Medical Oncologist
Targeted therapy side effects
Hand-Foot Skin Reaction: — Prevention and Relief
Hand-foot skin reaction causes redness, peeling, and sometimes painful sores on the palms and soles of the feet. It is common with targeted therapies and rarely dangerous on its own — but it can become severe quickly when it is not managed early.
Medically reviewed by Dr. T. Raghavender Reddy, Medical Oncologist, MBBS · DM (Medical Oncology) · MD (Radiation Oncology) · Last reviewed August 2026
- Common, not rare — Hand-foot skin reaction is one of the most frequently reported side effects of targeted therapy.
- Not the same as chemotherapy hand-foot — It looks and feels different from hand-foot syndrome caused by some chemotherapy drugs, and is managed differently.
- Start skin care early — Moisturising and protecting pressure points from the first day of treatment reduces how severe it becomes.
- Severity is graded — Your team uses a three-level scale to decide whether to continue treatment, adjust the dose, or pause.
17+
Cancer Specialists
on Panel
on Panel
96.9%
Breast Cancer
Survival Rate*
Survival Rate*
15,000+
Patients
Treated
Treated
4.8★
Google Rating
(800+ reviews)
(800+ reviews)
Hand-foot skin reaction is a common side effect of targeted therapy that causes redness, peeling, blisters, and pain at pressure points on your palms and soles. It is rarely dangerous, but it can worsen within days. Mild symptoms can be managed at home with thick moisturisers and protective footwear. Pain that stops you walking or using your hands means call your team today.
If a symptom below applies to you, do not wait for a callback. Call 1800-202-8726 or go to your nearest emergency department.
How do you know how serious your reaction is?
| Feature | Mild — manage at home | Moderate — call your team this week | Severe — call your team today |
|---|---|---|---|
| Pain | None or very mild | Enough to slow you down but daily tasks are still possible | Stops you walking, cooking, or dressing |
| Skin appearance | Redness, numbness, tingling, or peeling at pressure points | Blisters, thickened skin, or soreness over a wider area | Open sores, weeping blisters, or large areas of broken skin |
| Effect on daily life | None | Some tasks are harder than usual | Unable to manage basic self-care |
| Signs of infection | None | None | Spreading redness, warmth, pus, or fever alongside skin changes |
| Typically starts | Often within the first few weeks of starting targeted therapy — but can appear or worsen at any point | Can develop quickly from mild if pressure areas are not protected | Escalation from moderate can happen within days — report early |
Meet the Specialists
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Interventional Radiologist
Dr. Mohammed Imran
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
Want a specific doctor for your case? Mention them when booking.
Book Free ConsultationBook an appointment with our specialist
Share your name and number — we'll call you back within 30 minutes to schedule your consultation.
You do not have to work this out alone
A 45-minute consultation with a specialist who treats this every week.
What can you do at home for mild symptoms?
Moisturise early and often — ideally from the first day of treatment, before any symptoms appear. Thick creams and ointments stay on the skin longer than thin lotions. Apply them to your palms and soles at least twice a day and after washing.
Protect pressure points. Soft, padded footwear and cushioned insoles reduce friction on the soles. Cotton socks help. Padded grips or thin gloves ease pressure on the hands.
Avoid hot water, tight shoes, and any activity that creates repeated friction on the same spot. These worsen the reaction even when symptoms are mild.
Tell your team about any skin changes at your next appointment, even if they seem minor. Catching a reaction early is what keeps it from becoming severe.
Did you know?
Hand-foot skin reaction from targeted therapy tends to appear at specific pressure points — the heels, balls of the feet, and fingertips — rather than spreading diffusely across the whole hand or foot.
This pattern is why well-padded footwear and targeted moisturising of pressure spots, started before symptoms appear, are consistently recommended in ASCO and ESMO guidance on managing this side effect.
Source: ASCO and ESMO Guidance on Dermatologic Toxicities from Targeted Therapy
Questions people ask about hand-foot skin reaction
Will I have to stop my targeted therapy because of this?
Not necessarily, and this is one of the most important things to understand about this side effect. Mild to moderate reactions are usually managed while treatment continues, sometimes with a short dose reduction or brief pause rather than stopping altogether. The decision depends on how severe the reaction is and how well it responds to care. Reporting early keeps the milder options — dose adjustment rather than stopping — available to you. Your oncologist will weigh the benefit of continuing treatment against the impact on your quality of life.
Which moisturiser works best?
Thick emollient creams and ointments are generally recommended over thinner lotions because they stay on the skin longer and form a better barrier. Urea-based creams are commonly suggested for the thickened, callus-like patches that targeted therapy tends to cause. Ask your oncology team or an oncology pharmacist what is available locally and what fits your specific drug and pattern of reaction — different targeted therapies cause slightly different skin changes. Whatever you use, apply it before bed and allow it to absorb overnight when your hands and feet are not being used.
Is there anything I should stop doing?
Avoid prolonged exposure to hot water — long baths, hot showers, and washing dishes in very hot water all worsen the reaction. Avoid walking barefoot on hard floors. Avoid tight footwear or shoes that rub at specific points. Avoid activities that put sustained, repeated pressure on already-sensitive spots — carrying heavy bags, gripping tools for long periods, or exercise that loads the same area of the sole repeatedly. These are not permanent restrictions; during a period of active skin reaction, avoiding them makes a real difference to how quickly you recover.
Can I prevent it before it starts?
You cannot reliably prevent it from appearing because it is a direct result of how the drug works on the body. What you can do is reduce how severe it becomes. Starting thick moisturiser on your palms and soles from day one of treatment — before any redness appears — is the most consistently recommended step in ASCO and ESMO guidance. Wearing comfortable, well-padded footwear from the start is the second. Tell your team before you begin if you already have calluses or areas of thickened skin, because those spots are where the reaction tends to concentrate.
What about coconut oil, turmeric, or home remedies?
Coconut oil and similar natural emollients are unlikely to cause harm and may offer some moisturising comfort, though they are generally less occlusive than the thick pharmaceutical creams your team may recommend. The concern with any home preparation applied to broken or blistered skin is infection risk — anything you put on open skin should be clean, and ideally recommended by your team. Avoid applying abrasive pastes or anything with a rough texture to affected skin. Most importantly, tell your oncology team what you are using. Some preparations can irritate already-sensitive skin, and your team can only give you the right advice if they know what is already being applied.
Explore 108 more Side Effects, Emergencies & Daily Living topics
Side Effects - Symptom-Specific Deep Dives
- Abdominal Pain on Targeted Therapy: When to Worry
- Acne-Like Rash on EGFR Inhibitors: Why It Happens and How to Treat It
- Anaemia and Low Haemoglobin During Targeted Therapy
- Blood Clots and Stroke Risk on Targeted Therapy
- Blurred Vision and Eye Problems on Cancer Drugs
- Brain Fog and Memory Problems During Treatment
- Breathlessness and Cough on Targeted Therapy: Ruling Out ILD
- Constipation During Targeted Therapy
- Diarrhoea on Targeted Therapy: How to Control It at Home
- Dry Eyes and Light Sensitivity During Treatment
- Extreme Fatigue on Targeted Therapy: Causes and What Helps
- Extremely Dry, Cracking Skin on Cancer Tablets
- Fever During Targeted Therapy: Home Care vs Emergency
- Hair Thinning, Curling and Colour Change on Targeted Therapy
- Hand-Foot Skin Reaction: Prevention and Relief
- Headaches and Dizziness on Targeted Therapy
- Heart Function Drop (Low Ejection Fraction) on Targeted Therapy
- High Blood Pressure Caused by Cancer Drugs
- High Blood Sugar on PI3K and mTOR Inhibitors
- Infusion Reactions: What Happens and How They're Managed
- Interstitial Lung Disease (ILD): The Side Effect You Must Not Ignore
- Itching That Won't Stop on Targeted Therapy
- Kidney Function Changes on Targeted Therapy
- Loss of Appetite and Weight Loss During Targeted Therapy
- Low Magnesium and Electrolyte Problems on Anti-EGFR Antibodies
- Low Platelets on PARP Inhibitors and TKIs
- Low White Cells and Infection Risk on Targeted Therapy
- Mouth Ulcers and Mucositis: Practical Relief
- Muscle Cramps and Joint Pain on Cancer Drugs
- Nausea and Vomiting on Oral Cancer Drugs
- Osteonecrosis of the Jaw: Prevention During Bone-Targeted Treatment
- Paronychia and Nail Changes on Targeted Therapy
- Peripheral Neuropathy: Tingling and Numbness in Hands and Feet
- Protein in Urine (Proteinuria) During Treatment
- QT Prolongation: What It Means on Your ECG Report
- Raised Liver Enzymes (SGPT/SGOT) on Targeted Therapy
- Secondary Cancers After Long-Term PARP Inhibitor Use
- Severe Rash With Fever or Blistering: A Medical Emergency
- Skin Darkening, Depigmentation and Pigment Changes
- Slow Heart Rate and Dizziness on Certain TKIs
- Sun Sensitivity and Photosensitivity on Cancer Drugs
- Swallowing Difficulty and Reflux on Cancer Tablets
- Swelling of Face, Legs and Around the Eyes
- Taste Changes and Metallic Mouth on Cancer Drugs
- Tumour Lysis Syndrome: A Rare but Serious Early Complication
- Underactive Thyroid (Hypothyroidism) Caused by Cancer Drugs
- Unusual Bleeding or Bruising on Cancer Drugs
- Voice Changes and Hoarseness on Targeted Therapy
- Weight Gain During Long-Term Targeted Therapy
- When Diarrhoea Becomes an Emergency: The Rule You Must Know
- Wound Healing Problems on Antiangiogenic Drugs
Daily Living & Adherence
- Can I Drink Alcohol on Targeted Therapy?
- Can I Drive While on Targeted Therapy?
- Can I Fast for Religious Reasons During Targeted Therapy?
- Can I Have Dental Treatment While on Targeted Therapy?
- Exercise During Targeted Therapy: How Much Is Safe?
- Haircuts, Waxing, Facials and Tattoos During Treatment
- How Should Family Members Handle Your Cancer Tablets Safely?
- I Accidentally Took a Double Dose: How Serious Is It?
- I Missed a Dose of My Targeted Therapy: What Should I Do?
- I Vomited Right After Taking My Tablet: Do I Repeat the Dose?
- Managing a Household Routine Around Your Dosing Schedule
- Pets, Gardening and Infection Precautions
- Running Out of Medicine: What to Do About Refills and Shortages
- Safe Disposal of Unused Cancer Medicines
- Sex and Intimacy While on Targeted Therapy: Safety Questions
- Sleep Problems on Targeted Therapy and What Actually Helps
- Smoking and Targeted Therapy: How It Changes Your Drug Levels
- Travelling With Cancer Tablets: Flights, Security and Storage
Emergency & Red-Flag Triage
- Chest Pain or Palpitations During Cancer Treatment
- Emergency Contact Card: What to Keep in Your Wallet
- Fever Above 100.4F on Cancer Treatment: The 1-Hour Rule
- Heavy Bleeding, Blood in Vomit or Black Stools
- Not Passing Urine or Sudden Swelling All Over
- Severe Rash Spreading Rapidly With Mouth or Eye Involvement
- Sudden Breathlessness on Cancer Tablets: Go to Emergency or Wait?
- Sudden Confusion, Seizure or Weakness on One Side
- Sudden Severe Abdominal Pain: Ruling Out Perforation
- Sudden Vision Loss or Double Vision: What to Do Right Now
- Swollen, Painful Leg: Recognising a Blood Clot
- Uncontrolled Diarrhoea: The 6-Stool Rule Every Patient Should Know
- What to Tell an ER Doctor Who Doesn't Know Your Cancer Drug
- Yellow Eyes, Dark Urine or Severe Right-Sided Pain
Food, Drug & Supplement Interactions
- Antacids and Acidity Tablets Can Block Your Cancer Drug
- Anti-Nausea and Anti-Acidity Drugs That Prolong QT
- Anti-TB Treatment and Targeted Therapy: A Dangerous Combination
- Antibiotics and Antifungals That Interfere With Cancer Drugs
- Ayurvedic and Herbal Medicines With Targeted Therapy: The Real Risks
- Blood Thinners and Targeted Therapy: Managing the Bleeding Risk
- Contraceptive Pills and Hormone Medicines With Cancer Drugs
- Diabetes and Blood Pressure Medicines With Targeted Therapy
- Grapefruit, Pomegranate and Starfruit: Why They're Banned on Many Cancer Drugs
- Green Tea, Coffee and Caffeine on Targeted Therapy
- Homeopathy Alongside Targeted Therapy: What You Should Know
- How to Check Any New Medicine Against Your Cancer Drug
- Painkillers: Which Ones Are Safe on Targeted Therapy?
- Protein Powders and Immunity Boosters: Helpful or Harmful?
- Statins and Cholesterol Medicines During Cancer Treatment
- The Complete Do-Not-Take List for Common Targeted Therapy Drugs
- Turmeric, Ashwagandha, Giloy and Wheatgrass During Cancer Treatment
- Vaccines and Antivirals During Targeted Therapy
- Vitamin, Calcium and Iron Supplements During Treatment
Side Effects - General & Timeline
- Are Side Effects a Sign That the Drug Is Working?
- Side Effect Timeline: What Happens in Week 1, Month 1 and Month 6
- Targeted Therapy Side Effects: The Complete List by Drug Class
- Understanding Side Effect Grades 1 to 4 (In Plain Language)
- When to Call Your Oncologist Immediately: The Red Flag List
- Will a Dose Reduction Make My Treatment Less Effective?
Next step
Still not sure what applies to you?
Send your reports across and a senior medical oncologist will go through what they mean, what is known, and what the options actually are.
Common questions
Frequently asked questions
Is hand-foot skin reaction a sign my targeted therapy is working?
There is some research suggesting a possible association between hand-foot skin reaction and treatment activity for certain targeted therapies, but it is not consistent enough to use as a reliable signal and it is not part of how your oncologist assesses response. Having a severe reaction does not mean the treatment is working better, and a mild one does not mean it is failing. Response is assessed through scans and blood markers. Do not manage your symptoms less carefully in the hope that the reaction means something positive — severe reactions can force a dose reduction that is entirely avoidable.
How long does hand-foot skin reaction last?
It depends on the drug, the severity, and how well it is managed. Mild reactions often improve with consistent moisturising and protective measures even while treatment continues. More severe reactions that need a dose reduction or pause typically begin to recover within a few weeks of the change. For some people the reaction settles into a stable, manageable pattern over time. For others it varies with each cycle. Your team will monitor it at each visit and adjust the approach as needed.
Can I use pain relief tablets for the discomfort?
Mild discomfort can sometimes be eased with over-the-counter pain relief, but check with your oncology team or pharmacist before taking any new medicine while on targeted therapy. Some common pain medicines interact with targeted therapy drugs or place additional load on the kidneys and liver in ways that matter for your specific treatment. Your team can tell you what is safe for you — a general answer may not apply to your situation.
Will my skin look normal again after treatment ends?
For most people, yes. Once the drug is reduced or stopped, the skin typically recovers over several weeks to months. Thickened or calloused areas soften, and redness fades. Lasting changes are uncommon when reactions are caught and managed early. Consistent moisturising and protecting the skin from sun during recovery helps.
Should I tell my team about creams I am already using?
Yes, always — and this includes moisturisers, antifungal creams, steroid creams bought without a prescription, and anything else applied to affected skin. Some preparations help, some can irritate reactive skin further, and a few may affect how well the skin barrier recovers. Writing a brief list of what you are using before your appointment takes a moment and gives your team what they need to advise you accurately.