Caring for Your Skin During Cancer Treatment

By Nancy Gardner, Ph.D., Board Certified Nurse Practitioner at South Osprey Dermatology, Sarasota, Florida
Featured in Health and Wellness Magazine

Cancer treatments can take a toll on the skin, causing skin-related side effects such as dryness, itchiness, rashes, and sun sensitivity.

Taking care of your skin can help you feel better and more comfortable during cancer treatment.

Chemotherapy, Immunotherapy, and Hormonal therapy can cause skin-related side effects due to the slowing down of cellular turnover in the skin and exposure to drugs, alterations in immune response to irritants, or endocrine imbalance. It is usually mild dryness and sensitivity. It can be easily managed with proper skin care, limited sun exposure, hydration, rest, and good nutritional status before and throughout cancer treatment.

Radiation treatment causes redness, irritation, swelling, and skin breakdown if not cared for properly. Avoid using any products in the area being treated that are potentially irritants. Every day, use your radiation skincare routine at least three, but preferably four times a day. Moisturize the treated area and apply a hydrating barrier such as Aquaphor. The exception is on the day of treatment; wait to use moisturizers until after the radiation treatment that day is completed; then apply your skin care.

Hand and Foot Syndrome is a unique side effect that can cause redness, swelling, and pain in the palms of the hands and soles of the feet. The side effects can become severe, and if left untreated, it can even result in the delay of scheduled treatment. Your oncology team can prescribe dose adjustments, creams, and ointments to manage serious side effects.

Skin color changes such as yellowing, bluish, or becoming pale can be serious indicators and you will need to notify your oncology team as soon as possible. This can represent other health problems.

Nail and cuticle changes are associated with cancer treatment. Your cuticles may become tender; nails may discolor or have white or dark lines across your nails. They can also become dry, cracked, and brittle and grow more slowly. Use topical cuticle removers and massage cuticle oils or cream to prevent hangnails, splitting, and dryness. Wear gloves when exposing your hands to water other than washing them. Excessive exposure to water can increase the risk of nail fungal infections.

Here is what you can do to keep your skin feeling and looking healthy:
Cleansers you should choose one for dry and sensitive skin and hypoallergenic and gentle. Over-the-counter brands of facial and body cleansers we recommend are Cetaphil, Lubriderm, Eucerin, and CeraVe. Your dermatologist may recommend a high-quality facial cleanser like SkinCeuticals, Gentle Cleanser.

Body and Facial Moisturizers help repair dry- dehydrated skin, damaged skin, and promote healing. They are gentle and hypoallergenic, with no additional additives like parabens, fragrance, or alcohol. All moisturizers should be applied when the skin is damp. Some commonly recommended include Cetaphil Intensive Healing Lotion with ceramides for dry, flaky, rough skin, Eucerin Intensive Repair Body Lotion or Eucerin Calming lotion for dry, itchy skin, CeraVe Moisturizing Lotion, or cream for Dry to Very Dry Skin with Hyaluronic Acid and three essential Ceramides, Aveeno Calm and Restorative Oat Repair Body lotion Therapy.

Chemotherapy and Radiation therapy-specific lotions and creams that may be recommended by your oncology team include Bag Balm Moisturizing Hand and Foot Lotion is free of irritants. It is for Low-grade Hand and Foot Syndrome and severely dry and chafed hand and foot skin. It is free of skin irritants. Recovery Skin Relief Radiation Ultimate Soothing Cream is for sensitive skin. It has additional ingredients such as mineral oil, lanolin, and salicylic acid to help rehydrate the dry, cracked, or itchy skin due to radiation or chemotherapy. OncoDerm chemotherapy cream with urea helps hold onto moisture and glycolic acid, which helps increase cellular turnover. It contains ceramides, which protect the moisture in the skin. It can provide hydration for severely cracked and dry skin. However, some of its ingredients could irritate due to alcohol and fragrance.

Sun Protection, such as Mineral sunscreen for sensitive skin with an SPF of 30 or greater, is recommended. Reapply every two hours when you’re outside, and always wear sun protection gear such as a brimmed hat, sunglasses, and protective clothing from the sun. Chemotherapy, immunotherapy, and radiation can interact with solar radiation. Your dermatologist may recommend a high-quality sunscreen, for example, ELTA MD.

Helpful Tips –
• Avoid harsh detergents; try those for allergy-prone use, such as Tide Free and Clear.
• Avoid bathing or showering using warm or tepid temperatures.
• Avoid products with alcohol or perfumes.
• Avoid shaving with a blade; use an electric razor to avoid nicks and cuts that could become infected.
• A good rule is to avoid products that make your skin more itchy, dry, sensitive, or red.

A Dermatologist can be helpful if you have a pre-existing skin condition that has become worse on treatment or if skin changes during and after treatment are challenging.