Protocol · Oncology/Side Effect Management
Hand-Foot Syndrome (Palmar-Plantar Erythrodysesthesia) Support Protocol
Vitamin B6 (Pyridoxine) is the core of this stack, with 3 supporting supplements. Each row gives the amount the protocol lists and the grade our evidence database holds for that supplement in Hand-Foot Syndrome (Palmar-Plantar Erythrodysesthesia) Support.
We are re-verifying the studies cited on protocol pages; only confirmed citations are shown.
The stack
4 supplements · none graded yet
| Grade | Supplement | Amount listed | Why it’s in the stack | Evidence on file |
|---|---|---|---|---|
| Primary stackThe core of this protocol | ||||
| Vitamin B6 (Pyridoxine) | Amount listed: 50–200 mg daily (discuss with oncologist) | May help prevent or reduce HFS with certain chemotherapy drugs
| Not graded yet | |
| Supporting stackListed as additions to the core | ||||
| Vitamin E (Topical) | Amount listed: Apply topical vitamin E oil to hands/feet twice daily | Moisturizing and antioxidant; may soothe affected skin | Not graded yet | |
| Urea Cream (10-40%) | Amount listed: Apply to affected areas twice daily | Keratolytic and moisturizing; reduces hyperkeratosis | Not graded yet | |
| Omega-3 Fatty Acids | Amount listed: 2–3 g EPA+DHA daily | Anti-inflammatory; may support skin health | Not graded yet | |
How this protocol works
In plain language
Hand-foot syndrome (HFS), also called palmar-plantar erythrodysesthesia (PPE), is a side effect of certain chemotherapy drugs that causes redness, swelling, and pain on the palms of hands and soles of feet.
SYMPTOMS:
- Redness (like sunburn)
- Swelling
- Tingling or burning sensation
- Tenderness
- Blisters or peeling skin
- Pain affecting daily activities
COMMON CAUSES:
- Capecitabine (Xeloda)
- 5-Fluorouracil (5-FU)
- Doxorubicin (liposomal)
- Sorafenib, sunitinib (targeted therapies)
- Cytarabine
GRADES:
- Grade 1: Redness, minimal discomfort
- Grade 2: Painful redness, swelling, affects function
- Grade 3: Severe; blistering, ulceration, can't use hands/feet
PREVENTION & MANAGEMENT:
- Avoid friction, heat, pressure on hands/feet
- Wear soft cotton gloves and socks
- Avoid hot water
- Use emollient creams frequently
- Avoid tight shoes
- May need dose reduction
Vitamin B6* may help prevent HFS with some drugs.
Urea creams* help with dryness and peeling.
Topical vitamin E* may soothe skin.
Expected timeline: HFS typically appears 2-12 weeks after starting chemotherapy. Symptoms usually improve with dose modification and supportive care.