How to manage cancer-related skin irritation and dryness

Cancer treatments, like radiation and chemotherapy can cause a variety of uncomfortable side effects, some of which involve skin irritation around the treatment area. During radiation, some people experience a sunburn-like reaction, with redness, itching, burning, peeling and soreness. Some chemo and immunotherapies can cause dry, itchy skin or acne-like rash. Prior to treatment, your doctor should explain any expected side effects and recommend products that may help mitigate these effects.

The good news is that there are a variety of strategies to try before and after your experience skin irritation. While every patient is different, oftentimes early and consistent intervention can help achieve the desired result. If you haven’t already, schedule some time with a Jasper counselor—they’re trained by the American Cancer Society to help patients with a variety of concerns, including managing side effects.

Establish an appropriate skin care routine

• Don’t cut down on washing (especially handwashing), since it’s important to remove bacteria and potential viruses from your skin. But be as gentle as possible. Use a mild soap (stay away from anything medicated for acne or rashes, etc.) and lukewarm (not hot) water when showering, or washing your hands. Skip any kind of exfoliant, loofahs, or sponges. Consider switching to soaps and cleansers designed for sensitive skin, like Acure, as well as a gentle hand sanitizer for when you’re not near soap and water.
• Avoid shaving until treatment is complete or talk to your oncologist about when it might be the right time to shave. Nicks and cuts can introduce bacteria into the skin, increasing the risk of infection while your immune system is compromised.
• After cleansing, apply a rich, unscented moisturizer while your skin is still damp. This will help seal hydration into the skin. Pay special attention to areas that are particularly dry or sensitive, such as your eyes and lips. For spot-treating particularly vulnerable areas (like hands and feet) Bag Balm and Aquaphor are two standbys recommended by doctors and patients alike.
• With the exception of compresses such as heating pads or ice packs that have been recommended by your doctor, avoid temperature extremes such as hot baths or showers, an unprotected face in frigid weather, etc, as this can exacerbate symptoms.
• If you’ve had  radiation to an area of the skin that comes in direct contact with clothing (such as your breasts), choose soft materials with no wires, buckles, or zippers which can irritate the skin further.
• Avoid prolonged sun exposure. Ask your doctor about the use of sunscreen. Some will recommend using sunscreen with an SPF of 15 or higher, while others will ask you not to apply any lotions or creams to the skin. Choose a sunscreen using a mineral formula, like Pipette, which tends to be gentler and safer on the skin than chemical sunscreens. Don’t forget to wear long-sleeved UV-protective clothing and wide-brimmed UPF hats when heading outside.
• Use only products that have been approved or prescribed by your doctor. Ask them if there are any particular products to avoid. Some therapies interact with certain ingredients, such as hydrocortisone.
• Though the notion that antiperspirants can interfere with radiation therapy has been debunked, your doctor may still ask you to avoid wearing them during treatment, especially radiation treatment for breast cancer. That’s because any product applied to that area could further irritate the skin beyond what the radiation is already doing. Ask your doctor about natural deodorants like Ursa Major, which are formulated with ingredients that are less likely to compound redness or irritation caused by radiation.
• Because radiation can cause temporary pigmentation changes in the skin, tanning or redness may occur during and after treatment. If you choose to cover this with makeup, talk to a dermatologist—or a cosmetologist who is well-versed in the unique needs of people undergoing cancer treatment. They will help find the products that are right for you. To reduce the risk of irritation, be sure all makeup is fresh (not expired) and fragrance-free.
• Not sure how to apply your new beauty products? Check out YouTube, which offers a ton of tutorials with makeup tips especially for people with cancer. Look Good, Feel Better is also a great resource for online makeup tutorials and virtual workshops.
• Hands and feet can be the first to crack from dryness. In addition to using heavy duty moisturizers like Bag Balm and Aquaphor, NatraCare gel gloves and boots can be a good deep treatment. Also, wear socks as often as possible to reduce friction, and wash the dishes and do chores with rubber gloves to protect your hands from irritants.
• Clean beauty products reduce your exposure to harsh chemicals and other irritants that can make skin problems worse. Credo Beauty is a great marketplace to get started. You can also vet products you’re interested in for safety on the Environmental Working Group’s Skin Deep site.

Invest in nail care

During cancer treatment, your nails may become brittle, grooved, discolored, or more sensitive. All of these are normal and temporary. To minimize these effects, experts recommend a few steps:

• Wear waterproof gloves when your hands will be submerged in water for long periods of time (such as doing the dishes or washing laundry by hand). Excessive exposure to water can lead to fungal infections of the nail bed.
• Keep the nails cut short. In addition to minimizing the surface area of the nails, shorter nails are less likely to lift from the nail bed.
• If your nail does lift from the bed, talk to your doctor about what is best for your situation before trying to remove it fully at home. Removing your own nail can be painful, and can increase the risk of infection.
• Don’t cut your cuticles, as this can increase the risk of infection while your immune system is compromised. Apply a moisturizing cuticle cream to the nail beds every night to prevent dryness, splitting, and hangnails.
• Though you should avoid artificial nails, which can trap bacteria that can cause infection, you may find it helpful to wear clear or colored nail polish to strengthen the nails and protect them from further damage. If you choose to wear polish, opt for formulas that are easy to remove using gentle nail polish removers. This will keep the nails from drying out further.

Stay healthy in treatment

While cancer treatment can cause a variety of uncomfortable side effects, there are things you can do to prepare and alleviate symptoms as they pop up, even after treatment ends. Try to maintain a healthy diet and approach to eating, be proactive about managing any pain that you may experience, and enlist the help of a trained counselor or support network to help you identify coping strategies for any side effects that you may experience. Your Jasper counselor can be particularly helpful here.

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