Skin conditions

Below you will find common skin conditions during oncology treatments.

radiotherapy ~ skin conditions side effects
chemotherapy ~ skin conditions side effects
Hormone therapy
Immune therapy & Biologicals
Skin inflammation ~ skin condition

Radiotherapy ~ Skin conditions    Chemotherapy ~ Skin conditions   Hormone therapy ~ Skin conditions   

Skin inflammation

(bumps, tags and rashes)

Oncology treatments can cause skin irritation and inflammation by different routes, such as damaging the rapidly dividing skin cells, therefore inducing an inflammatory response. These may lead to skin inflammation which refers to a state where the skin becomes red, swollen and itchy. It is a natural mechanism that aids in combating harmful pathogens and healing1.

Brittle, cracked nails and cuticles

Radiotherapy ~ Skin conditions    Chemotherapy ~ Skin conditions      

Cracked nails – Brittleness

Oncology treatments can have an impact on the quickly dividing cells in the nail matrix, leading to various alterations in the nails. These changes often manifest as brittle, dry, and fragile nails, accompanied by cuticles that are more susceptible to cracking and splitting. Patients undergoing oncology treatments have frequently reported experiencing these nail-related issues2. The primary reason behind nail brittleness and cracked nails is attributed to the breakdown of the intercellular cement substance that binds the horny lamellae of the nail together. As a result, the nails tend to split in layers, often starting from the free edge. These nail alterations are among the potential side effects that patients undergoing oncology treatments may encounter3.

Stomatitis condition

Radiotherapy ~ Skin conditions    Chemotherapy ~ Skin conditions      

Stomatitis – Oral mucositis

(oral blisters, difficulty in ingestion)

Stomatitis, a frequent adverse effect of chemotherapy, is marked by inflammation and tenderness in the mouth or the mucous membranes that line the oral cavity. Its symptoms encompass pain, redness, swelling, and the formation of mouth sores or ulcers4. Oral mucositis is distinguished by the presence of red and ulcerative lesions on the oral mucosa, which can cause considerable pain and may negatively impact nutrition and oral hygiene. Additionally, these lesions heighten the risk of both local and systemic infections5.

Malignant wounds ~ skin condition

Radiotherapy ~ Skin conditions    Chemotherapy ~ Skin conditions      

Malignant wounds

(tumors breaking through the skin)

Malignant wounds are chronic wounds that occur when cancer cells invade and destroy healthy skin or underlying tissues. These wounds are usually ulcers that may be accompanied by pain or discharge of fluid6.

Atopic dermatitis ~ skin condition


Atopic dermatitis

(itchiness, sores)

Patients undergoing oncology treatments frequently encounter a compromised immune system, making them more susceptible to skin infections, including atopic dermatitis. Atopic dermatitis is an inflammatory skin disorder characterized by itchy skin lesions. It is a prevalent condition that exhibits eczematous lesions and intense itching, significantly impacting the patient’s quality of life7.



Eczema, also known as Atopic dermatitis, is a prevalent chronic and recurrent condition marked by pruritus and a disruption of the epidermal barrier function8. This skin condition leads to inflammation, irritation, and redness9.

Chemotherapy extravasation ~ condition

Chemotherapy ~ Skin conditions   

Chemotherapy extravasation

(leaking of chemo drugs in the skin & wounds)

Chemotherapy extravasation is when chemotherapy drugs leak into the surrounding tissue instead of entering the intended vein. This can lead to symptoms such as pain, swelling, redness, blistering or even ulcers in the affected area and can cause damage to the surrounding tissues10.

Radiation dermatitis ~ skin condition

Radiotherapy ~ Skin conditions

Radiation dermatitis

Radiation therapy frequently leads to radiation dermatitis, a condition that affects a significant proportion of patients undergoing treatment, with rates reaching up to 85%. This condition can result in moderate-to-severe skin reactions, characterized by distinct changes like swelling, redness, pigmentation disturbances, and tissue necrosis11. Radiation dermatitis can present as acute erythema and peeling, or as chronic effects, including skin thinning, visible blood vessels (telangiectasias), and fibrosis12. Acute radiation dermatitis appears as skin lesions caused by ionizing radiation and typically emerges within days or weeks after treatment, while chronic radiation effects may manifest months or even years after radiation therapy. The impact of radiation therapy on healthy tissues is evident in cell death, particularly noticeable in regenerating tissues like the epidermis and mucosal epithelia13.

Radiation dermatitis can manifest as acute erythema and desquamation, or as chronic effects including skin atrophy, telangiectasias, and fibrosis14. Chronic radiation can be observed months or years after the radiation therapy unlike acute radiation that can be seen days or weeks after the treatment. The effect of radiation therapy has on healthy tissues can be even seen by cell death and it is easily shown on renewing tissues like the epidermis and mucosal epithelia15.

Radiotherapy ~ Skin conditions

Acute radiation dermatitis

It is a common adverse effect in patients receiving radiotherapy. It can be observed as a burn injury of which the severity may vary according to the treatment and factors related to the patient. The burn injury may resolve weeks after its appearance but there were cases where the reaction persisted and caused complications to the treatment16. A variation of acute radiation dermatitis may be observed, known as radiation recall which is an acute inflammatory reaction usually focused in the area of the previous radiation. Drug agents that treat cancer seem to trigger the phenomenon17.

  1. Alley, E., et al. (2002). ‘Cutaneous toxicities of cancer therapy’, Current opinion in oncology, 14(2), 212–216.
  2. Mittal, S., et al. (2022). ‘Nail Changes With Chemotherapeutic Agents and Targeted Therapies’ Indian Dermatol Online J. 24;13(1):13-22.
  3. Colombo, E,V et al (1990). ‘Treatment of brittle fingernails and onychoschizia with biotin: Scanning electron microscopy’ Journal of the American Academy of Dermatology. 23(6) p 1127-32 doi:10.1016/0190-9622(90)70345-I.
  4. Wojtaszek C. (2000). ‘Management of chemotherapy-induced stomatitis’, Clinical journal of oncology nursing, 4(6), 263–270.
  5. Lalla RV, et al (2008) ‘Management of oral mucositis in patients with cancer’ Dent Clin North Am. 2008 January ; 52(1): 61–viii. doi:10.1016/j.cden.2007.10.002.
  6. Tsichlakidou, A., et al. (2019). ‘Intervention for symptom management in patients with malignant fungating wounds – a systematic review’, Journal of B.U.ON.: official journal of the Balkan Union of Oncology, 24(3), 1301–1308.
  7. Langan, S,M et al. (2020). ‘Atopic dermatitis’, Lancet, 396(10523), 758.
  8. Sohn A et al (2011), ‘Eczema’ Mt Sinai J Med 78(5) p730-9 doi:10.1002/msj.20289.
  9. Nemeth V et al (2021), ‘Eczema’ StatPearls[Internet] Treasure Island (FL) :StatPearls Publishing.
  10. Jackson-Rose, et al. (2017). ‘Chemotherapy Extravasation: Establishing a National Benchmark for Incidence Among Cancer Centers’, Clinical journal of oncology nursing, 21(4), 438–445.
  11. Rosenthal, A., et al. (2019). ‘Management of acute radiation dermatitis: A review of the literature and proposal for treatment algorithm’, Journal of the American Academy of Dermatology, 81(2), 558–567.
  12. Leventhal, J, et al (2017). ‘Radiation Dermatitis: Recognition, Prevention, and Management’, Oncology (Williston park), 15;31(12):885-7,894-9.
  13. Benomar, S. et al (2010). ‘Treatment and prevention of acute radiation dermatitis’, Cancer/Radiotherapy, 14(3),p213-216 doi:10.1016/j.canrad.2010.02.001.
  14. Gosselin, T. K., Schneider, S. M., Plambeck, M. A., & Rowe, K. (2010). A prospective randomized, placebo-controlled skin care study in women diagnosed with breast cancer undergoing radiation therapy. Oncology nursing forum, 37(5), 619–626.
  15. Kole, A. J., Kole, L., & Moran, M. S. (2017). Acute radiation dermatitis in breast cancer patients: challenges and solutions. Breast cancer (Dove Medical Press), 9, 313–323.
  16. Seite, S. et al (2017).’Prevention and treatment of acute and chronic radiodermatitis.’ Breast Cancer(Dove Med Press). 2(9) , p551-557 doi:10.2147/BCTT.S149752.
  17. Burris, H, A,3rd et al (2010).’Radiation recall with anticancer agents.’ The oncologist. 15(11), p1227-37. doi:10.1634/theoncologist.