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Coping with skin problems after cancer-Cancer Survivorship

Everyone has skin problems

When you have cancer, skin problems just seem to multiply.  The drugs we are on do no favours to our skin support system, so expect them, then make an effort to deal with them properly.  This means using special skincare.

Treatments (chemotherapy, hormone therapy, hormonse therapy) have side effects that make your skin dry, scaly or itchy. Your fingernails can become brittle or weak. If you lose hair the areas left exposed, such as your scalp, can be sensitive. Radiotherapy exposes your skin to radiation, which can make it sore, dry or itchy. It might also become red or look darker than usual. Biological therapy and hormone therapy can cause skin rashes.

In Britain we can be very blazé about looking after our skin, even though it is our largest organ.  We can think skincare means cosmetics, and that a new foundation or the latest lipstick will miraculously give us a model-like complexion; but t’aint so. Men don’t think it’s manly to take care of skin, so take a look at this video boys  ..                                            https://www.laroche-posay.com/article/Better-skin-throughout-cancer/a27668.aspx

Looking after our skin takes hard work and dedication, and we can be made to feel vain if we ask doctors what to do  So I asked Dr. Louise Fearfield of the British Association of Dermatologists (BAD) for her advice:

“Some cancer treatments (chemotherapy, immunotherapy) can lead to persistent skin issues including dry skin although most will recover. Hair loss, nail changes and dyspigmentation (hyperpigmentation or hypopigmentation) can also rarely be permanent. This is generally related to how the drug targets the cancer cells and as a result of the way the drug works this can also interfere with ‘normal’ skin homeostasis and functioning.

Radiotherapy in particular can cause longer-term dryness and permanent skin changes including thickening of the affected area, loss of sweating and hair production, prominent blood vessels (telangiectasia) and in some cases rarely persistent chronic radiodermatitis (irritated itchy dry skin)”.

She’s right about loss of sweating – that has been a bonus during recent hot weather, but I have found that whatever caused my skin problems (R/T, drugs, hormone therapy etc) it’s an on-going nuisance.

Finding help

BAD says, “we can’t endorse any particular treatments but general principles should apply : use a soap substitute, avoid bubble baths/shower gels, use unperfumed emollients frequently and seek professional help if symptoms persist  And most important, don’t forget sunscreen, and apply this frequently.

So if you find you get sidelined when you ask for help, go to BAD’s website https://portal.bad.org.uk/Contact/FindADermatologist.aspx                                           key in your postcode.  Up will come a ist of their local members, whom I have found knowledgeable and very helpfull.

Getting help

NHS –  show your GP the BAD list and they will be able to make an appointment as long as members work in the NHS                                                                      Private –  You can book direct – Google to get information if a Consultant deals with children, complex cases, etc.and often they express an interest in your type of problem.

What to look for in skincare ingredients

Now we get into my thoughts;  don’t forget, I haven’t had medical training, so I write about what works for me.  I tend to be keen on evidence and clinical trials that I can understand, and I regard with suspicion any skincare that arrives in glittering packaging and loads of hype about ‘dewy fresh’ ‘free-from’ etc.

Googling can bring up websites that have latched on to the lucrative cancer market.  Employing every long and every obscure word they can find to blind you with science, these sites are often vague on what clinical trials their products have undergone, and what evidence there is that their skincare is suitable. They offer words like comfort, pampering, scientifically-proven (but don’t say how or who by).

Clinical trials                                                                                                       

  • To cut through the hype look for evidence and results from clinical trials  such as name of laboratory, name of doctor/s in charge, etc.
  • does the company have a research laboratory
  • If you are suspicious, email to ask what research they have done with cancer patients

I have a great loyalty towards La Roche Posay skincare company, who welcomed me, gave me sound, practical advice and help, when I was told bloody skin blisters that popped out all over my body three days after starting Tamoxifen were “due to your age”.  That was just a cop-out from my doctors.

History

Napoleon sent his troops to Roche Posay to be treated if they had skin problems., and tFACADE TDC (8)he centre came to prominence during World War II, treating bomb blast burns victims.  Today, they treat about 8,000 patients a year, and say “520 clinical studies involving 45,000 patients from all over the world will have been carried out in close collaboration with dermatologists since the creation of La Roche-Posay Dermatological Laboratory. These highly regulated trials have given rise to numerous scientific publications in renowned dermatology journals, representing real recognition of our commitment and the quality of our scientific approach”.

More info:  https://www.laroche-posay.com/article/Useful-initiatives-places/a27722.aspx

Warning!  I found a company on Google that boasted they’ve carried out clinical trials with less than 100 participants, yet a major British cancer charity were promoting them on such limited evidence. Unbelievable.

On my website  I mention skincare products that work for me, and come from companies that have worked with national cancer associations, cancer hospitals and used clinical trials to find the best products to help us.  It’s sad we don’t have large trials in Britain.

Know your Chemicals

When I show nurses products I use, they always look at ingredients to see if they contain Parabens. But Parabens are chemicals used as a preservative, and appear in products used in hospitals. Better to look for the manufacturers’ name, and once you have established this firm is reputable, stick to their products as much as possible.  There are good chemicals, and bad chemicals.  And unless you are very knowledgeable how can you tell the difference?

Jacques Courtin-Clarins was head of the French company Clarins.  Discussing an excellent, cheap Romanian skincare which I bought whenever I went to Romania;  “we looked to buy them after 1989 because their formulas are so good, but they don’t use any preservatives”.  No wonder I couldn’t stockpile them, because they developed mould if not used within a couple of weeks.

Any firm can claim ‘contains NO xxxxxxx’  but do they contain the right ingredients?An eminent research chemist once told me “a number of skincare products claim they don’t contain this or that – there’s not much they do contain.”

Don’t look for the cheapest product, as ‘good’ chemicals an ingredients are often expensive.  My favourite cream contains 48 ingredients; the manufacturers owned a cancer hospital, where their products were rigorously tested in internationally-renowned laboratories – and a female dermatologist with lovely skin recommended it to me!

I never write about a product unless I have tested it on my skin.  Ages on from my treatment, my skin still breaks out, and I’m told the drugs we were given are known to stay in the bodyive  for years after treatment ends.  Fo me, a new drug is usually the signal for another skin outbreak.  Don’t be surprised if this happens – just reach for a cream you know will work.

What causes skin problems?

There are a number of possible causes of skin problems if you have cancer. :

  • Drugs side effects make your skin dry, scaly or itchy.
  • If you lose hair your scalp can become sensitive.
  • Radiotherapy can make skin sore, dry or itchy.; it can become red or look darker than usual. (My surgeon told me my radiotherapy site was still warm two years after I finished)
  • Hormone therapy can cause skin rashes.
  • Some types of cancer cause itching. It is not fully known why this happens, but it may be because of the body’s reaction to the tumour or due to substances released by the tumour.
  • Some people feel itchy after starting new treatment. This may be a sign of an allergy to a drug or treatment. You should talk to your doctor or nurse if this happens to you.
  • Some kinds of cancer – e.g. of the liver or pancreas – can cause jaundice.
  • Stress – it’s not surprising if this causes skin problems

Helping with dry and scaly skin

Watch out – some cosmetics (especially inexpensive skincare and perfume) are full of cheap chemicals, as are household cleaning products. Learn to buy products containing as few as possible. It may not be possible to get 100% pure Organic or eco products;  honest ones will often say 90-97% pure, because they include a tiny amount of chemical preservative
Use moisturisers regularly throughout the day, not just in the morning. This will help keep your skin hydrated. Choose products developed especially for cancer patients. If you want perfumed products, remember rose and lavender used to be used as antiseptics.                                                                                                                   A nght cream doesn’t need SPF
Try urea-based lotions. Urea based body lotions and moisturisers are better for reducing dryness, scaling and itching than the usual glycerol-based creams. Products with 10% urea are a good choice.
Use hand creams. Your hands can become very dry and cracked, especially if you’re washing them very often.
Use oil or lotion-based facial cleansers. Avoid using alcohol or water-based cleansers or toners as these can dry your skin.  Choose an oil, balm or lotion based cleanser which will clean your skin and moisturise too.
Try unscented lip balms.
Take care in the sun. Use chemical-free sunscreens when going out.
Watch your feet.  Cancer treatment is notorious for giving you horrible deep cracks in feet.  The Australian company Flexitol worked with their cancer society and has produced a brilliant cream that really helped me. It’s cheap, but if you are entitled to free NHS prescritions you can get this on prescription.

Coping with itchy skin

Medical advice is speak to your GP.  But many GPs have very limited knowledge. And the British Association of Dermatologists says that the NHS doesn’t have enough Dermatologists – it’s not seen as a priority.

Try speaking to your doctor about Itching, which may be caused by drugs or treatment, etc.
Don’t scratch. it leads to more itching. One tip is to keep your fingernails short, so you can’t do too much damage.
Try itch relieving lotions. Ask advice from your Pharmacist.
Stay cool. Itchiness can be worse if you get hot. Keep rooms cool.
Use shower and bath gels instead of soap. Take shorter baths in lukewarm rather than hot water. Pat rather than rub your skin dry.  Or put on a towelling bathrobe.
Wear cotton or bamboo. Man-made fabrics can irritate your skin. Choose clothes made from lightweight fabrics or natural fibres such as cotton for your clothes and bedding. Bamboo is a great fabric for people with sensitive skin.  Watch out for sales of cashmere, as  wool, particularly Merino wool, is often too ‘scratchy; If you are using fleeces ensure they really keep you warm and your skin is well ventilated (sometimes man-made material isn’t porous), and watch out for fibres shedding; Eco-warriors don’t rate fleeces highly!.

Don’t give up

Desperate to do something about bloody skin blisters all over my body, I was told by the hospital doctors’ head honcho  “it’s your age”.  The hospital chaplain sent me to go to a friend of his at Roche Posay and they sorted me out.

I’d forgotten that looking good makes you feel good.

Look Good Feel Better logoLook Good, Feel Better are a fantastic charity offering free workshops on skincare and make-up to cancer patients. Run by experienced professionals, you spend a couple of hours with them exploring how to use make-up to your advantage; how to look after your skin; and how to ‘fake’ eyebrows.

On top, you get a fantastic goodie box; I am still using some contents months later.

Stop press:  they now run sessions for men-only.

What I use

Roche Posay’s nurses recommend for daily use

  1. Cleanser
  2. Toner
  3. Day moisturiser
  4. Night cream  – Toleraine Ultra Night

Buy British

Sadly, clinically-trialled skincare doesn’t seem to feature in NICE’s programme.

Nakin https://aftercancers.com/category/diary-archive/

 

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