If you are having hormone therapy for prostate cancer, you may already expect side effects such as hot flushes, tiredness or changes in sexual function. Androgen deprivation therapy (ADT) reduces androgen activity by lowering testosterone or blocking its effects. During treatment, you may notice skin-related changes such as dryness, itching or flushing, while hot flushes can also increase sweating.
You should remember that not every skin change is caused by ADT. Radiotherapy, other medicines, existing skin conditions and problems such as eczema can cause similar symptoms. If you notice a persistent rash, significant irritation or changes around an injection site, you can discuss them with your cancer team or a dermatologist.
What Is Androgen Deprivation Therapy?
Androgen deprivation therapy (ADT) is a group of prostate cancer treatments that reduce testosterone or block its effects. You may receive ADT alongside radiotherapy or when prostate cancer has spread, as reducing androgen activity can help slow cancer growth.
Your treatment may involve injections, implants or tablets, while surgery to remove the testicles is used much less often. You should also know that side effects can vary depending on the treatment you receive, so you can ask your cancer team which effects are most relevant to you.
Why Can Lowering Androgens Affect Your Skin?
Your skin responds to hormones such as androgens, which influence the sebaceous glands, hair follicles, skin barrier and other functions. When ADT lowers androgen activity, you may notice changes such as less oily skin, increased dryness or a different skin sensation.
However, you should not assume that ADT will automatically cause dry or irritated skin. Your age, skin type, other medicines, washing habits, climate and cancer treatments can all affect how your skin responds. You can discuss any new or persistent changes with your cancer team to understand what may be contributing to them.
Evidence Note
Androgens have recognised effects on sebaceous glands, sebum production, hair follicles and skin-barrier biology. However, this biological link does not mean that every episode of dry or itchy skin during ADT is directly caused by testosterone suppression, so other medicines, radiotherapy and common skin conditions should also be considered.
Can ADT Make Your Skin Feel Dry?
ADT may contribute to dry skin because androgens influence the sebaceous glands and the oils that help protect your skin. You may notice tightness after washing, roughness or fine flaking, particularly on your hands, arms and lower legs. Ageing can also make your skin naturally drier, so you may notice these changes more during treatment.
You can often manage mild dryness with a regular moisturiser and gentle skincare. You should avoid very hot showers, fragranced soaps and excessive washing, as these can make dryness worse. If your skin becomes very itchy, cracked or persistently irritated, speak to your cancer team or a dermatologist.
Why Might Your Skin Itch During Hormone Therapy?
You may experience itching during hormone therapy for several reasons. Dry skin can make your skin more sensitive and itchy, while some specific hormone medicines can also cause itching or rashes. You should also consider other causes, such as eczema, contact dermatitis, fungal infections or reactions to skincare products.
You can look at how your skin has changed, as this may provide useful clues about the cause. If the itching is persistent, widespread or keeps you awake at night, or you develop a new rash or blisters, you should tell your healthcare team rather than assuming it is simply a side effect of ADT.
Why Does ADT Cause Hot Flushes?
Hot flushes are one of the most common side effects of hormone therapy for prostate cancer. When ADT lowers testosterone, it affects the systems that regulate body temperature, so you may suddenly feel very warm even when the surrounding temperature has not changed.
You may notice flushing on your face, neck, chest or back, sometimes with sweating. The appearance can vary depending on your skin tone, with redness being more obvious on lighter skin and colour changes appearing differently on darker skin. Some hot flushes are brief, while others can last longer, and you may continue to experience them for as long as you receive hormone therapy.
Why Can Hot Flushes Make You Sweat So Much?
You may sweat during a hot flush because your body is trying to regulate a sudden feeling of heat. You may notice warmth across your face, neck or chest followed by sweating, while night sweats can leave you waking with damp clothing or bedding and feeling tired afterwards.
You can reduce skin irritation by changing damp clothes, washing gently and allowing your skin to dry properly. Breathable fabrics may also help you stay more comfortable. If sweating regularly disrupts your sleep or daily activities, you should tell your cancer team, as treatment for troublesome hot flushes may be available.
Can ADT Cause Facial Flushing and Redness?
Yes, you may notice facial flushing during a hot flush caused by ADT. You may feel sudden warmth around your face or neck, followed by a temporary change in skin colour, sweating and warmth across your upper body. This usually comes and goes rather than causing constant redness.
You should not assume that persistent facial redness is always related to ADT. Conditions such as rosacea, dermatitis, infection or a reaction to another medicine can also cause redness, particularly if you have itching, scaling or inflammation. If your face remains red between hot flushes, you should discuss it with your healthcare team.
Can Your Skin Become More Sensitive or Easily Irritated?
You may find that products you previously tolerated now sting or feel uncomfortable, particularly if your skin has become drier during ADT. You can reduce irritation by using gentle, fragrance-free products, avoiding strong soaps and limiting unnecessary washing.
You should not assume that every burning, stinging or red area is caused by ADT, as dermatitis, allergies or other medicines can have similar effects. Sun sensitivity also depends on your individual medicines rather than ADT as a whole, so you should check your treatment information and tell your cancer team about any new reactions.
What Skin Changes Should You Keep an Eye On During ADT?
It can help to notice how and when a skin change develops during treatment. These details may help your healthcare team work out whether ADT, another medicine or a separate skin condition could be responsible.
- Where the change appears: Note whether dryness, redness or irritation is localised or affecting several areas.
- When it started: Consider whether symptoms began after a new medicine, ADT injection or radiotherapy session.
- How the skin feels: Mention itching, burning, pain, tenderness or increasing sensitivity.
- Whether it is getting worse: Report spreading redness, blistering, swelling or symptoms that do not settle.
Keeping track of these changes can make it easier to explain your symptoms to your cancer team or dermatologist and decide whether further assessment is needed.
Can ADT Cause a Skin Rash?
You may develop a rash during prostate cancer hormone treatment, but the risk can vary between different medicines. Some hormone treatments can cause rash or itching, while other rashes may be linked to another cancer treatment, medication or an unrelated skin condition.
You should tell your cancer team about any new rash rather than stopping your treatment yourself. You can note when it started, where it appears and whether it is itchy, painful or spreading, and a photograph may help if it changes quickly. If you develop blistering, significant swelling or a rapidly worsening rash, seek prompt medical advice.
Research Insight
A 2022 study of 303 patients treated with apalutamide reported dermatological adverse events in 71 patients (23.4%). Maculopapular rash and xerosis were among the most commonly reported skin problems. These findings relate specifically to apalutamide and should not be used to estimate skin side effects from every form of prostate-cancer hormone therapy.
Can ADT Change Your Hair or Body Hair?
You may notice changes in your body hair during longer-term ADT because androgens influence hair follicles and growth. Your body hair may become finer or less noticeable in some areas, although changes can vary between people.
You should not assume that every change in hair density is caused by ADT, as ageing and other factors can also affect your hair. If you develop sudden patchy hair loss, scalp inflammation or significant itching, you should discuss it with your cancer team or a dermatologist.
What About Skin Reactions Where ADT Is Injected?
You may notice temporary tenderness, redness, bruising, swelling or irritation where your ADT is injected. These reactions can vary depending on the medicine and how it is given, and you should ask your treatment team what is normal for you.
You can avoid rubbing or scratching the area if it feels mildly irritated. If you develop increasing pain, marked swelling, warmth, discharge or redness spreading beyond the injection site, you should contact your healthcare team. Injection-site reactions relate to the treatment method, so they do not affect everyone receiving ADT.
Could Radiotherapy or Other Cancer Treatment Be Causing the Skin Problem?
Yes, your skin changes may be linked to radiotherapy or another treatment rather than ADT alone. Radiotherapy can cause redness, darkening, soreness, itching or sensitivity in the treated area, so you should tell your healthcare team where the skin change has appeared and when it started.
You should also mention every medicine, supplement and skincare product you use, as these can sometimes cause rashes or irritation. The timing and location of your symptoms can help your team work out which treatment is most likely to be responsible, rather than assuming ADT is the only cause.
What Could Be Causing a Skin Change During Prostate Cancer Treatment?
| Skin change | Possible explanation | What to consider |
| Sudden flushing and sweating | Hormone-treatment hot flush | Often comes and goes; speak to your cancer team if troublesome |
| Dry, rough or itchy skin | Dry skin, treatment effect, eczema or irritation | Review skincare, medicines and other possible causes |
| New widespread rash | Drug reaction or another skin condition | Tell your cancer team, especially if spreading |
| Redness or soreness only in a radiotherapy field | Radiotherapy skin reaction | Follow your radiotherapy team’s skincare advice |
| Red, sore injection site | Local injection reaction | Often temporary, but increasing pain, warmth or spreading redness need review |
| Persistent facial redness | Rosacea, dermatitis or another cause rather than a transient hot flush | Consider medical or dermatology assessment |
| Blistering, peeling or facial swelling | Potential serious drug/allergic reaction | Needs urgent medical assessment |
How Can You Look After Dry or Sensitive Skin During ADT?
You can keep your skincare routine simple if your skin becomes dry or sensitive during ADT. Use lukewarm rather than hot water, choose a gentle fragrance-free cleanser and pat your skin dry instead of rubbing it. You should apply a fragrance-free moisturiser while your skin is still slightly damp to help retain moisture.
You may find thicker creams or ointments more comfortable on very dry areas such as your hands, elbows or lower legs. If a product stings, you can try a different formulation rather than stopping moisturising altogether. Avoid introducing several new products at once, so you can identify what is causing irritation if your skin reacts.
Clinical Tip
If a new rash or irritation appears, take a clear photograph and note when it started in relation to your ADT injection, tablets, radiotherapy or any other new medicine or skincare product. This timeline can help your cancer or dermatology team identify whether the reaction is treatment-related or has another cause.
How Can You Make Hot Flushes and Sweating Easier to Manage?
You can make hot flushes more manageable by keeping your room cool and wearing loose, breathable layers that are easy to remove. A fan, lighter bedding and staying well hydrated may also help, while you can keep a record of possible triggers such as caffeine, alcohol, spicy foods, stress or sudden temperature changes.
You should change damp clothes and gently wash areas where sweat collects to reduce skin irritation. If hot flushes are severe or regularly affect your sleep and daily life, you can speak to your cancer doctor or specialist nurse about other ways to manage them.
UK Guidance Note
Troublesome hot flushes caused by long-term androgen suppression can sometimes require medical treatment. If they are significantly affecting your daily life, discuss them with your prostate-cancer team rather than starting medicines or supplements yourself.
When Should a Skin Change Be Reported to Your Cancer Team?
You should tell your cancer team about any new, persistent or worsening skin change. A mild dry patch may improve with moisturiser, but you should report a widespread itchy rash, significant irritation, blistering, peeling, swelling, severe pain or a rash that spreads quickly.
Seek urgent medical assessment if you develop blistering or peeling skin, particularly if you also develop sores in your mouth or around your eyes. Call 999 or go to A&E if you develop difficulty breathing or swelling of your face, mouth or tongue.
Signs of infection, such as increasing warmth, tenderness, pus or rapidly spreading redness, also need prompt assessment. You should not stop ADT yourself because of a suspected skin side effect; discuss any treatment changes with your cancer team.
When Might Seeing a Dermatologist Help?
Your prostate cancer team should usually be your first point of contact if you develop a new skin problem during ADT. You can ask for a dermatologist’s assessment if the cause is unclear, symptoms persist despite simple skincare or an existing condition such as eczema, psoriasis or rosacea becomes harder to control.
You should also consider dermatology advice if you have severe unexplained itching or an unusual rash that does not settle after your cancer team reviews your medicines. You can note when the problem started in relation to ADT, other medicines or radiotherapy, as this may help identify the cause.
Myth vs Fact
| Myth | Fact |
| Every rash during ADT is caused by low testosterone. | Rashes can be drug-specific or caused by radiotherapy, eczema, infection or another medicine. |
| Facial redness during treatment always means dermatitis. | Temporary facial flushing can occur during an ADT-related hot flush. |
| All prostate-cancer hormone therapies have the same skin side effects. | Side-effect profiles vary considerably between injections and different oral treatments. |
| You should stop your prostate-cancer medicine if a rash appears. | Contact your cancer team; do not stop prescribed treatment unless they advise you to. |
| A dermatologist replaces your cancer team for treatment-related reactions. | Your oncology team should usually know about the reaction first, with dermatology input when diagnosis or management needs specialist help. |
Key Takeaways
- Hot flushes and sweating are well-recognised effects of testosterone suppression during prostate-cancer hormone therapy.
- Dryness, itching and rash can occur during treatment, but they are not always caused directly by ADT.
- Different prostate-cancer medicines have different skin side-effect profiles, so the exact treatment you take matters.
- Radiotherapy, eczema, infection and other medicines can cause skin changes that resemble treatment side effects.
- Gentle cleansing and regular emollient use can help uncomplicated dry skin, but persistent or worsening symptoms should be assessed.
- Rapidly spreading rash, blistering, peeling, facial swelling or difficulty breathing requires urgent medical advice.
Frequently Asked Questions
1. Can ADT cause dry skin?
Yes, ADT may contribute to dry skin because lower androgen activity can affect the sebaceous glands and skin oils. You may notice tightness, roughness or flaking.
2. Why might you experience itching during ADT?
Dry skin can make your skin more sensitive and itchy during hormone therapy. Itching can also have other causes, including eczema, dermatitis, infections or reactions to medicines or skincare products.
3. Why does ADT cause hot flushes?
ADT lowers testosterone and can affect the systems that regulate your body temperature. This may cause sudden warmth, flushing and sweating, particularly around your face, neck and upper body.
4. Can ADT cause facial flushing or redness?
Yes, facial flushing can occur during an ADT-related hot flush. Persistent redness between flushes may have another cause, such as rosacea, dermatitis or a reaction to another medicine.
5. Can ADT make your skin more sensitive?
You may find that skincare products you previously tolerated begin to sting or irritate your skin. Gentle, fragrance-free products can help reduce irritation.
6. Can ADT cause a skin rash?
Some hormone treatments can cause rash or itching, although other medicines, radiotherapy or skin conditions can also be responsible. You should tell your cancer team about any new or worsening rash.
7. Can ADT change your body hair?
Long-term ADT may affect body hair because androgens influence hair follicles and growth. Changes vary between people and can also have other causes.
8. Can ADT cause a reaction at the injection site?
You may experience temporary tenderness, redness, bruising, swelling or irritation where ADT is injected. Increasing pain, marked swelling, discharge or spreading redness should be reported to your healthcare team.
9. How can you manage dry or sensitive skin during ADT?
Use lukewarm water, a gentle fragrance-free cleanser and a regular moisturiser. Avoid very hot showers, harsh soaps and unnecessary washing, and consider thicker creams for very dry areas.
10. When should you report a skin change during ADT?
You should tell your cancer team about new, persistent or worsening skin changes, particularly widespread rashes, blistering, swelling or severe irritation. Difficulty breathing or swelling of the face, mouth or tongue requires urgent medical attention.
Final Thoughts: Hormone Therapy for Prostate Cancer and Skin Changes
ADT can affect your skin in several ways, including dryness, itching, flushing, sweating and increased sensitivity. However, not every skin change is caused by hormone therapy, so you should report persistent, severe or unusual symptoms to your cancer team for assessment.
If you need advice from a dermatologist in London about a skin problem during prostate cancer treatment, you can contact the London Dermatology Centre to discuss your symptoms and arrange a consultation.
References:
- Zouboulis, C.C. and Degitz, K. (2004) ‘Androgen action on human skin – from basic research to clinical significance’, Experimental Dermatology, 13(Suppl. 4), pp. 5–10. Available at: https://pubmed.ncbi.nlm.nih.gov/15507105/
- Del Rosso, J.Q., Kircik, L.H., Stein Gold, L. and Thiboutot, D. (2020) ‘Androgens, androgen receptors, and the skin: from the laboratory to the clinic with emphasis on clinical and therapeutic implications’, Journal of Drugs in Dermatology, 19(3 Suppl. 1), pp. s30–s35. Available at: https://pubmed.ncbi.nlm.nih.gov/32550699/
- Pan, A., Reingold, R.E., Zhao, J.L., Moy, A., Kraehenbuehl, L., Dranitsaris, G., McBride, S.M., Scher, H.I., Kollmeier, M.A., Xiao, H., Rathkopf, D.E. and Lacouture, M.E. (2022) ‘Dermatological adverse events in prostate cancer patients treated with the androgen receptor inhibitor apalutamide’, The Journal of Urology, 207(5), pp. 1010–1019. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC9554897/
- Ajmera, M., Lou, K.-J., Ng, S. and Helbing, M. (2026) ‘Burden of treatment-induced vasomotor symptoms in men with prostate cancer on androgen-deprivation therapy: a systematic literature review’, Prostate Cancer, 2026, 7791468. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC13559472/
- Chowdhury, D., Chin, L., Odabashian, R., Fawaz, A., Canil, C., Ong, M., Kirchhof, M.G., Reaume, M.N., Beltran-Bless, A.-A., Savard, M.-F., Tsoulis, D.J. and Bossé, D. (2025) ‘Diagnosis and management of skin toxicities in systemic treatment of genitourinary cancers’, Cancers, 17(2), 251. Available at: https://www.mdpi.com/2072-6694/17/2/251