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Itchy Skin and Multiple Myeloma

Posted on September 20, 2021
Medically reviewed by
Todd Gersten, M.D.
Article written by
Joanne Zamora

Multiple myeloma is a type of cancer that happens when lymphocytes (white blood cells) called plasma B cells begin to grow quickly and uncontrollably. Treatments for multiple myeloma can cause many skin-related symptoms, including rashes, blisters, and itchy skin. Itchiness (also known as pruritus) can be an irritating symptom. As one MyMyelomaTeam member shared, “I have a terrible, awful itchy rash. My doctor says it’s related to chemo. It’s supposed to go away on its own or ease up, but it’s really uncomfortable.”

If itchy skin has been interfering with daily life, talk to your health care team. Although itching can be uncomfortable and stressful, there are ways of managing it. An oncologist or dermatologist can determine the underlying cause of your itching and work with you to find the best treatment course.

What Causes Itchy Skin in Multiple Myeloma?

Cutaneous itching (itchy skin) is occasionally caused by treatments for multiple myeloma. Rarely, people with multiple myeloma may also experience itching as a result of complications caused by cancer.

Other risk factors may contribute to itching. It is possible to experience skin itchiness unrelated to multiple myeloma and its treatments when living with cancer. If you have allergies to specific foods or substances, for example, you may develop an itchy allergic rash after coming into contact with them. Other skin conditions, such as eczema, may also cause the skin to itch.

Treatments and Procedures for Multiple Myeloma

Chemotherapy, radiation therapy, bone marrow transplantation, and some medications can cause itchy skin in people with multiple myeloma.

Radiation Therapy

Radiation therapy, also known as radiotherapy, can result in changes, including itching. This is typically accompanied by dry, peeling skin, which may give it the appearance of sunburn.

Chemotherapy

Certain forms of chemotherapy (also called chemo) can cause uncomfortable itchiness and dryness. When this happens, the skin may also redden, darken, or peel and take on a rashlike appearance.

Stem Cell Transplants

People with cancer who have undergone allogeneic (donor) stem cell transplants commonly develop a condition known as graft-versus-host disease (GVHD). GVHD occurs when the donor’s immune cells recognize your body as a foreign invader. The first symptom of GVHD is often an itchy, dry rash on the palms or the soles of the feet.

Medications for Multiple Myeloma

Some medications used in multiple myeloma treatment can cause itchy skin as a side effect. These drugs include corticosteroids and bortezomib (Velcade).

Complications of Multiple Myeloma

Complications of multiple myeloma and its treatment, including chronic kidney disease (CKD) and uremic pruritus, may lead to itching.

Chronic Kidney Disease

Kidney failure is common among people with multiple myeloma. As many as half of people with multiple myeloma experience problems with renal (kidney) function. People who don’t seek treatment for kidney damage may eventually experience the later-stage symptoms of CKD.

Uremic Pruritus

Late-stage CKD commonly leads to uremic pruritus. In this condition, the kidneys can no longer filter urea (a waste product) from the body, causing the substance to accumulate in the bloodstream. This accumulation results in chronic itchiness that comes and goes throughout the day and is often worse at nighttime.

Managing Itchy Skin With Multiple Myeloma

If you have been dealing with itchy skin after a myeloma diagnosis, talk to your oncology team or another health care provider, such as a dermatologist. They will be able to help determine the best way of managing and finding relief from itching.

Topical Steroid Creams

Topical creams, such as mometasone (Elocon), may be used if you’re undergoing radiation therapy or X-ray procedures. The steroids are mainly used to help delay or prevent skin changes that can lead to itching.

Steroid creams should be used in the short term — for a few days or up to six weeks. Topical steroids should also be used in a relatively small area to avoid side effects, such as dry skin.

Treatment Adjustments

If it’s confirmed that your myeloma medications are responsible for itching, your health care team may work with you to find alternatives. Although the medications ixazomib (Ninlaro) and bortezomib can cause itching, carfilzomib (Kyprolis) may not. Several MyMyelomaTeam members have also reported itchiness as a side effect of the medication lenalidomide (Revlimid).

If there are no possible alternatives at the time, your oncologist may adjust the dosage and observe how your skin responds to the change. During this period, you should report any changes you see so the doctor can make other relevant adjustments.

At-Home Management of Itchy Skin

You may be able to manage itching by yourself with certain over-the-counter treatment options or changes to your routine. Your health care provider may recommend some of these approaches if adjusting your myeloma treatment is not currently possible. As one MyMyelomaTeam member shared, “They won’t stop chemo because of itching, so all I can do is use anti-itch cream, avoid the heat, and take Benadryl.”

If you consider trying any of the approaches below, consult your health care team first. Do not start taking new medications — even over-the-counter drugs — without talking to your doctor.

Hydration

Whether your skin is itching or not, it is a good habit to stay hydrated and drink enough water. Proper hydration helps your skin regenerate more efficiently by increasing the rate at which harmful toxins are removed. The more itch-causing impurities are removed from the skin, the less dry it will become, lessening irritation and decreasing episodes of skin itching.

According to Mayo Clinic, about 15 cups of water a day is recommended for men, while women are advised to drink 11 cups of water daily. You may need to increase this amount depending on your body’s current needs. If you live in a warmer climate, you should drink more fluids.

If you’re having a hard time drinking plain water, you may want to begin with water infused with fruit or broth. Make sure to get clearance from your doctor first. You may need to determine whether you have allergies to the ingredients in the foods and drinks that you consume, which may trigger allergic itching.

Moisturizing

Dry skin has a higher chance of being itchy, regardless of the cause. Keeping your skin as moisturized as possible may help prevent itching or keep existing itching from getting worse. Avoid using moisturizers with fragrances, as these chemicals may cause allergic reactions or exacerbate skin symptoms. Ask your dermatology team for some brands to use.

Apply your moisturizer at least twice daily — once during the daytime and once before you go to bed. Ideally, use the moisturizer right after bathing or showering to help seal the moisturizer into your skin, for best results.

Antihistamine Medications

Over-the-counter antihistamines, such as Claritin and Benadryl, may help you manage itching and other skin symptoms you experience with multiple myeloma. Be sure to coordinate with your health care team before taking these medications.

Meet Your Team

Living with multiple myeloma can be challenging. The good news is that you are not alone. MyMyelomaTeam is the social network for people with multiple myeloma. Here, a growing community of more than 16,000 members comes together to ask questions, offer advice and support, and meet others who understand life with multiple myeloma.

Have you experienced itchy skin with multiple myeloma? What has been helpful in managing it? Share your tips in the comments below or by posting on your Activities page.

All updates must be accompanied by text or a picture.
Todd Gersten, M.D. is a hematologist-oncologist at the Florida Cancer Specialists & Research Institute in Wellington, Florida. Review provided by VeriMed Healthcare Network. Learn more about him here.
Joanne Zamora is a pharmacist with nearly a decade of clinical experience in a tertiary hospital setting. Learn more about her here.

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