Cancer treatments, including chemotherapy, radiation therapy, immunotherapy, and targeted therapies, can profoundly impact the skin. These treatments, while life-saving, often lead to a range of challenging dermatological side effects, including extreme dryness, sensitivity, redness, itching, rashes (sometimes resembling acne), hyperpigmentation, thinning, and fragility. Protecting and nurturing the skin during this time becomes paramount, not only for comfort but also to prevent complications like infection in a potentially immunocompromised state. The guiding principle is gentleness, hydration, and a minimalist approach, always in consultation with your oncology care team.
Understanding Skin Changes During Cancer Treatment
The specific skin changes depend on the type and duration of treatment, but common manifestations include:
- Profound Dryness and Dehydration: Treatments often disrupt the skin's natural barrier, leading to significant transepidermal water loss. Skin can become rough, flaky, itchy, cracked, and even painful.
- Increased Sensitivity and Irritation: The skin barrier is compromised, making the skin highly reactive to previously tolerated products, fragrances, friction, and environmental factors.
- Redness and Inflammation: Rashes (sometimes referred to as "chemo rash" or "radiation dermatitis") are common. Skin can appear red, inflamed, or darker (hyperpigmentation) depending on skin tone, and may feel hot, tender, or sting.
- Hand-Foot Syndrome (Palmar-Plantar Erythrodysesthesia): A painful side effect of some chemotherapies, causing redness, swelling, blistering, and peeling on the palms of the hands and soles of the feet.
- Photosensitivity: Many treatments make the skin exceptionally sensitive to sunlight, increasing the risk of severe sunburn and exacerbating pigmentation.
- Nail Changes: Nails can become brittle, discoloured, cracked, or painful, and cuticles may suffer.
- Thinning Skin: Skin may become thinner and more fragile, prone to bruising or tearing.
Strategic Skincare During Treatment: Safety & Comfort
The primary goals are to soothe discomfort, prevent infection, maintain skin integrity, and support healing. Always consult your oncology team before introducing any new skincare products or making significant changes to your routine.
Essential At-Home Adjustments:
- Ultra-Gentle Cleansing:
- Purpose: To cleanse effectively without stripping the skin or causing further irritation.
- Method: Use a mild, unscented, pH-balanced, soap-free cleanser (cream, balm, or gentle lotion texture) for both face and body. Avoid foaming cleansers, harsh soaps (especially antibacterial ones), fragrances, dyes, and sulfates.
- Application: Use lukewarm (not hot) water. Apply cleanser gently with hands; avoid washcloths, loofahs, or scrubbing brushes. Pat skin dry softly with a clean, soft towel.
- Intensive, Frequent Moisturisation:
- Purpose: To deeply hydrate, repair the compromised skin barrier, reduce dryness and itching, and prevent cracking.
- Method: Apply a thick, emollient-rich, unscented, hypoallergenic moisturiser liberally and frequently (multiple times a day), especially immediately after bathing while skin is still damp.
- Ingredients to Look For: Ceramides, hyaluronic acid, glycerin, colloidal oatmeal, urea (at low concentrations, e.g., 5-10% unless advised otherwise), shea butter, petrolatum (e.g., Vaseline, Aquaphor – bland, fragrance-free options are excellent occlusives).
- Ingredients to Avoid: Alcohol, fragrance, parabens, lanolin (for those with potential allergy), strong essential oils, active ingredients like retinoids, AHAs, BHAs, Vitamin C (unless specifically recommended by your team for a particular issue and skin tolerance).
- Tip for Hand-Foot Syndrome: Apply thick emollient creams, use cooling compresses, and avoid friction/pressure on hands and feet.
- Rigorous Sun Protection:
- Purpose: To protect photosensitive skin from UV damage, prevent sunburn, and minimise pigmentation changes.
- Method: Use a broad-spectrum SPF 30+ (or 50+) mineral-based sunscreen containing zinc oxide and/or titanium dioxide every day, even indoors or on cloudy days, on all exposed skin. Reapply frequently.
- Further Protection: Wear loose-fitting, long-sleeved clothing, wide-brimmed hats, and sunglasses when outdoors. Seek shade whenever possible.
- Managing Itchiness:
- Purpose: To alleviate discomfort and prevent scratching, which can lead to skin breakdown and infection.
- Methods: Apply cool, moist compresses. Use specific anti-itch lotions recommended by your care team. Keep nails short and clean. Consider colloidal oatmeal baths for soothing relief.
- Addressing Rashes/Inflammation:
- Purpose: To soothe and manage treatment-induced skin reactions.
- Method: Follow your oncology team's specific advice. They may recommend particular barrier creams, steroid creams (prescription only), or other anti-inflammatory topicals. Do not use unprescribed acne products, as these rashes are often not typical acne.
- Nail and Cuticle Care:
- Purpose: To prevent breakage, infection, and discomfort.
- Method: Keep nails short and clean. Use a rich cuticle cream or balm frequently. Avoid nail polish remover with acetone or alcohol. Some may be advised to use ice baths for hands and feet during certain infusions.
- General Skin Protection:
- Clothing: Wear loose-fitting clothing made of soft, natural fibres (like cotton) over treated or sensitive areas to minimise friction. Avoid tight bras or collars in radiation areas.
- Avoid Irritants: Steer clear of perfumes, colognes, aftershaves, deodorants (especially in treated areas or on broken skin), and harsh hair removal methods (waxing, depilatories). If shaving, use an electric razor gently.
- Temperature Extremes: Avoid very hot baths/showers, heating pads, ice packs, and extreme cold/wind on sensitive areas.
When to Contact Your Healthcare Team:
It is crucial to promptly inform your oncology nurse or doctor about any new or worsening skin changes, especially:
- Spreading rashes or blisters.
- Skin that is broken, wet, or showing signs of infection (increased redness, warmth, pus, pain).
- Severe itching that is not relieved by home measures.
- Sudden or severe skin reactions.
- Painful skin changes.
Skincare during cancer treatment requires immense gentleness, diligence, and personalised guidance from your medical team. By prioritising simple, soothing, and protective measures, you can significantly enhance comfort and support your skin's healing journey.
