When you first learn you will be undergoing chemotherapy, changes to your skin and haircare routine may be the last thing on your mind. But when treatment begins, many women find themselves experiencing unpleasant side effects related to their skin, hair, and nails, and must find new products in consideration of such changes.
Chemotherapy is designed to target cancerous cells, which grow and multiply rapidly. Healthy cells that also grow and replenish themselves rapidly– like skin and hair cells – are ultimately affected too as a result of treatment. Therefore, the natural cell regeneration cycle is interrupted, leading to drier, irritated, more sensitive skin; hair thinning or loss; and more brittle nails (18).
In this guide, we will discuss what you should look for in your bathroom products, based on science and the recommendations of breast cancer survivors, in order to address some of the unwanted and difficult side effects that occur as a result of your breast cancer treatment. Here’s what we’ll cover:
Skin cells naturally undergo cell repair and replenishment quickly, which causes them to be targeted by chemotherapy chemicals which are intended to slow down cellular reproduction. This means the cell repair cycle is temporarily interrupted, leaving skin more susceptible to damage (2). Chemotherapy can also reduce the amount of oil secreted by your glands, causing dry and itchy skin.
It is important to avoid products that contain parabens, alcohol, or fragrances. Parabens are a type of preservative used in cosmetic products, and includes most ingredients with the following prefixes: ethyl, butyl, methyl, and propyl. Studies have shown that this chemical can mimic estrogenic activity, a contributor to the most common type of breast cancer – estrogen receptor positive breast cancer.
It also reportedly interferes with the efficacy of tamoxifen, a common chemotherapy drug (3). Alcohol does not have any direct effect on chemotherapy or cancer cells, but significantly aggravates drying of the skin.
Similarly, chemicals used in fragrances are common skin irritants. The effect of any irritant will be pronounced during chemotherapy due to the increased sensitivity of the skin.
Chemotherapy often removes skin of some of its oils, so it’s important to look for richer creams that help replenish moisture. Effective moisturizing products penetrate the epithelial layer of the skin and restore moisture to the skin cells. While lotions and creams are effective, ointments are thicker, more penetrative, and can also serve as a protective barrier from harsh elements (4). During treatment, it’s best to skip exfoliants or products containing exfoliants.
Dry skin is a common side effect of chemotherapy as a result of the disrupted skin cell renewal process. For many patients, an effective facial moisturizer is crucial, as they can both prevent further moisture loss by protecting the skin barrier as well as replenish any lost moisture.
One great option can be creams that contain Hyaluronic Acid – a powerful, natural component of the skin’s connective tissue that binds to water and helps the skin retain moisture. Some studies have also suggested this can reduce the skin’s inflammatory response to irritants (5).
Because your skin is more susceptible to sunburn and oxidative damage than usual – a side effect known as “photosensitivity” – it is important to choose a high-quality sunscreen that blocks both UVA and UVB rays.
Only sunscreen products labeled as “broad spectrum” protection blocks both types. Those without this label only protect against UVB rays, which are responsible for sunburn; whereas UVA rays contribute to skin cancer and aging (or oxidative damage). “Broad spectrum” sunscreens require at least one of the following ingredients: ecamsule, avobenzone, oxybenzone, titanium dioxide, sulisobenzone, or zinc oxide (6).
Zinc oxide is especially recommended as it serves as a physical protective barrier and is less likely to cause skin irritation. As with all skin care products you use while undergoing chemotherapy, be sure to select one that does not use fragrances or other harsh chemicals, like parabens and alcohol.
Look for sunscreens recommended by dermatologists for people with eczema and rosacea, and those that have earned an accreditation from the National Eczema Association
Chemotherapy warrants changes to your facial skin care routine as well. First, it is no longer beneficial, and can actually be harmful, to use exfoliating facial products. Exfoliators are designed to remove the buildup of dead cells; and because chemotherapy interrupts that process, abrasive scrubs will only damage or irritate healthy skin cells.
Avoid products that contain sulfates – detergents that can strip the skin of moisture; and parabens, preservatives often used in skin care products to lengthen their shelf life. Parabens have a similar chemical structure to Estrogen, and may promote the growth of abnormal cancer cells in breast tissue (7). The scientific community has yet to reach consensus on whether studies affirmatively demonstrate a causal link between parabens and cancer growth, but until conclusive evidence is found, it is best to avoid them during treatment.
Sensitive-skin cleansers help retain moisture without blocking pores. They should be free of sulfates, oils, fragrances, parabens, and be non-comedogenic. Look for allergy-tested and dermatologist-tested products.
Baths can be a great way to decompress and relax throughout your treatment; and, using the right products, can alleviate skin-related side effects at the same time. Avoid bath products with artificial fragrances or preservatives. As a rule of thumb, look specifically for bath products labeled as hypoallergenic as these will not have parabens, phthalates, dyes, or artificial fragrances.
Products that contain chamomile can soothe irritation, and jojoba oil can replenish sensitive skin. Cocoa butter and oatmeal can also be soothing ingredients.
Choosing a new deodorant that is suitable for use upon a cancer diagnosis requires much discretion. First, the skin in the armpit is at an increased sensitivity during chemotherapy, and will therefore be more likely to be irritated by deodorants and perfumes. Secondly, aluminum, one of the most common ingredients in commercial deodorants, is believed to form a “high risk of skin toxicity” during chemotherapy (8). While other doctors and professionals disagree with this, it is still true that aluminum can accelerate radiation dermatitis, leaving the skin more sensitive and inflamed. Try to choose a deodorant without any parabens or phthalates as well.
Losing hair as a result of chemotherapy is an extremely common side effect of cancer treatment. There are many different drugs that can help counteract a good amount of the nausea, pain and fatigue that chemotherapy brings, but there is currently nothing available to help avoid hair loss.
Not all types of chemotherapy drugs cause hair loss, but it’s often a side effect because hair follicles are some of the fastest-growing cells in the body, which makes them a target for cancer medications that are designed to destroy rapidly-dividing cells (9). Because skin cells are also rapidly-dividing, chemotherapy can have damaging effects on your scalp and cause it to be sensitive to many types of chemicals that are common in hair care products.
Styling tools and processes that are damaging to the hair should be avoided during chemotherapy. The hair and skin cells are unable to repair and replenish themselves as normal, so harsh chemicals and styling tools can cause even more damage than usual. This includes heat styling with straighteners, curlers, or hair dryers; chemical treatments, such as highlights, perms, and dyes; hair styles that use hair-pulling accessories, such as hair ties; and harsh brushing, such as with a fine-tooth comb.
Finally, while it may be tempting to use scalp-stimulating hair treatments to combat hair thinning and loss, dermatologists find that the chemicals in these products irritate the scalp. Furthermore, because the hair loss occurs at a cellular level, a topical treatment is unlikely to make a difference.
Shampoo and conditioner
The ingredients to avoid in hair care products include most of those that should also be avoided in skin care products, such as parabens and sulfates are both known irritate the scalp and damage the hair cuticle. Be sure to choose a shampoo that is fragrance-free, alcohol-free, and designed to be gentle on sensitive skin. Look for shampoos labeled “mild” or ones for babies, and for conditioners specifically designed to support damaged or fine hair.
Wide-tooth combs are ideal for use on delicate hair. There are some that are infused with oils that nourish the hair and reduce pulling on the follicle by enabling the comb to glide through more smoothly. Combs that contain keratin can minimize pulling and stretching of the hair shaft.
While it is best to avoid updos altogether, this isn’t always practical. When choosing hair accessories, select those that hold the hair loosely with gentle material.
Hair coils, sometimes called hair rings or spiral hair ties, allow the hair to be held back loosely but securely. Because they are made of resin, they are relatively easy to slide off the hair. This material also does not harbor bacteria like fabric or elastic ties and are much easier to clean. The coil shape prevents the hair from being dented and broken as it is when using traditional elastic hair ties.
Nails, eyebrows, eyelashes
Chemotherapy can have damaging, but temporary effects on nails for the same reasons it affects hair cells. The cells that make up the nail bed are not being regenerated as rapidly; therefore, nails become brittle, grow much slower, and can become discolored; the cuticles can become dry and frayed; and the nail can sometimes lift off the nail bed.
In addition to keeping your nails trimmed short, there are a variety of products that can help minimize the side effects of chemotherapy on your nails.
Chemotherapy can increase dryness of the cuticles, leading to hangnails, splitting, and discomfort. Rather than cutting away frayed cuticles, use a natural cream (paraben-free and hypoallergenic) designed to repair and renew them. This can help prevent them from drying and splitting throughout treatment. Shea butter and beeswax are great ingredients to look for in a cuticle cream.
Ordinary nail polishes contain chemicals that are toxic to the nail. Instead, use water-based nail polishes that won’t damage delicate nail beds. It can help to wear a nail strengthener underneath the polish as well. There are even nail polishes specifically formulated to protect and repair nails during chemotherapy. They moisturize and nourish the nail, helps restore keratin through a protective layer of hydrophilic silicone, and contains ingredients that block UVA rays.
Nail polish remover
Traditional nail polish removers are very damaging to the nail. Avoid the use of acetone-based nail polish remover as well as those containing alcohol. While acetone-based nail polish removers work faster, they are extremely drying and contain harsh chemicals that will severely exacerbate nail damage. Look for soy-based formulas as well.
Eyebrows and eyelashes
Chemotherapy is just as likely to target your eyelashes and eyebrows for the same reasons it targets the hair follicles on the head. Unfortunately, cosmetic eyebrow pencils tend to contain toxic ingredients, as do most adhesives used for false eyebrows and eyelashes.
Fake brows are one great option. They have come a long way in recent years, and you can find ones made of 100% human hair and made specifically for those undergoing chemotherapy.
The effects of chemotherapy on dental health are not as widely known; in fact, 70% of dental hygienists reported that they were unaware of the effect of anti-estrogen therapy (common form of chemotherapy used for breast cancer) on patients’ dental health.
However, patients receiving such therapies commonly report “increased gingival inflammation [and] bleeding, periodontal pocketing, xerostomia (dry mouth), and burning tissues” (12). Choosing the right products can help minimize these side effects. It also helps to keep extremely diligent about your oral health, such as changing your toothbrush every three months to minimize build-up on the bristles; flossing regularly; and avoiding mouthwashes that have harsh ingredients like hydrogen peroxide or alcohol.
When selecting a toothbrush, keep in mind that your mouth may become sore during chemotherapy. Small, soft-bristle toothbrushes will clean your teeth thoroughly without causing significant irritation to any sore areas.
Look for toothbrushes with very small heads, allowing for more precise control when brushing sensitive areas of the gum. Bristles that are double tapered at the end are especially soft and gentle on the mouth. The head should never touch the surface it rests on, to avoid bacteria.
Some patients undergoing chemotherapy develop mouth sores, and report that traditional toothpastes cause them to burn (11). To help alleviate any discomfort, choose a toothpaste made with fluoride or baking soda and those specifically marked as “gentle”; and avoid products with tartar control and whitening formulas. Toothpastes that contain natural salivary enzymes can help replenish the oral defense system. This is especially beneficial for those undergoing chemotherapy as the salivary glands can be inhibited during chemotherapy, leading to dry mouth.
Flossing is highly beneficial for most patients; however, because flossing can often cause gums to bleed, it is important that you only floss if you have a satisfactory platelet count.
Check with your doctor for their recommendation based on your specific circumstances before electing to add flossing to your new dental care routine. If you do, look for unflavored, waxed floss.
Many patients develop taste aversions during treatment, and flavored flosses can trigger nausea. The coating on waxed floss allows it to slide easier between teeth and avoid causing unnecessary irritation.
Silk floss is a great option because it is softer than traditional nylon floss but is equally effective in removing plaque. Most contain no artificial flavors, colors, parabens, or phthalates.
Dry mouth solutions
Chemotherapy can inhibit the natural salivary processes, leading the salivary glands to produce less saliva than usual. Dry mouth can cause a lot of uncomfortable symptoms, like dry lips, difficulty chewing, and difficulty swallowing. A lack of saliva can also pose health risks – bacteria and other organisms are able to grow and thrive much easier in a dry mouth.
An increased presence of bacteria in your mouth leads you more susceptible to infections, which can spread to other parts of the body. Additionally, saliva washes down food particles that will otherwise become stuck in the teeth and form plaque or eventually cavities. It is therefore very important to find other ways to keep the mouth moist during treatment.
Choose mouthwashes that do not contain any alcohol or sugar, are low in acidity, and provide natural enzymes found in saliva to assist in the inhibited salivary process that washes away plaque and biofilm.
You may find that certain products work better for you throughout the course of your breast cancer journey. More importantly, you should always talk to your doctor about his or her recommendations for your specific body. Every person is different and can react differently to certain chemicals and additives. Your doctor knows you intimately, so ask for their opinion and trust it. Additionally, if any of these products cause painful or uncomfortable side effects for you, stop using them immediately and discuss with your physician.
This list of products is by no means exhaustive and you may find that certain products work better for you throughout the course of your breast cancer journey. More importantly, you should always talk to your doctor about his or her recommendations for your specific body. Every person is different and can react differently to certain chemicals and additives. Your doctor knows you intimately, so ask for their opinion and trust it. Additionally, if any of these products cause painful or uncomfortable side effects for you, stop using them immediately and discuss with your physician.
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