Receive our monthly lifestyle research newsletter Email:

Hand foot syndrome otherwise known as Palmer-Planter erythema is a condition which can occur with some chemotherapy and biological agents. The severity of the condition depends on:

- The type of drug used
- The dose used
- How many cycles have been given
- The inherent sensitivity of the recipient
- How the hands are looked after during treatment. 

Initially the skin can get thicker and split in the creases or around the nails. As the number of cycles progresses, they can start reddening, as in the adjacent picture, then flake with the underlying skin becoming swollen and uncomfortable. On the feet, this can lead to blisters and ulceration making walking difficult, just at a time when it is advised to keep mobile. Secondary infection can set causing more swelling, pain and pus formation especially around the nail beds

Hand foot syndrome can also be associated with a skin  rash in other parts of the body and commonly with thinning of the nails, which if severe can split and break away from the nail beds.

The  common chemotherapy drugs most commonly associated with this side effect include Capecitabine (xeloda), Caelyx and infusional 5 Florouracil Other biological agents such as Sunitinib and Sorafeneib can cause this uncomfortable condition but these drugs often cause a rash elsewhere. 

What can be done to help (self help guidelines)? 

[1] Your doctor may reduce the dose of your medication or increase the time between the cycles - reduce dose intensity  to allow your skin to recover. In most cases, reducing the dose intensity in response to hand foot syndrome should not reduce the effectiveness.

[2]Your doctor may prescribe some pyridoxine 50mg tablets three times a day to be take with capecitabine. Although the evidence for this is small some patients have reported this is helpful.

[3]Keep the skin clean especially around the nail beds but avoid strong soaps or those with artificial perfumes and colours 

[4]Avoid friction - wear well fitting shoes, perhaps gloves at night. 

[5]You may have to consider wearing training shoes when the skin is at its worse. Many patients often report that shoes with leather insoles are more comfortable than those made with synthetic materials

[6]Keep the skin and nail beds well moisturised but avoid creams which are based on petroleum (the vast majority available over the counter) and those which contain artificial chemicals, preservatives, colours and perfumes. 

[7]For the nails beds we recommend naturemedical nail remedy as an ideal moisturiser as it is based only on natural waxes and oils combined with essential oils which have  and anti-microbial properties. 

[8]For the rest of the skin on the hands and feet, massage liberal quantities of a natural oil which does not contain artificial chemicals which can irritate sensitive broken skin such as perfumes, colours or preserves. As with the nails and lips natureMedical products are ideal because of their completely natural, artificial chemical free philosophy. In particular, the hand-foot oil has natural salicylates which have strong anti-inflammatory properties (see below). 

How to use natureMedical hand-foot oil. 

• From the start of the chemotherapy, even before any skin changes appear, massage liberal quantities of the oil onto the hands and feet for 2-3 minutes (particularly emphasise the dry and cracked areas)
• Do not leave liberal quantities of the oil on the skin -  wash excess off with luke warm water, then rinse with cold water. 
• Dry thoroughly with a clean towel or tissue.
• Repeat as often as you like but aim for at least three times a day.
• When the hand-foot syndrome starts refer to the guidance above. 

 

About natureMedical hand-foot Remedy

This completely natural oil has been designed and manufactured in the UK by leading oncologists and natural alchemists. Instead of petrol and other hydrocarbons, as used by the vast majority of commercial hand creams, the waxes and oil base are made entirely from organic natural oils derived from plants. Furthermore, only the absolute top quality ingredients have been used. For example, instead of simple olive oil it uses organic, extra virgin, cold pressed olive oil. Instead of regular shea butter is uses the vastly more expensive unrefined raw, organic variety. 

The type and concentration of rare essential oils have also been carefully selected for their  anti-inflammatory (natural salicylate)  as well anti-microbial properties which preserve the oil and help prevent secondary infection on the skin. Other oils attempting this effect tend to use tea tree oil but this tends to be irritating to the skin and can cause further drying. Instead natureMedical uses Leleschwa oil which is less drying yet a much stronger antiseptic. 

It was tested only on healthy volunteers and has passed all European Unit cosmetics standards and safety checks (see full product license). EU compliant 76/768/EEC. 

As a result of these high quality ingredients there is a high manufacturing cost (that is why you will not see this on the shelves). However, by cutting out marketing and shop mark ups by ordering direct from the manufacturers online, the price to the consumer is kept as low as possible. 

List of ingredients:

• Extra virgin organic cold pressed Olive oil (Olea Europaea), Organic bees wax (Cera Alba),  Organic unrefined Shea Butter (Butyrospermum Parkii), Cocoa seed butter (Theobroma Cacao).
•  Essential oils of African sage: (Tarchonanthus Camphoratus Oil (Leleschwa), Gaultheria Procumbens (Wintergreen) Leaf Oil , Eucalyptus Globus, Lavandula Spica (Lavender) Flower Oil.
• Traces of  Linalool, Limonene Farnesol  

 

Other useful links and further resources:
What is cancer;  About specific cancers; Breast | Prostate | Bowel.  Cancer treatments; Chemotherapy | Radiotherapy | Hormones | Biological agents | Complementary.  Lifestyle advice; Exercise | Diet | Smoking | Sunbathing | Alcohol.  Cope with symptoms;  Traveling | Insurance | Making a will | Support groups  | Tests for cancer | Clinical trials. ...site map
An excess or a deficiency of vitamins and trace mineral can lead to an increased risk of cancer, other illnesses and troublesome symptoms. A reliable way to ensure you have the correct amounts is to measure them. You will then be a to make able to make informed dietary decisions including and whether to take specific supplements in order to restore your nutritional balance. ...read more / order online
The first broad spectrum anti oxidant rich super food  designed by a leading oncologist. This supplement aims to  boost your daily antioxidant levels using only carefully selected natural wholes foods which have been dried and concentrated for convenience    ...read more about ongoing clinical trials.
An inspiring new lifestyle advice book, based only on the facts, empowers readers with the knowledge to help their chances of living longer and stronger ..read more / order  Después de una diagnosis del cáncer, es; “Qué puede nosotros hacer para ayudarse?” La respuesta, que este libro trata, está “mucho”.  order online	This little book  identifies the situations where arguments breakout and gives simple tips to navigate around them. Ideal reading for families after cancer .. order online
This 21 minute DVD explains chemotherapy & radiotherapy. The only preparatory film which was evaluated in a randomised study and shown to reduce anxiety and improve well-being during treatments. Available in English, Italian, Urdu, Bengali, Gujarati & Hindi   ... read more / order online
Cracked and sore lips are common during chemotherapy and afterwards. There is evidence that natural oil based creams are better than petroleum based creams. Nature-medical lip balm  contains only  natural waxes and essential oils selected for their anti-inflammatory and DNA stabilizing properties.. read more..order
Glossary  |   About us  |  Disclaimer  |  Contact us  |  How to advertise on this site