5 Ways Lung Cancer Treatment Affects Your Skin and How You Can Manage It

Lung cancer, and some of the treatments for it, can have a significant impact on the look and feel of your skin. EGFR inhibitors (EGFRIs), a targeted drug for EGFR-positive non-small-cell lung cancer, can cause a host of uncomfortable skin side effects in up to 90% of people who take them. Lung cancer itself can sometimes cause skin changes, too. Learn what to expect and what to do when you see changes in your own skin.

These bumps look like pimples without blackheads or whiteheads. A common side effect of EGFRIs, they may crop up on your face, scalp, neck, chest, back, or shoulders around the second week of treatment. To prevent or treat them, during the first six months of treatment, moisturize with alcohol- and fragrance-free emollient cream or ointment, use hydrocortisone cream on the bumps, and always wear sunscreen outdoors. You might also take an antibiotic during this time. 

Dry, scaly, itchy skin can develop after the first month or two of treatment. It may continue or get worse throughout treatment. Moisturize your entire body twice a day with thick, unscented emollient cream or ointment. Avoid hot showers, scented products, and sunburn. Always use sunscreen when you're outside. Severely dry skin is more infection prone. Tell your doctor if your skin cracks, bleeds, or looks infected.

Fingertips, skin between the fingers, and the heels may be hardest hit by EGFRI-related dry skin. These areas can become brittle, crack, and even bleed. That same thick cream you’re using everywhere else will help prevent or soothe painful fissures. Cover cracks with a liquid bandage – as long as they’re not bleeding or infected – and change it every week. Wear gloves for tasks like preparing spicy or acidic foods or using cleaning products. 

Fingernails and toenails may become inflamed several weeks or months into treatment. Paronychia, as doctors call it, tends to affect the first few fingers and toes. Most cases are mild. But severe cases cause swelling, pain, and pus under the skin and around the nail bed. Keep your nails trimmed, but avoid professional manicures. Use gloves when needed to avoid irritants. Try soaking in diluted bleach or vinegar. If the problem continues, your doctor can prescribe an antibiotic or antifungal. 

EGFRIs increase your skin’s sensitivity to light, which makes you sunburn-prone. Sunburn on its own is unpleasant enough, but it can also worsen the rashes and dry skin that come with your treatment. Avoiding the sun can help prevent or improve EGFRI skin problems. If you can’t avoid it, apply broad-spectrum sunscreen with SPF 30 or higher twice a day to sun-exposed areas. Get extra protection from a wide brimmed hat and sun-protective clothing. 

• Gentle, fragrance-free cleansers
• Cleansers with moisturizing ingredients like ceramides and hyaluronic acid
• Thick, unscented, alcohol-free creams for all-over use
• Thick, healing ointments for fingertips and heels
• Unscented, alcohol-free mineral sunscreen
• Hydrocortisone for pimply rashes
• Products with the National Eczema Association Seal of Acceptance, which have been approved for sensitive skin

• Scented products
• Dyes
• Lotions in favor of ointments and creams
• Anything containing alcohol, including acne treatments
• Hot showers

Some skin changes aren’t just drug side effects and can’t be treated with heavy creams. The lung cancer itself can affect your skin. If you see any of these changes, tell your doctor:

• Lumps under the skin
• Yellow skin
• Easy bruising
• Facial flushing
• Rash around eyes and cheeks
• Bumps on knuckles and joints