When you’re on a cancer regime, that sensitivity may be amplified. Many people will experience a range of problems from a mild itch to the appearance of sores and lesions. Most of the time skin problems are irritating and uncomfortable rather than serious, and taking simple measures, such as moisturizing, can help. However, some people may have more severe reactions that require medical intervention.
Managing skin conditions
Most of the time catching a skin reaction early is the best way to manage the problem. Sometimes an itch, pain, or discomfort is the first sign that a skin condition is beginning. Talk to your healthcare team if you have any of these symptoms and they can advise.
Dry and itchy skin
Dry skin or itchy skin is a common side effect for people having chemotherapy, targeted therapy, and radiation therapy, especially with cancers of the blood, such as leukemia, lymphoma, and multiple myeloma.
People with cancer are also more susceptible to Jaundice, which can also give you itchy skin. This is because bile salts are deposited in your skin. Having a shower may help as it can wash the bile salts off. Ask your doctor, they may prescribe medicines to help reduce the itching.
If you’re suffering from dry skin:
- shower and bathe with warm water. Hot water can dry the skin even more
- use a moisturizing cream at least twice a day and within 15 minutes of having a shower or bath
- when skin is very dry and cracked, use moisturizers containing salicylic acid, urea, ammonium, or lactic acid. These will soften the skin and allow water to be retained – although always patch test anything new before you apply it to your skin.
- avoid products that irritate the skin including soaps, detergents, and creams with fragrance
- avoid products that scratch or scrub your skin, such as sponges, bath scrubs, or loofahs
- If you’re suffering from itchy skin follow the advice above, but also:
- use creams with menthol, camphor, or pramoxine, which are available over the counter. You can also use topical steroids prescribed by your doctor. Once again, always patch test anything new
- try using oral medications called antihistamines - but always talk with your health care team before taking any medication because you don’t want it to conflict with your cancer medication
A rash can be a side effect of chemotherapy, targeted therapy, immunotherapy or radiation therapy. It can vary in appearance and severity and may look like slightly reddened skin, acne or measles.
There are several ways to manage a rash depending on how severe it is:
For a mild or a moderate rash: your doctor may prescribe corticosteroids, given as a cream, and antibiotic creams or antibiotics in tablet form.
For a more severe rash: your doctor may prescribe oral corticosteroid tablets, as well as the cream.
In extreme cases: your doctor may also stop your chemotherapy for a short time and restart at a lower dose
Sensitivity to light
Some types of chemotherapy, radiation therapy and stem cell transplants may make the skin more sensitive to light - this is called photosensitivity. Consult your medical team – they will advise on the measures you need to take.
However, there are some general guidelines to follow:
- cover up your skin with clothing and use a hat when outside
- avoid going out at the height of the day
- if venturing outside, use a sunscreen that has a sun protection factor (SPF) of at least 20 and make sure to apply enough to cover your entire body every 2 hours.
- before you apply trying anything different, patch test first. Even if it’s a product you’ve used before, the medication you are taking may reduce your tolerance to chemical and ingredients that you’re normally fine with
Radiation therapy-related skin problems
Radiation therapy used on cancer cells can also affect healthy skin cells. You may find the skin in the treatment area becomes red or darkens. It may also feel sore or itchy. Sometimes the skin gets very sore and it may blister, break or leak fluid. Often referred to as ‘skin burn’, it usually appears after 1 to 2 weeks of treatment and generally gets better when treatment ends.
However, if it does become a problem, your doctor may need to reduce your dose or reschedule when the condition improves.
During your treatment you are usually advised to:
wear loose-fitting clothes made from natural fibers, such as a cotton t-shirt
wash your skin gently with mild, unperfumed soap and water and gently pat it dry
- avoid rubbing the skin
- avoid heating and cooling pads
- avoid wet shaving
- avoid hair-removing creams or products, including wax
- avoid the sun during treatment – and protect your skin from the sun for 12 months after treatment
- Tell your medical team:
- depending on the severity they may prescribe a corticosteroid skin cream which may help prevent skin changes from radiation therapy, although should not apply within 4 hours of radiation therapy
- If you have any open sores or areas where your skin is moist, this may be a sign of an infection and need treating with oral antibiotics.
Many types of cancer can cause these wounds, but they are most common with skin cancer and breast cancer. Malignant wounds can easily become infected and be very painful or itchy. They may also leak fluid or blood and have a very strong odor.
- Tell your medical team immediately if you have an open wound and they will help you to treat it
- To help with any odor topical antibiotics, in cream or ointment form, may help
- Place an odor absorber in the room, such as cat litter or charcoal, that can help to lessen the smell
- Try burning a scented candle, incense or use a reed diffuser
Pressure ulcers or bedsores
Pressure ulcers, or bedsores, are caused if someone is unable to get out of bed or move for a period of time. They often form on the heels of the feet, the coccyx area, and other parts of the body with a thin layer of fat. To prevent and treat bed sores:
- try using an air or water pad that lies on top of your mattress
- use a low-air-loss bed or air-fluidized bed, which distribute a person's body weight more evenly over the surface
- seek treatment for bed sores to reduce pain and keep them from getting worse
Sources: cancer.net / macmillan.org.uk / cancerresearchuk.org
If you are experiencing skin-related symptoms, or have any advice to offer others based on your own experience, please join the Chemotherapy Support Group on Facebook. The group has over 7000 members, all of whom are or have been affected by cancer.
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