Medical Oncologist
Skin side effects
Rash during chemotherapy
Most rashes during treatment are expected effects of the drugs and can be managed while treatment continues, from acne-like spots with some targeted drugs to red, itchy patches. A small number are allergic or serious reactions. The signs that separate them are blistering, peeling, rapid spread, fever, and sores in the mouth or eyes.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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The short answer
Is a rash during chemotherapy serious?
Usually not. Most rashes during treatment are expected effects of the drugs and are managed while treatment continues: acne-like spots on the face and chest with some targeted drugs, red itchy patches, or small raised bumps. A small number are allergic or serious reactions, and the signs that separate them are fairly clear.
Blistering, peeling, a rash that spreads quickly over hours, a rash with fever, sores in the mouth, eyes or genitals, and swelling of the face or difficulty breathing all need urgent attention. Everything else should be reported, photographed, and cared for gently, but is rarely an emergency.
Photograph it when it appears
Rashes change quickly, and a photograph taken on the first day helps your team see how it has developed, especially if it has faded by the appointment.
Note when it started
Which cycle, how many days after treatment, and whether a new medicine was started around the same time. Timing often points to the cause.
Do not treat it with creams from the shop
Steroid creams, antifungals and herbal pastes can hide or worsen some rashes. Ask your team before putting anything on it.
Never stop chemotherapy tablets because of a mild rash without speaking to your team first.Types of rash
The rashes patients most often see
- Acne-like rash
- Red spots and pustules on the face, scalp, chest and back, common with some targeted treatments. It is not ordinary acne and should not be treated with acne products without advice.
- Red, itchy patches
- Flat or slightly raised patches, often on the trunk and limbs, sometimes linked to a drug or to a supportive medicine. Usually managed with gentle care and medicines your team prescribes.
- Hives
- Raised, itchy welts that come and go, sometimes during or soon after an infusion. With swelling of the lips or face, or breathing difficulty, this is an emergency.
- Rash in a previously treated area
- Redness appearing in skin that had radiotherapy in the past, triggered by certain chemotherapy drugs. Report it; it is uncommon and usually manageable.
- Small red or purple dots
- Tiny flat spots that do not fade when pressed can mean a low platelet count rather than a rash. These need a blood test the same day.
- Blistering or peeling rash
- Skin that blisters, peels or looks burnt, especially with fever or sores in the mouth or eyes. Rare, serious, and needs emergency care immediately.
Not sure whether this applies to you?
Ask an oncologistPractical
Caring for a mild rash
Gentle, cool and uncovered by guesswork.
Report it the same day or at your next contact
Send a photograph if your team accepts them, or describe where it is, when it started, whether it itches or hurts, and any new medicines.
Note
- Which cycle and how many days after
- Any new tablet, injection or cream
Keep the skin cool and clean
Lukewarm water, a mild unperfumed soap, patting dry, and loose cotton clothing. Heat and sweat usually make rashes itchier.
Use only what the team recommends
A plain moisturiser is usually safe. For anything more, such as steroid creams, antibiotic gels or anti-itch tablets, wait for your team's advice.
Avoid without advice
- Acne creams and face washes
- Steroid or antifungal creams from the shop
Do not pick or squeeze spots
Squeezing acne-like spots invites infection and darkening, especially when counts are low. Leave them alone and keep the area clean.
Protect from the sun
Many rashes worsen in sun, and some drugs make skin sun-sensitive. Shade, a hat and covering clothing help the skin settle.
!
Go to the nearest emergency department immediately for any of these
Swelling of the face, lips, tongue or throat, or difficulty breathing · a rash that is blistering, peeling or looks like a burn · a rash spreading quickly over hours · a rash with fever or feeling very unwell · sores in the mouth, eyes or genitals with a rash · small red or purple dots that do not fade when pressed, or unexplained bruising or bleeding · a painful, hot, spreading red area of skin. Say clearly that the person is on chemotherapy, and bring the list of recent medicines.
Being straight with you
What this page cannot tell you
It cannot diagnose your rash, and a page is a poor substitute for a clinician looking at it. Rashes that look similar can have very different causes, including the chemotherapy, a supportive medicine, an antibiotic, an infection, or a low platelet count. Your team needs to see it.
It also cannot tell you whether your treatment needs to change. For some drug-related rashes the dose is adjusted; for many, treatment continues with added skin care. That decision is your oncologist's.
A rash can be a sign the drug is working
With some targeted treatments, an acne-like rash is common and does not mean treatment should stop. Ask your team whether that applies to your medicine.
Supportive medicines cause rashes too
Antibiotics, anti-sickness medicines and painkillers started during a course can be the cause. Keep a list of everything started recently.
Darker skin can hide redness
On brown skin a rash may look darker, purple or simply raised rather than red. Go by texture, itching and spread as well as colour.
Keep a medicine list with dates
Write down every tablet, injection, cream and supplement started during the course, with the date. When a rash appears, that list is often the quickest way to find the cause.
Photographs help when appointments are far away
For patients travelling in from a district, a clear photograph sent to the team, where they accept them, can save a journey or show that one is needed urgently. Take it in daylight, close enough to see the texture, with a second one showing where on the body it is.
What to do next
Photograph the rash and note when it started and any new medicines. Report it to your team, keep the skin cool and gently cared for, and avoid shop creams until advised. Go to emergency immediately for blistering, fever, mouth or eye sores, face swelling, or dots that do not fade when pressed.
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Commonly believed
Four ideas about rashes on treatment
"Any rash means I am allergic and must stop treatment."
Most rashes are expected drug effects managed alongside treatment. Report it and follow advice; do not stop treatment yourself unless there are emergency signs.
"An acne cream will clear the spots."
The acne-like rash from some targeted drugs is not ordinary acne, and acne products can irritate it. Your team can prescribe what works.
"A steroid cream from the pharmacy is harmless."
Steroid creams can hide some rashes and worsen others, including infections. Ask your team before using one.
"Small red dots are just a heat rash."
Tiny red or purple dots that do not fade when pressed can mean a low platelet count. They need a blood test the same day.
Questions we are asked
Common questions about rashes
Is a rash during chemotherapy normal?
Rashes are common and usually expected drug effects. Report any new rash, and seek urgent help for blistering, fever, mouth or eye sores, or face swelling.
When is a rash an emergency?
With swelling of the face or difficulty breathing, blistering or peeling, rapid spread, fever, sores in the mouth or eyes, or red dots that do not fade when pressed.
Should I stop my tablets?
Not for a mild rash without speaking to your team. For emergency signs, seek care immediately and bring the tablets and a list of recent medicines.
What can I put on it?
A plain fragrance-free moisturiser is usually safe. Wait for your team's advice before using steroid, antifungal, acne or herbal creams.
Why do I have acne on my face?
Some targeted treatments cause an acne-like rash. It is not ordinary acne and needs different care. Ask your team what to use.
Can a rash be from other medicines?
Yes. Antibiotics, painkillers and anti-sickness medicines can cause rashes. Keep a list of everything started recently and show it to your team.
How do I see a rash on dark skin?
It may look darker or purple rather than red. Look for raised areas, itching, texture changes and spread, and photograph it in good light.
Will the rash leave marks?
Some rashes leave temporary darkening, especially on brown skin or if scratched. Avoid picking, protect from sun, and it usually fades over months.
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Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
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Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
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Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
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Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
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Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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Sources
- American Cancer Society — Skin Problems
- Macmillan Cancer Support — Skin changes
- Cancer Research UK — Side effects of chemotherapy
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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