IMPACT OF CANCER TREATMENT ON SKIN: TARGETED THERAPY
HAIR LOSS

Article Read Duration 4 min read

 

Alopecia, or hair loss, is caused by treatments which specifically target rapidly-multiplying cells, as this is a feature not only of cancer cells but also of hair bulbs (i.e. hair roots). This leads to sudden or gradual loss of hair and body hair. Hair and body hair will grow back after the treatment, once the body has eliminated all traces of the drug.

Hygiene

• Wash with a small amount of gentle shampoo and tepid water(1)
• Avoid any aggressive treatments (e.g. blow-drying, bleaching, etc.)(1)
• Use a soft bristle brush(1)

Before chemotherapy

• Do not brush or wash your hair too often. Ideally, wash it the day before chemotherapy and wait up to 8 days before the next shampoo wash(2)
• Get a short haircut before chemotherapy(1)

FOLLICULITIS

Grouping of granulocytes in the epidermis or around the hair follicle, leading to the formation of a pustule that does not contain bacteria.


Hygiene

  • Gentle cleansing products that respect the skin’s natural pH balance, such as syndet(1)
  • Avoid shaving(2)
  • Avoid using products that contain alcohol fragrance, deodorants, etc.(1)

Skin care products

Light texture moisturizers(1)

Photo-protection

Anti-UVA/anti-UVB photo-protection At least SPF 50(1)

Make-up

Corrective make-up(1)

Clothing

Avoid wearing tight clothing(2)

Hand and foot syndrome

Two kinds:

  • A form involving redness and very painful swelling (burning, dysesthesia) This may include blisters which cause peeling as they dry out.
  • A form with secondary hyperkeratosis (thickening of the skin), which appears yellowish, and secondary peeling of the skin with pain at pressure points.

Hygiene

  • Gentle cleansing products that respect the skin’s natural pH balance, such as syndet(1)
  • Regular foot hygiene (wash morning and night / gently pat dry)(2)

Skin care products

  • Moisturizing cream with urea(1)
  • Soothing skin care product for irritated and weakened skin.(1)

Trauma / protection

  • Avoid any activities which may cause friction or put repeated pressure on the skin(3)
  • Avoid standing for long periods of time and long walks(1)
  • Wear comfortable shoes: open shoes without high heels with soles that cushion impacts, cotton or silk socks, etc.(1)

Heat / moisturising

  • Refresh your hands and feet with ice packs or cold pads (e.g. damp towel) for 15 to 20 minutes(2)
  • Keep your skin moisturized(2)
  • Avoid heat(2)

XEROSIS, PRURITUS

Dry skin with widespread peeling, often with itching

Dull skin 


Hygiene

  • Gentle cleansing products that respect the skin’s natural pH balance, such as syndet(1)
  • Bath oils(1)
  • Take 33-35 °C showers instead of baths(2)
  • Gently pat the skin dry, do not rub the skin(2)
  • Apply skin care products immediately on damp skin(1)

Skin care products

Light texture moisturizers(1), may contain urea

Photo-protection

Anti-UVA/anti-UVB photo-protection At least SPF 50(1) 

Clothing

  • Wear cotton clothing(2)
  • Do not wear wool (microfibers) or synthetic clothing (not breathable...)(2)
  • Avoid irritants which cause itching (e.g. soaps, detergents, chemical products, abrasive fabrics, etc.)(1) 

Heat / moisturising

Avoid dressing too warmly because heat and sweating trigger pruritus(1)

PULPITIS, CREVICES

Hyperkeratosis with painful linear erosions which may be more or less deep


Hygiene

  • Gentle cleansing products that respect the skin’s natural pH balance, such as syndet(1)
  • Avoid contact with water if possible(2)
  • Pat dry(1)

Skin care products

  • Moisturizing creams(1)
  • Soothing skin care product for irritated and weakened skin.(1)
  • If there are crevices(1): Use a repairing emollient / balm with an occlusive dressing. 

Clothing

  • Gloves are recommended for indoor and outdoor work(1)
  • Use an inner pair of gloves made of suitable fabric (e.g. silk)(1)

PARONYCHIA

  • Painful inflammation of the periungual area (where the nail and skin meet at the base of the nail)
  • A fleshy bump may sometimes form or a pseudo-botriomycoma at the side of the nail
  • May lead to a bacterial infection by staphylococcus aureus or candida

 

Hygiene

  • Gentle cleansing products that respect the skin’s natural pH balance, such as syndet(1)
  • Always practice proper hand hygiene(2)
  • Cut your nails properly: straight cut, not too short, avoiding any jagged edges (especially at the sides of the nails)(1)
  • Use proper clippers and antiseptic products(1)
  • Avoid invasive manicures and pedicures(2)

Skin care products

  • Strengthening nail polish(1)
  • Soothing skin care product for irritated and weakened skin.(1)
  • Apply two coats of nail polish before chemotherapy:

1/ silicon base

2/ dark, non-pearly nail polish(1)

 

If you have asymptomatic paronychia: avoid invasive pedicures/manicures(1)

If you have moderate-to-severe symptomatic paronychia: Pedicures/manicures only under dermatological supervision(1)

MACULOPAPULAR RASH

Polymorphic erythematous, macular and/or papular rash interspersed with patches of healthy skin. Progressive spread. Frequent pruritis.

 

Hygiene

  • Gentle cleansing products that respect the skin’s natural pH balance, such as syndet(1)
  • Nail care(2)

Skin care products

  • Light texture moisturizers(1)
  • Avoid products which may dry the skin out (e.g. alcohol-based products, soaps, etc.)(2)

KERATOSIS PILARIS

Protruding, greyish and adhesive elements located at the follicular openings.

 

Hygiene

  • Gentle cleansing products that respect the skin’s natural pH balance, such as syndet(1)
  • Apply the various products to damp skin(2)

Skin care products

Moisturizing creams with urea(1)

Environment

Humidify the air(2)

SQUAMOUS-CELL CARCINOMA KERATOACANTHOMA

Benign skin tumor (non-cancerous). Single lesion or multiple lesions

 

Hygiene

Gentle cleansing products that respect the skin’s natural pH balance, such as syndet(1)

Skin care products

  • Moisturizing cream with urea
  • After treating the skin lesion, use a care product for irritated and weakened skin

PHOTOTOXICITY

The skin is sensitized when exposed to light or sun rays. This may lead to cutaneous reactions, such as swelling, redness or inflammation.

 

Photo-protection

Anti-UVA/anti-UVB photo-protection At least SPF 50(1)

 

 

 

 

Sources
(1) Livret pharmaciens – gérer les effets secondaires cutanés des thérapies anti-cancer. [Booklet for pharmacists – managing the cutaneous side effects of cancer treatments. 
(2) ESKIMO group round table: Bensadoun RJ, Dreno B, Humbert P, Krutmann J, Luger T, Rougier A, Triller R.

Updated in May 2016 by
Professor Brigitte Dréno 
Director of the Department of Dermato Cancerology 
Director of the Unit of Gene and Cell Therapy 
Vice Dean for Research at the Faculty of Medicine Nantes France

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