Dryness, flaking, and redness of the skin are the most common skin-related side effects of chemotherapy and radiation therapy in breast cancer patients. The proper skincare regimen is vital in order to reduce these side effects, as well as minimize potential risk factors that could negatively affect the outcome of the treatment.
Skincare Recommendations During Chemotherapy
Breast cancer patients receiving chemotherapy should be encouraged to bring in skincare products to their doctor’s office prior to using them to make sure the ingredients are acceptable. Below are general guidelines for reducing side effects and risks.
Avoid Ingredients That Activate Estrogen Receptors
There is some evidence that using certain personal care products that contain endocrine-disrupting chemicals may increase the risk of breast cancer. Ingredients that breast cancer patients should therefore avoid include estradiol, soy, sunscreens with oxybenzone or homosalate, and some parabens and phthalates. However, some parabens such as methylparaben and propylparaben are not a problem and are likely a safer choice than preservative alternatives that have been studied very little compared to these parabens.
Use Barrier Repair Moisturizers to Treat Dry Skin
Chemotherapy causes the skin to become dry. Barrier repair moisturizers that use MLE technology mimic the lamellar structure of the skin and strengthen its natural barrier, sealing in moisture and preventing irritants and bacteria from penetrating the skin.
Use a Mineral-Based Sunscreen
Chemotherapy drugs can make the skin more sensitive to the sun. Patients should use a mineral-based sunscreen to protect their skin. Some ingredients like oxybenzone commonly found in chemical sunscreens may be linked with an increased risk of breast cancer and should therefore be avoided.
Avoid Antioxidants
Let patients know that some doctors suggest avoiding antioxidants during chemotherapy. Because they protect the cells, antioxidants could decrease the treatment’s efficacy. Patients should understand that each doctor may have his or her own set of recommendations, which should be followed as closely as possible for the best outcomes.
Skincare Recommendations During Radiation Therapy
Dry skin and redness are very common in patients receiving radiation therapy for breast cancer. According to Radiation Oncologist Dr. Stuart Samuels, MD, PhD of University of Miami Health System, the severity of side effects is “related mostly to the total dose of radiation per day that the patient is getting, the size of the treated area, the patient’s anatomy, and intrinsic radiosensitivity – some patients have more severe reactions than others.”
However, these side effects are typically easy to manage with the proper skincare regimen.
Keep the Skin Covered with an Emollient
“The skin should be covered with an emollient cream or gel such as Aquaphor or 100% aloe gel,” Dr. Samuels shares. These products should be free of fragrance and alcohol and should be applied to the skin at the start of radiation treatment, even if the skin has not yet become dry or irritated.
Directly before radiation treatment, patients should not put anything on their skin. Afterwards, they can use an emollient two to three times per day.
“There is no data supporting the use of anything specific in terms of preventing or modifying the severity of radiation dermatitis,” Dr. Samuels says. While patients can use other moisturizers such as argan oil or products with topical vitamin E if they like, these ingredients have not been shown to make a significant difference in the onset or severity of side effects.
Cleanse the Area with Unscented Soap
Studies have shown that breast cancer patients can safely cleanse the treated area with a gentle soap. Dr. Samuels recommends washing with an unscented gentle cleanser without scrubbing the skin, which can worsen irritation.
Use Topical Steroids as Needed
“There is a controversy with regards to steroid use,” says Dr. Samuels. “Some evidence shows that steroid use causes a delay in radiation dermatitis, but it doesn’t seem to decrease the overall severity of it. I, and most physicians, tend not to prescribe it until needed. For patients with early onset acute severe dermatitis – early is in the first one to two weeks – I prescribe 1% hydrocortisone.” Natural options such as Argan Oil are also a good choice.
Use Topical Silver To Treat Skin Breakdown
“Some patients may develop a breakdown of the skin under the arms or breasts,” says Dr. Samuels. “Once this happens, there is a risk of infection. I prescribe a silver-based antibiotic cream.” GCP Pre and Post Procedure Cleanser is another silver containing option. (Use physician code DRB)
These silver-containing products can be used until the skin completely closes. Once that occurs, the patient can return to using his or her chosen emollient.
In Summary
The goal of the skincare regimen for breast cancer patients is to reduce the side effects like dry skin, itching, and irritation caused by treatments like chemotherapy and radiation. Additionally, personal care products should be chosen to minimize the possibility of potentially contributing to breast cancer risk factors. This includes avoiding ingredients that may activate estrogen receptors.
Do you have additional skincare tips that you share with breast cancer patients? I would love to hear them! Please share your ideas with me (Dr. Leslie Baumann) on LinkedIn.
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