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HELP! My Skin’s Not the Same after Treatment

by Carol R. Drucker, MD

Knowledge image

“My skin just hasn’t been the same since chemo­therapy.” I hear this comment frequently from cancer survi­vors, who often follow the statement with a list of the changes they’ve ob­served: drier, more sensitive skin; brittle nails; hair alterations; skin discoloration; and more. Survivor skin can be different from pretreatment skin in many ways. Some skin changes will resolve with time; others may not.

Rest assured, however, that post-treatment skin changes are common. Many cancer survivors come out of treatment with alterations to their birthday suits.

Cancer Treatment vs. Your Skin
A common complaint among survivors is that their skin is drier after treatment. Chemotherapy, radiation, and hormone therapy all can alter your body’s oil and sweat gland functioning, sapping your skin of moisture. Dry skin is more sen­sitive and less elastic than hydrated skin, so it feels thinner and is more prone to tearing, bruising, and splitting.

Sometimes, one area of skin receives more damage than the rest. A prime example being skin that’s exposed to radiation. The affected area is more sen­sitive and prone to itch. Irritating factors like dry weather, certain cleansers, and new clothes can cause this portion of skin to break out in a rash while the surrounding skin remains unaffected.

The appearance of a rash can be alarming. However, keep in mind that some areas of skin may be less resilient than others after treatment, and it is unlikely that your skin irritation is a sign of something more serious, like cancer recurrence in the skin. Though that’s not to say you shouldn’t discuss skin discomfort or other concerns with your doctor.

Your skin is more sensitive now
than it was before treatment.

Author of Article photo

Dr. Carol Drucker

With radiation therapy, your skin will probably go through several stages of change. During treatment, you may experience sensitivity, redness, and burning in the treatment area. As your skin heals, discoloration can persist. Over time, you may notice dilated blood vessels, and the affected skin may become shiny and firm. In the long term, skin that has been exposed to radiation is more susceptible to developing growths and skin cancers, so it should be checked regularly. Simi­larly, radiation can leave skin vulnerable to discoloration, which warrants regular skin checks as well.

Not all skin changes are bad; some can be a bonus. Certain chemotherapies react with spots of precancerous sun damage in the skin. What appears to be a rash could actually be the rejuvenation of sun-damaged skin.

Give Your Skin a Fighting Chance
You may not be able to completely avoid treatment-related skin changes, but you can manage them by caring for your post-treatment skin.

To start, be aware that your skin is more sensitive now than it was before treatment. For dry skin, unscented creams and ointments are often more effective than lotions. Avoid scratching dry, itchy skin. Instead, stop the itch with an over-the-counter itch cream. Keep damp washcloths in the freezer that you can apply to the affected area; the cold can help stop a sudden itch attack.

Be gentle with your skin when bathing. A hot shower feels so good, especially after a long day, but the hot water actually increases the dry- ness and itchiness of your skin. Take warm showers instead, using gentle cleansers.

Use caution when trying any new skin product, fragrance, or procedure. If your skincare routine previously included products with harsh or abra­sive ingredients, reintroduce them into your routine one at a time. Start by adding one step back into your skin regimen for a week or two before adding another step.

Be careful if hair removal is part of your grooming routine, especially if you wax. Areas of your skin may be more sensitive than they were in the past. Additionally, newly resurfacing hairs can irritate the skin as they regrow. This irritation looks similar to acne, but it’s not, so don’t use harsh treatments meant for oily, acne-prone skin. Instead, man­age ingrown hairs with gentle cleansing and mild exfoliation.

During and after treatment, your skin may be more sensitive to the sun than ever. Before going outside, shield yourself from the sun’s rays with protec­tive clothing and sunscreen. The tincture of time is the real solution to treatment-related skin changes. Your skin has endured a barrage of insults through treatment, so it may take a while to heal. Until your skin returns to nor­mal, or to its new normal, pamper yourself by taking care of your skin.

♦ ♦ ♦ ♦ ♦

Dr. Carol Drucker is a professor of dermatology at the University of Texas MD Anderson Cancer Center in Houston, TX. She specializes in skin cancers and cancer-related skin conditions.

This article was published in Coping® with Cancer magazine, May/June 2015.