What are some skin-related symptoms that cancer treatments can trigger?
It really depends on the treatment being received. In some cases, the approach to treatment is surgical so the main issue is managing effectively a post -operative scar. If the treatment is radiotherapy, this again will vary depending on the dose and duration of radiotherapy and the site. When treating some head and neck cancers for example, it is important to make sure the skin is as healthy as possible before starting treatment as the radiotherapy can cause significant skin inflammation. I have found as a dermatologist if there is very clear guidance on skin care before, during and after radiotherapy treatment there is a significant benefit to the patient. Traditional chemotherapy for example targets the cancer cells whose strength lies in the rapidity of turnover. Other cells in our body that have a high turnover are skin, hair and oral mucosa amongst others, as such common side effects of chemotherapy are dry irritated sensitive skin, hair loss and mouth ulcers. There are newer targeted therapies that can have very specific side effects such as acneiform facial rashes, dermatitis and UV induced skin toxicity. The key here is to educate about the potential skin side effects, as some are very predictable, and to prepare the skin before, during and after treatment.
What ingredients should those going through cancer treatments avoid, and why?
Broadly I would advise skin care that has as few potential sensitisers as possible. For example, when receiving radiotherapy, the skin will invariably become red and irritated like a sunburn. This ‘sunburnt’ skin barrier is less robust and at more likely to be irritated and sensitised by certain ingredients such as perfumes, preservatives etc. There is a temptation to immediately seek out ‘natural’ and ‘organic’ topical products. This is completely understandable but remember these terms do not necessarily mean these products won’t irritate the skin or cause allergy. One 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 and developed specifically for ‘post –procedure” skin care. Whilst looking and feeling good is such an essential part of this journey to recovery there are some ingredients that I would avoid until the skin has settled. For example, it may be wise to reduce or stop potentially irritating actives such as retinols, AHA’s and BHA’s, even some vitamin C products may be difficult to tolerate on this newly sensitive skin. Some good news, as sun damaged cells are often targeted by chemotherapies, many patients find their skin beautifully renewed after many of these treatments.
What ingredients should those going through cancer treatments choose, and why?
The key for me is to prepare the skin barrier so that it is as robust as possible prior to starting treatment. The best way to do this is to look for the most calming, hydrating and nourishing skin care that will optimise skin health. Ideally this will also be skin care that is as gentle as possible and can be continued during and after treatment. Broadly I would advise skin care that has as few potential sensitisers as possible. For example, when receiving radiotherapy, the skin will invariably become red and irritated, I would advise using a skin care range that has been created specifically for the most sensitive skin. Use a cream cleanser that helps to clean the skin but leaves it calm and hydrated without stripping away natural oils. Choose moisturisers that are developed for the most sensitive skin including those for post procedure skin care. Look for humectants such as hyaluronic acid, glycerin and panthenol to draw moisture to the skin barrier. Then look ingredients such as ceramides, jojoba oil and shea butter that mimic the natural oils and fatty acids found in our skin barrier to protect against moisture loss. Calming anti-inflammatory ingredients such as madecassoside and niacinamide are also helpful.
What ingredients or types of skincare products should be used to care for wounds and scars, such as radiotherapy sites that may be sore after treatment?
I would look for creams developed specifically for the highly sensitive, inflammatory skin we see post procedure. Look for ingredients that will calm this skin, protect against infection and promote skin healing. Finally make sure that any new scars are protected against UV exposure to prevent unwanted post inflammatory pigmentation that can take many months to fade.
Are there any other general tips/advice you could recommend for those going through cancer treatment to look after their skin?
Prepare the skin prior to treatment, making sure the skin barrier is as calm, hydrated and robust as possible, especially before undergoing radiotherapy. Ensure that you understand the likely skin side effects of your treatment and a plan how to tackle these. Look to use the gentlest products, that are the least likely to cause sensitivity or irritation and seek early treatment to minimise skin complications. Don’t forget your sun cream, UV sensitivity is common, and scars are very vulnerable to unwanted pigmentation.
Finally, this is a marathon, not a sprint, be kind to yourself. Take that bath, get plenty of sleep and focus on ‘good enough’. Work can wait, as can the washing and ironing, for once put yourself first, your body will thank you later.
