Managing Hand-Foot Syndrome from Chemotherapy in Hot Weather

Some chemotherapy drugs, such as capecitabine (Xeloda), can cause the skin on the palms and soles to turn red, tingle, burn, and—in more severe cases—crack or blister. This is called hand-foot syndrome (palmar-plantar erythrodysesthesia). It is thought to occur because the drug affects skin in areas rich in sweat glands, and it often appears within the first few weeks of treatment. When it becomes painful, even buttoning a shirt or walking can become difficult.

The main idea is to reduce friction, heat, and pressure. Symptoms tend to flare when the hands and feet are repeatedly stressed or exposed to heat for long periods. It can help to avoid carrying heavy loads for a long time, repetitive tasks like hand-washing dishes, tight shoes and long walks, and hot baths or saunas. Keeping the hands and feet well moisturized and choosing soft, low-friction footwear can also make a difference.

People are often advised to wear thick socks to cushion the feet, but in hot summer weather thick socks can trap heat and sweat and feel worse. Instead of focusing on thickness, change the material and environment: breathable cotton or moisture-wicking socks, changed often when damp, keep the feet drier. Wear soft slippers indoors, avoid going out or standing for long periods during the hottest hours, and if the feet burn, briefly cool them with cool (not ice-cold) water, dry them gently, and apply moisturizer. Keeping the feet cool with a fan or air conditioning can also help.

If symptoms keep worsening, or if blisters, cracking, or pain make it hard to walk, tell your care team rather than trying to endure it. Depending on the situation, a dose adjustment, a short break, or specific skin and pain care may be needed. Rather than stopping the medication on your own or using unverified creams, keep a simple record of changes to show at your appointment.

This article is for general information only and is not a substitute for medical care. Management may differ depending on your condition and medications, so please discuss your situation with your healthcare team.