If you develop itchy skin with myeloma, it can be an unwelcome surprise. Skin symptoms, including itching, can be caused by myeloma itself, its complications, or side effects of cancer treatment. If itchy skin has been bothering you during the day or keeping you up at night, it’s important to talk to your health care team. They can help identify the cause and guide you in managing this uncomfortable symptom.

Although itching can be frustrating, there are ways to manage it at home, too. 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.

How Can Multiple Myeloma Cause Itchy Skin?

In about 1 percent of people with multiple myeloma, the cancer itself can lead to skin symptoms like itchy skin. Multiple myeloma is a type of blood cancer that begins when white blood cells called plasma cells grow quickly and uncontrollably. Plasma cells are part of the immune system and produce antibodies to kill germs and fight off infections. However, when these cells behave abnormally, they can cause inflammation in the skin as part of the body’s immune response.

Sometimes, skin symptoms from multiple myeloma can suggest a poorer prognosis (lower survival rate), so it’s important to identify the cause of your skin symptoms when you’re living with multiple myeloma.

Myeloma Treatment and Itching as a Side Effect

Itchy skin can also be a side effect of treatments for multiple myeloma. Cancer treatments often cause skin-related side effects, including skin rashes, blisters, and itchiness (which doctors sometimes call pruritus). 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.”

Several treatments for myeloma can cause itchy skin.

Chemotherapy

Certain forms of chemotherapy, or chemo, can cause uncomfortable itchiness and dryness. This can lead to red or darkened skin, peeling, and a rashlike appearance.

Medications for Multiple Myeloma

Some medications used in multiple myeloma treatment can cause itchy skin as a side effect. One study found that 19 percent of people taking lenalidomide (Revlimid) developed itchy rashes. However, more research is needed to identify the risk factors of developing a rash while taking lenalidomide. Some research suggests that rashes caused by lenalidomide may be linked to higher survival rates.

Other drugs that may cause itching include corticosteroids and bortezomib (Velcade).

Radiation Therapy

Radiation therapy, also known as radiotherapy, can cause skin changes such as itching, dryness, and peeling. The skin may appear sunburned as it becomes red and irritated.

Bone Marrow Transplants

People with cancer who have had allogeneic (donor) bone marrow transplants often 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.

Complications of Multiple Myeloma and Itching

Multiple myeloma can lead to other health problems. These are known as complications of myeloma, and they may also lead to itchy skin.

Chronic Kidney Disease

Kidney failure is common in people with multiple myeloma. Up to half of people with multiple myeloma experience kidney failure. If kidney damage is left untreated, it can progress to chronic kidney disease, which may eventually cause more severe symptoms.

Uremic Pruritus

In the later stages of chronic kidney disease, a condition called uremic pruritus can develop. Uremic pruritus happens when the kidneys are no longer able to filter out urea (a waste product), causing the substance to build up in the bloodstream. This buildup leads to long-term itchiness that comes and goes, often worsening at night and sometimes leading to insomnia.

Unrelated Causes of Itchy Skin

When living with cancer, you might also experience itchiness that is 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.

Managing Itchy Skin With Multiple Myeloma

If you’re dealing with itchy skin after a myeloma diagnosis, talk to your oncology team or another health care provider, such as a dermatologist. They can help identify the cause and recommend the best way to find relief from 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.

Over-the-Counter Itch Cream

You might 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.”

Always consult your health care team before using any OTC drug.

Prescription Steroid Creams

If OTC creams aren’t helping, your doctor may prescribe a topical steroid cream such as mometasone (Elocon). These creams should only be used for short periods — usually a few days to six weeks. High-potency topical steroids should be applied to a small area of skin to minimize side effects like dry skin.

MyMyelomaTeam members have shared positive experiences with steroids to clear rashes and itching. One member shared, “I developed a rash on pomalidomide. My doctor prescribed a steroid, and it cleared up the rash in a few hours.”

Staying Hydrated

Whether your skin is itching or not, it’s important to stay hydrated and drink enough water. Proper hydration helps your skin regenerate more efficiently by flushing out harmful toxins more quickly. The more itch-causing impurities are removed from the skin, the less dry it will become, reducing irritation and itching.

According to Mayo Clinic, men should aim for about 15 cups of water a day, while women should aim for 11 cups. If you live in a warmer climate or are more active, you may need to drink even more.

If you find plain water hard to drink, try infusing it with fruit or drinking broth.

It’s also essential to discuss your hydration needs with your doctor, especially if you have kidney failure related to myeloma. If you’re on dialysis, you will need to restrict your fluid intake. Be sure to consult your doctor to determine the right amount of water for you.

Keeping Your Skin Moisturized

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.

For best results, apply moisturizer at least twice daily — once in the morning, once before you go to bed, and as needed throughout the day. Ideally, use the moisturizer right after bathing or showering to help seal the moisturizer into your skin.

Antihistamine Medications

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

Treatment Adjustments

Advances in multiple myeloma treatments over the last two decades have greatly improved health outcomes. However, preventing or managing side effects like itchy skin is important to help 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.

Meet Others Who Understand

MyMyelomaTeam is the social network for people with multiple myeloma and their loved ones. On MyMyelomaTeam, a growing community of more than 27,000 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 start a conversation by posting on your Activities page.