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What is hand-foot syndrome?

Hand-foot syndrome (or palmer-plantar erythrodysesthesia) is a common side effect of certain chemotherapy and medicines. It is caused by small amounts of the drug leaking out of very small blood vessels in the palms of your hands and soles of your feet.

It can cause redness, swelling and pain in your palms and soles of your feet. It looks like a sunburn. In severe cases of hand-foot syndrome, blisters may also form and the skin on your hands and feet may crack. It may become hard for you to carry out normal activity, such as, walking or grabbing objects.

Tell your doctor if you start to get any of these symptoms on your palms or soles of your feet:

  • Redness

  • Swelling

  • Becomes tender or painful

  • Tingling, numbness or sense of burning 

  • Blisters

  • Cracked or flaking skin

How can I prevent hand-foot syndrome? 

Exposing your hands and feet to heat and friction while getting certain medicines can increase your chances of getting hand-foot syndrome. You may still get hand-foot syndrome despite trying to prevent it.

Ways to Avoid Hand-Foot Syndrome

  • Avoid hot water when bathing or doing dishes

  • Wear rubber gloves when washing dishes

  • Avoid saunas 

  • Avoid going out in the sun

  • Avoid activities that cause rubbing on your palms and soles, such as running, lifting weights, power walking or walking for a long time in one day

  • Avoid using tools that you have to grasp and cause friction, such as pliers, screwdrivers, knives and garden tools

  • Avoid harsh chemicals on your hands and feet 

What do I do if I develop hand-foot syndrome?

If your palms and soles of your feet turn red, become tender, have damaged or blistered skin, call your provider. 

For some patients, your doctor might decrease or stop the dose of your chemotherapy to allow your skin to heal. While the symptoms resolve, there are things you can do to reduce pain or discomfort.

  • Do not open any blisters if they develop. 

  • Over-the-counter pain relievers can reduce the discomfort and swelling in your hands and feet. Check with your provider before taking them.

  • Apply cold, such as an ice pack or bag of frozen peas, to your palms and soles as this may provide pain relief. Apply cold for 15-20 min and then take off for at least 15-20 min before re-applying.

  • Keep your hands and feet moist with creams that are free of fragrance, dye, and alcohol. Avoid rubbing the cream into your palms and soles. Instead wear a cotton sock or gloves over the cream to allow the cream to work. Ask your healthcare team for ideas on what creams to use

  • Keep avoiding sources of heat and friction.

  • Avoid tight clothing where your rash is. Wearing thick, soft cotton socks or gloves may provide comfort.

  • If you have symptoms that are not bearable, call your provider. 

How long will it last?

Hand-foot syndrome usually goes away 2-4 weeks after stopping the medicine. There are usually no long-term side effects.