Taking care of your skin during breast cancer treatment (2019 guide)

It’s no secret that cancer treatment takes a toll on your body, yet you might not have considered your skin’s specific needs. The therapies that fight cancer also cause some degree of toxicity in your skin, hair and nails. Your skin may temporarily change and become especially dry or sensitive during treatment, sending you in search of new skin care products.

Taking good care of your skin during cancer treatment can make a big difference in how you feel each day. Healthy skin guards against infections and injury, but we also know that a routine of skin care can be relaxing and therapeutic. A sense of normalcy in a time of life that is anything but normal.

In this guide, we’ve assembled some of the best skin care advice for women going through breast cancer treatment, assembled by doctors and breast cancer survivors – women who have experienced the brunt of chemotherapy and learned how to protect and care for their skin throughout it.

We’ll discuss:

  1. Why Skincare Matters
  2. Cleansing Products
    1. Facial Cleanser
    2. Body Wash
    3. Deodorant
    4. Hand Soap
  3. Skin Creams and Lotions
    1. For the Face
    2. For the Body
    3. Hand-Foot Syndrome
  4. Sun Protection
  5. Lip Balm
  6. Cosmetics
  7. Hair
  8. Nails
  9. Laundry
  10. What to Avoid
  11. Resources

Why Skin Care Matters

While rarely severe, skin conditions are a common side effect of chemotherapy and learning how to properly deal with them can help make your breast cancer journey easier and more comfortable.

However, the products you use matter.

Recent studies reveal that many of our favorite beauty products contain an ingredient or two that can be harmful to our health with extended use. The European Union has been alert to these hazards and has banned over 1,300 ingredients from cosmetics.

By contrast, the U.S. is much more lenient in cosmetic manufacturing and the industry is mostly unregulated. This means we must read labels and do some research to find safe beauty potions.

What we apply to our skin can be absorbed into our body.

Scientists continue to study our absorption of our skin care products. One small study revealed that among 54 breast-feeding mothers, 85.2% of the breast milk samples contained UV filters. It is eye-opening to realize that what we apply to our skin may have an effect on other parts of our body. In this case, the effect even reached to the babies of these women.

Safe products are a priority when you are sick, and yet that is precisely when you don’t feel up to research. So, we have done some reading for you, and below we offer you our best advice on skin care products to use during breast cancer treatment.

Cleansing Products

Daily grooming makes us feel more like ourselves, and skin that is freshly washed and soothed with lotion is always encouraging. Besides, well-nourished skin will better resist nasty germs that can lead to infections. Still, don’t overdo it. Give yourself permission to take a sabbatical on any unnecessary beauty routines.

The key to protecting stressed skin is gentle cleansing without unnecessary additives. For cleansing dry skin, The American Academy of Dermatologists recommends washing with lukewarm rather than hot water. Shorter showers and baths are better for your skin. Use soap sparingly: Remove dirt but leave natural skin oils, then rinse well.

Facial cleanser

Look for cleansers that are recommended for people with sensitive skin, that are fragrance-free and that are developed by dermatologists. Avoid cleansers that have any essential oils. The best cleansers remove dirt, oil, and makeup on the face while keeping it hydrated – gently. These will be pH-balanced, contain few irritants (a shorter list of ingredients is better), and will not make your skin feel dehydrated after cleansing.

If your skin feels tight, looks shiny or turns red after using a cleanser, avoid it. Reading customer reviews will be helpful in finding out what might work best for your skin.

Body wash

As with cleansers, choose body washes that are labeled for sensitive skin and don’t contain any fragrances are essential oils. “Soap-free” and “dye-free” options are great choices.

Shower & baths should also be warm and brief, not long and hot, so skin doesn’t dry out. Slather on creams and lotions directly after bathing to hold in skin hydration.

After surgery, if you have drains, your health care team will instruct you on how to manage them and to stay clean.

Deodorant

We want to stay fresh, even when we are not feeling great. Finding the right deodorant is a tricky balancing act between being gentle and being effective. Choose a deodorant that is fragrance-free; gel options are soothing and can be great choices. Avoid deodorants that contain alcohol or aluminum. Aluminum is a very common ingredient in deodorants and can clog your pores.

Right after surgery, wound healing is the priority, and both shaving and deodorant can wait. When you need to shave, use an electric razor to avoid nicks, and keep deodorant away from damaged skin. Antiperspirants and deodorants can cause problems for anyone, such as clogged pores, irritation, discolored armpits, and even cysts, Almay is kind on the skin and has good product ratings as well as a great track record with other users.

Hand Soap

We’ve learned that “antimicrobial” products can be overdone, so for hand soap, look for a plain, old-fashioned, gentle cleanser that can be used multiple times a day without drying the skin. It’s best to combine this soap with a hand lotion immediately afterward to avoid drying out the hands. Foaming soaps are easier to rinse off than gels, so potentially are less drying.

Be sure to reapply hand cream each time you wash your hands. This goes a long way to fight dry skin. And remember to wear gloves if you are using house cleaning products, washing dishes, or going out in the cold, even for a minute.

Hand sanitizer was recommended by one survivor, who used it constantly during chemotherapy when handling anything shared with the public.

Skin Creams and Lotions

Apply immediately after cleansing your skin, to lock in as much hydration as possible.

For the face:

The skin on our faces is naturally more sensitive than the rest of our body, and we want it to look as healthy as possible. During treatment, it’s best to skip exfoliation to protect your skin. Chemotherapy often removes skin of some of its oils, so it’s important to look for richer creams that help replenish moisture.

You may want to consider skin care products that are made to the stricter EU standards, especially when it comes to your face.

For the body, hands and feet:

Hand-foot syndrome (HFS) is a skin reaction that often affects chemotherapy patients and appears on the palms of the hands and/or the soles of the feet. Chemotherapy drugs that can cause HFS include: capecitabine (Xeloda®), fluorouracil (5-FU), liposomal doxorubicin (Doxil®), doxorubicin (Adriamycin®), cytarabine (Ara-c®), sunitinib (Sutent®) and sorafenib (Nexavar®).  Following chemotherapy, small amounts of drug can leak from capillaries in the hands and feet and cause redness and peeling.

Body creams and sensitive hand creams can help treat HFS. Avoid any lotions or creams that contain perfumes, alcohol or glycerin. Look for ones that tackle severely dry or cracked skin. For best results, apply generously before bed and then cover with light cotton gloves and socks. Avoid long long showers or baths, or other exposure to hot water. Also avoid anything that can cause friction on your palms, like chopping knives, garden tools or screwdrivers. Over the counter pain relievers can help relieve any pain associated with HFS.

Sun Protection

We know that staying in motion during breast cancer treatment helps patients feel better, so naturally, this can take you outside. You’ll need to stock up on sun protection products, whether you are exercising or just enjoying the outdoors.

Be aware that your skin may burn more easily and heal more slowly during chemotherapy, so be extra careful out in the sun. Don’t rely on the SPF in your foundation or moisturizer.

Your first line of defense is clothing; start with long sleeves, long pants, and a hat with a wide brim.

Try to avoid high noon in the sun: Go out early or late in the day, relax in the shade, and be sure to wear sunglasses.

The FDA regulates sun protection products and advises to choose broad spectrum products with SPF of 15 or higher, reapplying every two hours.

Finding the perfect balance between safe and effective products is especially tricky with sun care products.

Sunscreens contain chemicals that absorb UV light and allow tanning. Sunblock chemicals reflect light from the skin. The FDA has concluded that presently we only have evidence supporting the safety of two active ingredients, zinc oxide and titanium dioxide. Of other common sun protection ingredients, some are known to cause hormone disruption, and more study is needed.

Ironically, sun care products themselves don’t fare well in direct sun, but can begin to break down and lose effectiveness. Be sure to store them out of direct heat and sunlight.

EWG lists over 300 sun care products that meet their standards for beach and sport activities.

Lip Balm

Lips are the most overlooked area for sun protection, but they are also very susceptible to sun damage and dryness. It’s not enough to wear lip gloss; make sure whatever you are wearing has SPF protection. It’s good to stash lip balm wherever you spend time, with other makeup, in your handbag or by your favorite armchair.

If you don’t already have a favorite unscented lip balm, look for one without any camphor, menthol or phenol ingredients. And make sure you reapply any sun protection: The American Academy of Dermatology found only about 33 percent of Americans reapply their sunscreen as often as recommended.

Cosmetics

Skin can undergo color changes during treatment, so you’ll want a makeup that can even out your skin color. Foundation can also cover bruising and other side effects. One option for sensitive skin is mineral-based makeup.

Be sure to wash hands before applying makeup. Standard advice on cosmetic lifespan says to replace eye makeup products every three months, lipstick every year, and foundation every two years. While recovering from cancer, consider shortening those times if there is a chance the cosmetics have become contaminated. Applying liquid foundation with a new makeup wedge sponge applicator each time rather than your fingers will help it stay fresh longer.

Every woman’s individual cosmetic plan varies as much as each woman. Here are a few things we may share in our cosmetic routines:

  1. Always start with sunscreen on your face. Apply it evenly all over until it vanishes. For UVA and UVB protection, look for zinc oxide, titanium dioxide, and avobenzone. These can be used safely on sensitive skin.
  2. If you wear foundation, choose products that are hypoallergenic and low in toxins. Mineral-based foundations are often considered safer.
  3. Blush can irritate sensitive cheeks, but mineral-based blushes can come in powder or cream options. Powder blush works well for oily skin, while cream blush is good for normal or dry skin.
  4. Eyebrows are really taken for granted until they disappear. A former patient shared that she still needed to fill in her brows, a few years after chemotherapy. Some survivors have especially liked brow powders.
  5. Makeup remover finishes up the day. Micellar water can be a great option for sensitive skin. Make sure you’re using oil-free eye makeup remover that is ophthalmologist-tested.

Hair

It is certainly distressing to lose one’s hair. Even knowing that chemotherapy is targeting rapidly-dividing cells, which are in cancer growths as well as healthy hair, does not reduce our mourning over our reflection.

You will express yourself in the way you choose to respond to seeing your scalp, whether you put on earrings and your grit and head for the door, or attempt an artistic scarf arrangement, or reach for a hat or wig. Perhaps you will try all of these. You may wish to plan ahead for the sort of head covering that appeals to you and prepares you for the local weather.

When hair loss is imminent, a short haircut can reduce the volume of hair being shed, and a satin pillowcase is good for resting a tender head. A survivor shares that she got relief by applying Aquaphor Healing Ointment to her hurting scalp.

Not all cancer treatment results in complete or even partial hair loss. If you need shampoo and conditioner, look for gentle products which are formulated for babies.

Depending on the type of chemotherapy, eyebrows may be affected. With practice, you can learn to draw natural brows with a soft pencil. Having a photo of yourself on hand can serve as reference. Or, perhaps you’ll want to try using an eye brow stencil.

Nails

Since nails grow more slowly than skin and hair, nail changes during treatment are slower to reveal themselves. Nails can split or peel, and begin to lift from the nail beds because of certain therapies.

Keeping nails short and rounded will help. Remember not to use your nails as a tool, even for the simplest task. Make sure your nail products do not contain any form of formaldehyde. Choose a non-acetone nail polish remover.

Cuticle oil can really help your nails and cuticles during chemotherapy. This oil can be applied over nail polish and will not hurt a manicure. Cuticles should be gently pushed back but not cut.

Laundry

It’s so important that your clothes and bedding do not cause itchiness or irritation while your skin is tender from treatment. Choose a detergent that is labeled “free and clear,” meaning it has no dyes or perfumes. Look for labels that say they are recommended by dermatologists and allergists for people with sensitive skin.

Dryer sheets: for most loads of laundry, you can skip these altogether, or use ones labeled “gentle” or made for sensitive skin.

What to Avoid

Any unnecessary feminine hygiene products: This includes powders, anti-itch creams, douches, wipes and sprays, for their chemical compositions have raised questions, and the safety of their ingredients has not been determined.

Pools & Hot Tubs. Chlorinated water, in fresh and salt water pools, is often too drying for chemo-treated skin, and any open sores or rashes rule out aquatic exercise. Check with your doctor before swimming. It is especially important to avoid folliculitis, or “hot tub rash,” since lowered immunity could lead to a serious infection. The heat from a hot tub could also aggravate lymphedema.

What to Avoid in Your Skin Care Products

Essential Oils. These beloved ingredients can be too harsh and are advised against for extra sensitive skin.

Fragrance. Added fragrance in skin care products are the first thing to avoid. Fragrance can be a mix-up of hundreds of possible ingredients, and may include allergens and other harmful chemicals that aren’t listed on the label. Look for products that are fragrance free, not just unscented. Fragrance free items may still have a pleasant scent, just from the ingredients themselves, but no synthetic scent has been added.

Parabens. As these preservatives can mimic estrogen and disrupt normal hormone function, they are of special concern to breast cancer patients. Other hormone disrupting toxins: BHA, phthalates.

Formaldehyde and related compounds, such as methylene glycol or quarternium-15, are used to prevent the growth of bacteria. The International Agency on Research on Carcinogens (IARC) has labeled formaldehyde as a carcinogen. It can be found in nail polish, shampoo, eye shadow, and elsewhere.

Vitamin A formulations found in lip or skin products. EWG website states, “Government data show that tumors and lesions develop sooner on skin coated with creams laced with Vitamin A, also called retinyl palmitate, or retinol.”

Hydroquinone. This ingredient in skin lighteners is of concern for possible skin cancer, organ toxicity, and lung irritation.

This list is far from complete, but we have noted a few bad actors so you will see what you are up against. So, until you are ready to tackle lots of research, start with our list of products and check the resources below for more great ideas.

Resources

Environmental Working Group’s (EWG) Skin Deep Database has rated more than 64,000 personal products. Launched in 2004, this is a great resource for finding out more about the things we put on our skin, evaluating information, and looking up clinical studies on thousands of products. Look for a low score here, for that means low in toxins, irritants and dangerous ingredients. The safest products earn a spot on the EWG Verified list.

GoodGuide, on the web or as an app, has rated over 75,000 products, and uses a scale from one to ten, with a “10” crowning the safest items. They evaluate product ingredients against 14 key toxicity criteria, looking for potential human and ecological harms.

The Think Dirty app allows you to scan the barcode of a product with your phone and then it tells you the ingredients in easy-to-follow language. This is helpful for comparing products at the store and around the house. Lower scores are better on their one-to-ten scale.

Campaign for Safe Cosmetics, a project of Breast Cancer Prevention Partners (BCPP), is cofounded by Environmental Working Group. This website supplies lots of information, including more specifics on the chemicals of concern within beauty products.

Several skin care lines have been developed by breast cancer survivors, or with breast cancer patients specifically in mind, including: Lindi Skin, Dr. Cynthia Bailey Skin Care, Violets are Blue, Odacite, CamWell, Vapour Organic Beauty, 5YINA, and Hynt Beauty. Perhaps you will enjoy researching these on your own.

Spas. While the concern for avoiding infection is constant, cancer patients are finding benefits from spa treatments and massage.

After you are treated at a cancer center, you still need to heal, to take time for yourself, ideally in a beautiful place that’s created to help you reset and renew,” says Julie Bach. She is founder of Wellness for Cancer, or organization that has provided training to more than 200 hotels and spas in America on caring for cancer patients.

Disclaimer

Always check first with your health care team on all your skin care questions and follow their advice. Our recommendations are intended to support the many positive things you can do to manage your skin during breast cancer treatment, but are offered in a general way and may not be appropriate in your situation. We are grateful for the many breast cancer survivors who have shared their hard-won wisdom on skin care products, and we hope that many more are benefited here.

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