Is Itchy Skin a Sign of Cancer?

Itchy skin may be more than just a nuisance. In fact, itching that won’t go away can be a sign of an underlying disease. Up to 50% of adults with persistent itching are diagnosed with a health condition.

“If you have itchy skin that isn’t going away, it’s important to understand what’s causing it,” says medical oncologist James Isaacs, MD.

The connection between cancer and itchy skin

Anything from minor skin irritations to chronic disease can cause itchy skin — and yes, it can also be a symptom of cancer.

Though itchy skin isn’t the most common cancer symptom, a study of almost 17,000 adults found that people with itchy skin may be five times more likely to have cancer than people without it. It’s also a frequent reaction to certain cancer treatments.

Cancers that cause itchy skin

Many people with cancer experience itchy skin (pruritis) at some point, Dr. Isaacs says. Itchy skin associated with cancer can occur when:

• Bile, a fluid released by the liver to help with digestion, builds up under your skin due to a tumor.
• Inflammation occurs in response to cancer cells.
• Your body reacts to substances released by a tumor.

Itching linked to cancer often has certain characteristics. Typically it:

• Doesn’t include a rash or hives.
• Happens in response to water or without explanation.
• Occurs all over your body.
• Come with other symptoms like fatigue, low appetite and weight loss.

To understand what’s causing your itchiness, a healthcare provider will likely ask you how long you’ve been itching and whether you’ve been exposed to skin irritants, like poison ivy or a new laundry detergent.

But sometimes, itching is a symptom of certain types of cancer.

Gastrointestinal (GI) cancers

Your GI (digestive) system uses bile to break down food. But a tumor in your digestive tract can block the tubes (bile ducts) that carry bile from your liver to your gallbladder. When that happens, bile can build up and increase the amount of bilirubin (a substance found in bile) in your blood.

“Any GI cancer that blocks the bile ducts can increase bilirubin,” Dr. Isaacs explains. “It tends to happen when cancer is more advanced, but it’s not uncommon.” High levels of bilirubin can cause itchy skin and (jaundice) of your skin and eyes.

GI cancers that can block your bile duct include:

• Bile duct cancer.
• Gallbladder cancer.
• Liver cancer.
• Pancreatic cancer.

Blood cancers

Blood cancers involve white blood cells, red blood cells or bone marrow — the spongy center of bones. No one knows for sure why blood cancers can cause itching, but some experts believe blood cancer cells may release chemicals that irritate your skin’s nerve endings.

“Itchiness may be a sign of some blood cancers,” Dr. Isaacs says, “but it’s not a classic symptom for most of those diseases.”

The blood cancers most likely to cause itchy skin include:

• Acute myeloid leukemia, with atopic dermatitis (intense itching) as a possible first symptom.
• Hodgkin lymphoma.
• Polycythemia vera.
• Primary cutaneous B-cell lymphoma.
• T-cell lymphoma.

“We can screen for blood cancer with a simple blood test, and review of symptoms,” Dr. Isaacs adds. “If blood counts and physical exam are normal, you probably don’t have blood cancer.”

Metastatic cancers

Cancer that spreads (known as metastatic cancer) may cause itchy skin if it spreads to either your liver or skin.

It’s somewhat rare for cancer to spread to the skin, Dr. Isaacs says, but it can happen. Cancers most likely to spread to your skin include:

• Breast cancer.
• Colorectal cancer.
• Lung cancer.

Metastatic cancer is more likely to cause itching if it spreads to your liver and blocks your bile ducts. Cancers that may spread to your liver include:

• Breast cancer.
• GI cancers, including esophageal, colorectal, kidney, pancreatic and gastric (stomach) cancers.
• Lung cancer.
• Skin cancer (melanoma).

Breast cancers

Itchy breasts are rarely caused by cancer. But two types of breast cancer may involve an itchy rash:

• Inflammatory breast cancer can mimic a breast infection (mastitis) or begin with a small, itchy rash.
• Paget’s disease of the breast may involve a dry, scaly rash on the nipple.

“Whenever a spot on the skin of your breast is itchy, irregular or painful, have it checked by a healthcare provider,” Dr. Isaacs advises.

Skin cancers

Skin cancer may cause itchy skin, but not always. Melanoma, the most dangerous skin cancer, is the least likely to itch.

“A benign (noncancerous) mole shouldn’t cause pain, bleeding or itching, and it shouldn’t change in size or shape,” Dr. Isaacs says. He adds that itchy skin is rarely the only sign of skin cancer. “If you have any skin symptoms, a medical professional should check you.”

Itchy skin and cancer treatment

It’s often not cancer that causes itching; it’s cancer treatment. Itchiness that immediately follows cancer treatment may be an allergic reaction to the treatment, while persistent and possibly even long-term itching is a common side effect of immunotherapy.

Immunotherapy activates your immune system to target cancer. But the inflammation it causes can lead to an itchy rash — or even an itch without a rash. The itching usually goes away once you stop treatment, but some people experience long-term itchiness.

“It’s probably the most common symptom I see in people on immunotherapy,” Dr. Isaacs notes. “The itching can affect their quality of life and often becomes a serious issue.”

Itchy skin can also be a less common side effect of other treatments:

• Chemotherapy can cause an allergic reaction or liver inflammation.
• Hormone therapy for breast cancer can cause skin dryness and excessive sweating (due to hot flashes), which can lead to itching.
• Radiation therapy can slightly burn the skin and cause temporary itching.
• Targeted therapy targets specific genes, proteins and tissues to stop cancer growth and can cause a rash or itching.

Relief for itchy skin from cancer treatment

If you experience itchy skin as a side effect of cancer treatment, talk to your healthcare provider.

“You may think that itchy skin isn’t something your provider would be concerned about, but side effects can affect your quality of life, and keeping you comfortable during your treatment is important,” Dr. Isaacs reassures. “We can try home remedies or prescribed treatments.”

Treatments for itchy skin may include:

• At-home lifestyle changes like switching to perfume-free lotions, bathing in lukewarm water (instead of hot) and using a milder soap.
• Over-the-counter medications, including antihistamines and steroids.
• Biologics, prescribed drugs that come from living sources.

If you’re concerned about itchy skin and cancer

“If you’re up to date with your screenings, you’ve had labs and a healthcare provider has checked your symptoms, your itchy skin is likely not caused by cancer,” Dr. Isaacs says.

But remember: Itchy skin is often a sign of an underlying medical problem, even if that medical issue isn’t cancer. If it’s not going away, keep pursuing answers.

“Skin conditions and diseases like liver and kidney failure can contribute to itching,” he reiterates, “so it’s always important to see a healthcare provider for persistent itchiness.”