THE FOLLOWING INFORMATION WAS COMPILED BY EDEN STOTSKY-HIMELFARB, BSN, RN

Hand-foot syndrome can be a side effect of certain chemotherapy drugs. Hand-foot syndrome can be uncomfortable and can interfere with your ability to carry out normal activities.

How hand-foot syndrome shows up

• Leakage of drug results in redness and tenderness. The redness (also known as palmar-plantar erythema) looks like sunburn.  
• The areas affected can become dry and peel. Blistering, numbness or tingling can also develop.
• Hand foot syndrome can also affect the nails.

Hand-foot syndrome is caused by: Small amounts of drug leak out of very small blood vessels called capillariesin the palms of the hands and soles of the feet. Exposure of your hands and feet to heat as well as friction of your palms and soles increases the amount of drug in the capillaries and increases the amount of drug leakage.

Prevention is important to try to reduce the development of hand-foot syndrome. Actions taken to prevent hand-foot syndrome will help reduce the severity of symptoms should they develop.

For additional information, see:

• Hand-foot Syndrome Prevention Techniques 
• Treatment For Hand-Foot Syndrome

Prevention techniques for hand-foot syndrome include:

Modify your daily activities to reduce friction and exposure to heat to your hands and feet for a period of time following treatment (approximately one week after IV medication and as much as possible during the time you are taking medication orally (by mouth). For example:

• Avoid long exposure of hands and feet to hot water, such as from washing dishes, long showers, or baths in a tub.
• Short showers in tepid water will reduce the exposure of the soles of your feet to the dreug.
• Dishwashing gloves should not be worn. The rubber holds heat against your palms.
• Avoid increased pressure on the soles of your feet or the palms of your hands.
• Do not jog, do aerobics, power walk, or jump.
• Avoid long days of walking.
• Avoid using household or garden tools such as screwdrivers, and other tasks where you squeeze your hands on a hard surface.
• Be aware that using a knife to chop food may cause excessive pressure and friction on your palms.

Taking vitamin B6 may be useful in preventing hand-foot syndrome. Speak with your doctor before taking this or any other vitamin, herb or supplement.

Cooling procedures. 

• Cold may provide temporary relief for pain and tenderness caused by hand-foot syndrome.
• Placing your palms or bottoms of your feet on an ice pack or a bag of frozen peas may be very comforting. Alternate on and off for 15 to 20 minutes at a time. 

Avoid friction and heat.

Moisture: Keep the palms and soles of your feet moist between treatments. Products which provide moisturizing to your hands and feet to consider are (in alphabetical order):

• Bag Balm ®

• Lubriderm ®

• Udder Cream ®

Avoid rubbing lotions. Do not use rubbing lotions on your palms or soles should be avoided during the same period of time.

Showers: Take cool showers instead of hot ones.

Hydration: Stay well hydrated. Drink lots of water. (For information about knowing whether drinking water is safe, click here.

Clothing

• Wear thick cotton socks
• Avoid shoes which are tight

Pain relievers: Over the counter pain relievers such as acetaminophen may be helpful to relieve discomfort associated with hand-foot syndrome. Check with your doctor before taking any over the counter drugs, herbs, vitamins or supplementes.

Vitamin B6: may be beneficial in reducing symptoms. Check with your doctor before taking.

Drug treatment changes: Chemotherapy treatments may be interrupted or the dose adjusted to prevent worsening of hand-foot syndrome.