Healthy skin centre

Caring for your skin, hair and nails during chemotherapy

Treating cancer with chemotherapy kills cancer cells, but unfortunately, many patients also have unwanted side effects, such as hair loss, dry skin and brittle nails.

Watching your hair fall out can be especially distressing. "Generally, how we look is really important to most all of us. The thought of losing hair can be especially devastating to some people," says cancer nursing expert Terri Ades.

But cancer patients have many ways to cope with such changes from cutting their hair short to moisturising their skin regularly.

"It is important for people to know that there are many things that they can do to prevent these side effects," says dermatologist, Dr Mario Lacouture, who focuses on treating cancer therapy’s side effects to the skin, hair and nails.

Skin care during chemotherapy

Chemotherapy often causes dry, irritated skin. Rather than waiting to deal with symptoms after treatment starts, patients can take steps to minimise skin problems about one week before beginning chemo. Then, they can continue the routine during treatment.

"There are many things that you can do to prevent that dry skin," says Lacouture. "People tend to think of dry skin as just a cosmetic problem, but ... dry skin can get so severely dry that it becomes inflamed and more susceptible to infections."

Lacouture offers these tips to prevent skin problems during chemotherapy:

• Avoid long, hot showers or baths.
• Use gentle, fragrance-free soaps and laundry detergent.
• Use moisturisers, preferably creams or ointments rather than lotions because the thicker consistency is better at preventing skin dehydration. Apply the cream or ointment within 15 minutes of showering. Reapply moisturiser at night, and moisturise your hands every time after you wash them.
• Some chemotherapy drugs make skin more susceptible to sunburn. Use a sunblock with at least an SPF 30, and make sure that it protects against both UVA and UVB rays. Protection against UVA requires ingredients such as zinc oxide, titanium dioxide, or avobenzone. 

Chemotherapy patients don’t need to avoid the sun. Just be smart about sun exposure. Use a broad-brimmed hat, sun-protective clothing, and an SPF of 30 reapplied every two hours if you’re outside, for example.

Itching is also common and can stem from multiple causes: the chemotherapy medication, a patient’s naturally dry skin (particularly in people over 50), or as a symptom of the cancer itself.

While many patients aim for itch relief with over-the-counter hydrocortisone creams, they’re often too weak to be effective, says Lacouture. Instead, doctors can treat itching with steroids or anaesthetic medications applied to the skin. If itching interferes with sleep, oral medications might work.   

Skin can also go through colour changes during chemotherapy, particularly with breast or bowel cancer treatment. Sometimes, the hands or face are affected, which can make a patient feel self-conscious. If this happens there are skin lighteners and exfoliants containing salicylic acid that can be tried, Lacouture says. According to Ades, newer chemotherapy medications can also cause rashes.  

Check with your doctor but, as long as there are no open sores on your skin, swimming is fine for chemotherapy patients, Lacouture says. However, spas or hot tubs aren’t a good idea. They can cause more blood flow to the skin, which can lead to greater blood flow to areas of inflammation. "There’s no study that a hot tub will make it worse, but we tend to err on the cautious side," he says.