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Itchy skin can be an unwelcome surprise with myeloma. Although myeloma rarely causes skin involvement, you can still experience itching from the disease itself, its treatments, or complications such as kidney disease, dry skin, allergic reactions, or unrelated skin conditions.
Although itching can be frustrating, there are ways you can manage it. Read on to learn about the possible causes of itching in myeloma, how your doctor might treat it, and what you can do to start feeling better right now.
There isn’t just one reason why you might experience itchy skin with myeloma.
Sometimes, people with multiple myeloma may have itchy skin for reasons unrelated to the disease, including its treatments.
However, itchy skin can also be related directly to the disease. This happens when the body’s plasma cells grow quickly and uncontrollably, infiltrate the skin, and trigger an inflammatory response that causes itching.
This direct skin involvement is rare, happening in less than 1 percent of myeloma cases, and has been associated with a poorer prognosis (lower survival rate). However, ordinary itching is a nonspecific symptom with several possible causes.
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Cancer treatments often cause skin-related side effects, including skin rashes, dry skin, blisters, and itchiness (which doctors sometimes call pruritus).
Various multiple myeloma treatments can cause itchy skin, including chemotherapy, radiation therapy, and more.
Certain chemotherapy treatments can cause uncomfortable itchiness and dryness. This can lead to discolored skin, peeling, and a rash-like appearance.
One MyMyelomaTeam member shared that they developed skin symptoms after chemotherapy (or chemo): “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.”
Another possible cause of itching is radiation therapy, also known as radiotherapy. This treatment can cause skin changes like itching, dryness, and peeling.
Some medications used to treat multiple myeloma can cause itchy skin as a side effect, including:
A bone marrow (stem cell) transplant is a common treatment option for those with multiple myeloma.
People with multiple myeloma who are eligible for a stem cell transplant usually undergo an autologous stem cell transplant. During this procedure, their own blood-forming stem cells are collected and then returned to their body after high-dose chemotherapy. This helps the bone marrow make healthy blood cells again.
If an autologous stem cell transplant isn’t an option, your healthcare team may recommend an allogeneic (donor) bone marrow transplant, but this is rare.
People with cancer who have had allogeneic (donor) bone marrow transplants may develop a condition known as graft-versus-host disease (GVHD).
GVHD happens when the donor’s immune cells recognize your body as a foreign invader. One of the first symptoms of GVHD is usually an itchy, dry rash, often on the palms of the hands or the soles of the feet.
Multiple myeloma can lead to other health problems or “complications,” including kidney disease and renal failure. These complications happen when multiple myeloma cells make an abnormal protein that can damage the kidneys and lead to chronic kidney disease (CKD).
CKD can cause itching, known as CKD-associated pruritus (CKD-aP), formerly called uremic pruritus.
Itching can occur at any stage of CKD, but is particularly common among those with advanced kidney disease and those on dialysis.
Experts don’t know the exact cause of CKD-aP, but several factors can increase your risk, including high blood calcium levels, dialysis treatment, and dry skin.
When living with cancer, you might also experience itchiness that’s not related to multiple myeloma and its treatments.
For example, allergies to certain foods or substances may lead to an itchy skin rash. Other skin conditions, such as eczema, may also cause itchy skin.
If you’re dealing with itchy skin after a myeloma diagnosis, talk to your oncology team or another healthcare provider, such as a dermatologist. They can help identify the cause and recommend the best way to relieve itching.
To address itchy skin effectively, your care plan may include a combination of approaches, from over-the-counter (OTC) remedies to prescription treatments and lifestyle adjustments. Let’s explore these options in detail.
You may be able to manage itching with certain OTC treatment options. 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.”
While these creams may be helpful, always consult your healthcare team before using any OTC drug.
If OTC creams aren’t helping, your doctor may prescribe a topical steroid cream, which you apply directly to your skin. These creams can help reduce the inflammation that leads to itching.
However, it is important to follow your prescriber’s instructions on how to apply the cream and how long to use it.
MyMyelomaTeam members have shared positive experiences with steroid creams to clear rashes and itching. One member shared, “I developed a rash while on my medication. My doctor prescribed a steroid, and it cleared up the rash in a few hours.”
Whether your skin is itching or not, stay hydrated and drink enough water. Ask your healthcare team how much water you need each day.
It’s also essential to discuss your hydration needs with your doctor if you have kidney failure related to myeloma. If you’re on dialysis, you will need to restrict your fluid intake, so consult your doctor to determine the right amount of water for you.
Dry skin is more likely to be itchy, regardless of the cause. Keeping your skin as moisturized as possible can help prevent itching or keep existing itching from getting worse.
Avoid moisturizers with fragrances, as these chemicals may trigger allergic reactions or worsen your skin symptoms. Ask your dermatology team for recommendations on the best products for your skin.
OTC antihistamines may help manage itching caused by an allergic reaction or hives.
However, you should talk with your doctor before trying an antihistamine medication because these medications may not help with itching caused by dry skin, kidney disease, or cancer treatments.
Advances in multiple myeloma treatments over the past two decades have greatly improved health outcomes. However, preventing or managing side effects like itchy skin helps you stay on track with your treatment plan.
If itching becomes unbearable and other methods haven’t worked, talk to your cancer care team about adjusting your treatment plan. They may be able to suggest alternatives that are less likely to cause itching.
It’s always better to discuss potential treatment changes with your hematologist or oncologist rather than stopping treatment altogether.
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