Amid so many other transformations to your body, treatments such as chemotherapy, hormone therapy, and radiation therapy often cause dryness, itchiness, and sun sensitivity to the skin. "Studies show skin conditions are the most unexpected side effect of [cancer] treatment," says Bernice Kwong, a clinical associate professor of dermatology at Stanford University. More visible signs such as "acneiform eruptions [like rosacea] are also common, as is the darkening of the skin on the face and even dark streaks or discoloration of the nails," she tells Allure.
Though much of this is inevitable, you can be proactive to minimize both the severity and discomfort of these side effects. "You should never be ashamed to prioritize skin care, beauty, and skin comfort when it comes to this crazy difficult journey of cancer," emphasizes Kwong.
Start by sticking to a less-is-more approach since the skin is susceptible to irritation during cancer therapy. "Anything that comes in contact with the skin — including an ingredient as simple as water, especially with increased handwashing — can add to the irritation of the skin," explains Kwong.
That said, it's important to do a patch test on the inside of the arm or behind the ear before continuing to use skin-care active ingredients such as vitamin C, retinol, hyaluronic acid, and niacinamide. "While undergoing cancer treatment, the skin may be more sensitive to some products than usual, even products a patient has personally used for many years," Kwong explains.
For this reason, it's safest to stick to simple formulas like Cetaphil Gentle Skin Cleanser and Dove Original White Beauty Bar (both soap-free cleansing options) and Cetaphil Moisturizing Body & Face Lotion (to lock in hydration). But even with these mild products, it's imperative to always error on the side of caution. "If the application of anything leads to burning, pain, or irritation, trust what your body is telling you and seek expert guidance if the irritation does not go away," says Kwong.
And while many cancer patients have anecdotally shared success with the aforementioned recommendations, "a lot depends on what kind of cancer treatment and what kind of skin changes a patient is experiencing," says Mario E. Lacouture, director of the oncodermatology program at Memorial Sloan Kettering Cancer Center in New York City. It's all case-by-case. But, "part of the battle is knowing some of these things may happen, and having the tools necessary to mitigate them as they occur."
Below, board-certified dermatologists share skin-care changes to anticipate after a mastectomy, and during chemotherapy, radiation, and hormone therapy — and their best advice to keep your skin in check.
If You Had a Mastectomy…
Immediately after surgery, the top concern is preventing infection. "Make sure your skin is kept clean by following the instructions from your surgeon and look for signs like redness, drainage, or increasing pain," advises Kwong.
To help scars heal, keep the area hydrated with an ointment. "I'm a big fan of petroleum jelly," she says. "It seems so simple, but it doesn't have a lot of ingredients that can irritate the skin." We recommend Vaseline 100% Pure Petroleum Jelly.
Additionally, Mother Nature will do a lot of the work to promote healing and scars will usually look lighter within a year's time; however, sun exposure can delay this. "Anytime UV hits pigmented skin, the pigment will last longer, which will delay the fading of the color," explains Kwong. So always protect your skin with a broad-spectrum sunscreen that is SPF 30 or above. A few of Allure's favorites: La Roche-Posay's Anthelios 60 Clear Skin Dry Touch Sunscreen, Supergoop Glowscreen SPF 40, or Dermalogica Invisible Physical Defense SPF 30. The best option is the one you will use consistently.
If you are looking to accelerate healing, Biafine is a go-to for Dendy Engelman, a board-certified dermatologist in New York City. "It's a prescription medication that expedites healing by 33 percent, and is best used during the acute phase of healing right after surgery," Engelman says. Always consult your doctor beforehand.
If You're Going Through Chemotherapy…
Nausea is anticipated, but dry skin is just as common. "Chemotherapies tend to target cells that are replicating faster than they should be, like cancer cells," says Kwong. "But skin cells regenerate rapidly too." So it's essential to maintain a healthy, hydrated skin barrier.
"Dry skin can cause skin breakage, lead to infections, or itching that can contribute to the inability to rest — and rest is such an important part of healing," advises Kwong.
Keep skin hydrated with creams, ointments, or oils, making sure to "stick to bland formulas and be mindful about fragrances because skin tends to be more sensitive." Look for glycerin-rich formulas such as Aquaphor Healing Ointment and Neutrogena Norwegian Formula Hand Cream. "Many women say, 'I've never been allergic to this or my skin has never been like this before chemotherapy,' but many of these issues arise after treatment," says Lacouture.
Also: Timing is everything. "Immediately after any form of washing skin [whether it's a shower or even cleaning your hands] restore the skin barrier with a moisturizer," adds Kwong. One she suggests to patients: Vanicream Moisturizing Cream. And for areas prone to dryness, like the hands and feet, reach for formulas made with "urea or lactic acid to soften the dry skin," advises Lacouture.
If You're Undergoing Radiation…
"It's almost like getting a sunburn, and oftentimes, patients will develop a red rash — sometimes it's itchy, sometimes it has a burning feeling, and every once in a while it can blister," explains Kwong.
Many patients avoid treating those delicate areas entirely, but "washing the area regularly with soapy water removes excess bacteria and keeps skin less prone to infection," she says. You can wash the area with your hands or, "we tell our patients to get a washcloth for babies since they are usually super soft."
Either way, it's important to trust your body and what it's telling you: "If it hurts, that's the body saying it's too rough," says Kwong. This goes for ingredients you use on the irradiated skin, too. "It is best to avoid anything with a lot of active ingredients, especially AHAs and BHAs or vitamin A derivatives such as retinol," says Engelman. And again, always moisturize. Some research suggests calendula-spiked moisturizers could serve as a more natural alternative to the gold standard of petroleum jelly, notes Kwong. We like Weleda Nourishing Body Cream.
If You're Doing Hormone Therapy Treatment…
Moisturize... and moisturize some more. "The shift in hormones can lead to dryer skin," says Kwong. Another common side effect is melasma or pigmentation, which is often worsened by exposure to UV rays and blue light from tech devices. "Make it a habit to wear sunscreen every single day, no matter what."
Look for iron oxide on the label (often found in tinted sunscreens), a physical blocker that is "helpful in reducing the amount of the light that might be impacting the pigmentation on our skin from screens," Kwong says. A good option to try: Supergoop! CC Screen 100% Mineral CC Cream SPF 50.