Itching

Itching is usually an uncomfortable feeling that can cause restlessness, anxiety, skin sores, and infection. You might hear your cancer care team refer to itching as pruritus. In cancer patients, itching can be caused by:

• Cancer treatments such as chemotherapy, radiation, targeted therapy, or immunotherapy
• The cancer itself
• Certain medications used as part of cancer treatment such as pain medicines, drugs for nausea or vomiting, or hormone treatments
• Other causes of itching may include dry skin, infection, or a condition that is not cancer

Continuous itching can cause your skin to break, bleed, or get an infection especially if the skin is broken. Itching can be a sign of an infection, so be sure to let your doctor know about any new itching you might be experiencing. It is important that you know and communicate to your cancer care team what might make your itching worse or better so you can protect your skin and stay comfortable.

What to look for

• Dry, red, rough, flaky skin
• A yellowing of the skin or of the whites of eyes
• Rash or bumps
• Scratch marks
• Skin sores
• Scratching when you don’t notice it

What the patient can do

To soothe the skin

• Ask your pharmacist about skin creams that don’t contain alcohols or fragrances. Apply them 2 to 3 times a day, especially after a bath when the skin is damp. Ask your cancer care team which creams might be safe for you.
• Bathe in warm water instead of hot.
• Add baking soda, oatmeal (in a cloth or mesh bag), or bath oil to your bath water.
• Wash your skin gently using a mild, unscented soap and a soft washcloth.
• When drying off, try not to rub your skin. Instead, gently pat your skin dry.
• Use baking soda instead of deodorant.
• Avoid using scented or alcohol-based products on the skin (such as powders, after-shaves, or perfumes). Cornstarch-based powders may clump in moist areas and cause irritation.
• Use an electric razor rather than a blade to avoid cuts and irritation.
• Keep your room cool (60° to 70° F) and well ventilated to avoid sweating.
• Wear loose-fitting clothes made of soft fabric to avoid irritating your skin.
• Drink plenty of water and other fluids.
• Get enough rest. Ask about medicine (antihistamines) if itching keeps you awake.
• Ask your cancer care team for tips that might help reduce or prevent itching. If your itching is severe, your doctor may order prescription drugs to help relieve the itching.

To reduce the desire to scratch

• Apply cool, wet packs (such as crushed ice in a plastic bag wrapped in a damp towel) to the skin. Remove the pack when it becomes warm, and let your skin dry. Use again as needed.
• Keep nails clean and short. Wear clean fabric gloves if you scratch without thinking about it.
• Try rubbing, pressure, cool cloths, or vibration instead of scratching. Avoid breaking the skin.
• Wear loose, soft clothing.
• Distract yourself with music, reading, and the company of others.
• Take medicines for itching as prescribed.

What caregivers can do

• Try using mild, unscented detergents to wash the patient’s clothes and bedding.
• If the patient scratches in their sleep, ask them to wear clean cotton gloves to reduce the chance of skin damage.

Call the cancer care team if the patient

• Has itching that does not go away after 2 or more days
• Develops yellowish skin or has urine the color of tea
• Scratches skin until it’s open or bleeding
• Has a rash that gets worse after creams or ointments have been used
• Has blisters, bright red skin, or crusts on the skin
• Has foul-smelling drainage or has pus coming from the skin
• Becomes very anxious and restless (can’t sleep through the night due to itching)
• Develops hives (itchy white or red welts on the skin), shortness of breath, swelling of the throat or face, or other signs of a severe allergic reaction