.
  • Protect skin from cold and hot temperatures.
  • Avoid the sun, and use a recommended sunscreen.
  • Dress the affected area in loose, soft clothing.
  • If you’re prescribed any topical treatments, use them exactly as directed.
  • Seek urgent medical advice if your skin appears to be infected.

It’s essential to maintain any recommended treatment plan to avoid more serious complications and to improve your quality of life.

Tips From MyLungCancerMembers

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, creams, ointments, oils, etc., will heat up. I only put Aquaphor on my skin lightly on weekends in the areas that were focused with radiation.”

One member who mentioned having dry skin and weakened nails after treatment received this recommendation: “Hair, skin, nails gummies with biotin. It wouldn’t hurt to try.”

Some members have found relief with topical medications. “I used triamcinolone acetonide cream USP 0.1 percent and Minerin cream (same as Eucerin). They work really well for me.”

Others see their doctors for a steroid prescription. “Had a rash on my bald head. Steroids are already clearing it up,” one member reported.

Another agreed: “Steroids have been a lifesaver to prevent severe reactions.”

Some members have found taking an antihistamine can relieve the itch that comes with posttreatment rashes. “I started the Benadryl before bed and the itching has totally subsided. I’m sleeping much better,” one member said.

Whether you seek treatment for rashes from your doctor or try over-the-counter remedies, it’s important to be gentle with yourself. “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.”

Talk with Others Who Understand

MyLungCancerTeam is the social network for people with lung cancer and their loved ones. On MyLungCancerTeam, more than 12,000 members come together to ask questions, give advice, and share their stories with others who understand life with lung cancer.

Have you experienced rashes you believe are related to lung cancer treatment? Share your experience and tips for managing them in the comments below, or start a conversation by posting on your Activities page.

    Updated on April 16, 2024
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    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.

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