One of the many side-effects of cancer treatment are changes to the skin. As Dr Sebastian Cummins, a consultant oncologist (and husband to dermatologist Dr Justine Hextall) puts it, “the skin is the aspect of us that we all see. So when cancer, or more commonly the treatments for cancer, change the skin, it is a reminder that it would be nice to do without,” he says. “It is unpleasant to live with and it can be a label marking someone as different, not what they were.” It’s why he frequently seeks his wife’s advice for his patients. “When I can, I telephone my wife for help. The skin is her area. She understands it in a way I don’t and so she can help where I can’t. Which means my patients get to keep more of themselves.”
What happens to your skin when you have cancer treatment?
Dr Hextall, La Roche-Posay’s consultant dermatologist, says combining her own expertise with her husband’s has had a significant impact for some patients. “We have been able to minimise the impact on skin and speed up the healing process,” she says. “A pre-emptive strike with the right skincare had such a significant impact that I started to lecture oncologists, pharmacists and clinical nurse specialists nationally, to ensure all patients could have access to this advice.”
Depending on the treatment you receive, skin can be affected in different ways. Common side-effects range from itchy, dry and sensitive skin, to increased sun sensitivity, pigmentation, or becoming more susceptible to infection. Dr Kara Heelan, consultant dermatologist at the Royal Marsden Hospital and a specialist in oncodermatology, explains that “approximately half of people treated for cancer will develop a dermatologic issue during treatment affecting hair, skin or nails. Chemotherapy, radiotherapy or targeted treatments work by killing cancer cells, while immunotherapy treatments boost the body’s own immune system,” she says. “These effects can have repercussions, not just on the target organ, but also on other organ systems including the skin.”
Which ingredients should you avoid?
All cases are unique to the individual, but “broadly I would advise skincare that has as few potential sensitisers as possible,” says Dr Hextall. “For example, when receiving radiotherapy, the skin will invariably become red and irritated like a sunburn. This ‘sunburnt’ skin barrier is less robust and more likely to be irritated and sensitised by certain ingredients, such as perfumes and preservatives. There is a temptation to immediately seek out ‘natural’ and ‘organic’ topical products. But remember, these terms do not necessarily mean they won’t irritate the skin or cause allergy,” she points out. “Some of the most common sensitisers are essential oils, in themselves a ‘natural’ product. I would advise looking for products specifically created for sensitive skin, with as few potentially sensitising ingredients as possible. There are some very good creams developed specifically for ‘post-procedure’ skincare.”
Dr Heelan recommends avoiding:
- harsh toners,
- and any facial treatments that contain alcohol, BHAs (beta-hydroxy acids), irritant anti-acne products such as salicylic acid or benzoyl peroxide
- and scrubs,
- harsh exfoliants or
- bead containing products.
Patients often ask me about continuing their ‘active’ topical skin treatments, like vitamin C or retinoins. However, this often needs to be dealt with on a case-by-case basis, depending on the individual’s cancer treatment and the specific topical product constitution. Patients should consider consulting a dermatologist with a special interest in oncodermatolgy.”
The products you should use
“Exchange soaps for mild, gentle fragrance-free soap substitutes or washes, and take short, warm – not hot – showers and baths,” suggests Dr Heelan. When it comes to the skin on your face, Dr Heelan advises gently patting or dabbing your skin dry after washing and applying moisturisers or other products at this stage. “When the skin is damp, there is increased absorption of topical agents.”
Dr Hextall recommends “looking for a very gentle cleanser, preferably perfume-free, and if possible preservative-free. Look for skin-calming ingredients in moisturisers that hydrate the skin without trapping heat. I do not recommend using petroleum-based creams on warm, post-radiotherapy skin, as they can trap heat and make the skin redder and more uncomfortable.”
Look for those that will clean the skin without stripping it.
We recommend Hernuvin Wash as an effective yet simple solution for cleansing…
- the face
- the scalp
- the hair
- the body
Great effort has been made to ensure that the Hernuvin range is effective, yet as gentle and supportive as possible so as not to interfere with cancer management in any way.
Dr Heelan recommends moisturising regularly. “It’s extremely important for treating dry skin. Moisturisers hydrate and also create a skin barrier, so using them pre-emptively or prophylactically before starting cancer treatment will help enhance your skin barrier. On arms and legs, apply in a downward motion in the same direction as skin growth. This will help reduce or prevent folliculitis or inflammation of the hair follicle. Creams and ointments are usually better at hydrating the skin than lotions or gels, and ceramides can also be quite soothing. For skin pain or rashes, along with moisturisers, topical lidocaine or strong steroid ointments are sometimes used.”
We recommend Hernuvin Moisturiser to “reduce inflammation and hydrate skin”. “This immediately soothes, hydrates and reduces the risk of infection. Hernuvin Moisturiser can be applied for immediate relief to red inflamed skin. Hernuvin Moisturiser is preservative and perfume-free, and offers rich hydration. Previously well tolerated perfumes and creams may irritate vulnerable healing skin, so stick to calming, hydrating products that are created for sensitive skin, to reduce the risk of sensitisation and allergy. Hernuvin Moisturiser has been specifically developed for sensitive skin and has proven to be safe and effective during cancer treatment.
Dr Heelan also emphasises how crucial sun protection is. “Sun-sensitivity can be particularly severe depending on the drug you are on, and can occur quite quickly. Protect your skin with clothing and SPF and use lip balms with a high SPF, as lips can be particularly sensitive. You don’t have to avoid sunshine holidays, but be very careful and wear protective clothing, and regularly apply sun cream with a high SPF of at least 30. Look for mineral or physical sunscreens, which can be less irritating on very sensitive skin, particularly for acne type skins.”
Dr Hextall agrees: “After surgery or radiotherapy, the skin may take time to heal and settle. In the early stages when there is a new scar, or the skin is still red or inflamed after radiotherapy, there is an increased risk of pigmentation, particularly in those with skin of colour. I advise wearing a high factor broad spectrum sunscreen, even in winter, to protect against unwanted UV damage.”
A NEW PRODUCT FROM HERNUVIN
We are pleased to announce that we will be adding Sun Care to the Hernuvin Skin Care Range in the coming months. Watch our website and our social media pages for more information.
WHY HERNUVIN SKIN CARE
Medically designed and scientifically formulated by a specialist plastic surgeon (whose anaesthetist is a breast cancer survivor), Hernuvin is specifically formulated to address the side effects of Chemotherapy and traumatised skin.
Whether your skin is normal, showing the signs of ageing or recovering from the effects of chemotherapy and estrogen depletion, the Hernuvin Skin Care Range offers a simple skin care regime that facilitates the restoration of ailing skin, as well as providing effective prevention and protective assistance for all skin types.
Hernuvin’s cosmetologist, Liri Victor