Hand-foot syndrome: caring for palms and soles during treatment
by Dr. Onco Care Team
on Oct 04 2026
In short
- Hand-foot syndrome is a skin reaction on palms and soles caused by certain cancer medicines.
- Moisturising from Day 1 and reducing heat, friction and pressure all help.
- Report pain, blisters or cracks early. Your dose may need adjusting.
What hand-foot syndrome is
Hand-foot syndrome, also called palmar-plantar erythrodysaesthesia, is a reaction that affects the palms of the hands and the soles of the feet. It is linked to medicines including capecitabine, 5-fluorouracil, liposomal doxorubicin, and targeted therapies such as sorafenib, sunitinib and regorafenib.
Palms and soles are affected because they take constant pressure, heat and friction through walking, gripping and everyday tasks.
How it develops
It usually appears in the first few weeks or cycles of treatment. With some targeted therapies it can start sooner. Typical signs, from mild to more severe:
- Tingling or tenderness
- Redness, like sunburn
- Dry, tight skin that thickens on heels and pressure points
- Peeling and cracking
- Swelling, blisters and pain that makes walking or holding things difficult
Start early
Hand-foot syndrome tends to start mild and build. Many oncologists advise beginning moisturising care on the first day of treatment instead of waiting for symptoms. Creams containing urea are widely used, because urea draws water into the skin and softens thick, rough areas.
Reduce heat, friction and pressure
- Take short, lukewarm showers and baths. Avoid hot water, saunas and hot-water bottles on hands and feet.
- Pat skin dry. Do not rub.
- Wear soft, roomy, cushioned shoes and cotton socks.
- Avoid long walks, running and standing for long periods during flare-ups.
- Avoid gripping tools tightly, and use gloves for housework.
- If hands and feet feel hot, rest them on a cool compress. Avoid ice.
- Raise your feet when you sit.
- Do not pick or cut peeling skin.
Applying care when skin is tender
Rubbing in a thick cream can be uncomfortable when skin is sore, and reaching your own feet is harder when you are tired. A roll-on format, or help from a caregiver, lets you apply care with very little pressure. Soft cotton socks or gloves afterwards help overnight.
When to call your oncology team
- Pain, redness or swelling that makes it hard to walk or use your hands
- Blisters, open cracks or bleeding
- Signs of infection: pus, warmth or fever
Your oncologist may reduce your dose or pause treatment for a short time. Reporting early is what keeps treatment on track.
Where Dr. Onco fits
Foot Rescue Roll-On delivers 10% urea with skin-identical ceramides, niacinamide and panthenol to palms and soles, in a hands-free roll-on. It is free from exfoliating acids, fragrance, dyes, parabens and menthol. Do not apply it to open wounds or blisters.
This guide is for general education. It does not replace the advice of your oncologist. Dr. Onco products are cosmetics, not medicines.
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