Taking Care of Skin, Nails and Hair Issues During Cancer Treatment

There are many treatments for cancer, one of the common ones being chemotherapy. While treating cancer with chemotherapy does kill the cancer cells, but at the same time, many patients also experience many unwanted side effects of this treatment, including dry skin, brittle nails and hair loss. This is why it is important to discuss the potential side effects with your doctor before you begin treatment.^(1, 2, 3)

It can no doubt be distressing to watch your hair fall out because how we look is such an important part of our existence. The very thought of losing hair can be a cause of worry for most people. However, cancer patients need to find ways to deal with such changes and learn to manage nail and skin issues as they undergo treatment for their cancer. There are many things you can do to prevent these side effects. Here’s a closer look at the management of nail and skin issues during cancer treatment.

Cancer treatment is known to cause dry and irritated skin. However, instead of waiting to take care of the symptoms after the treatment begins, you can take certain steps that will help reduce these skin problems. You should ideally start your skincare at least one week before starting chemotherapy. And then, as the treatment continues, you should also continue the skin care regimen throughout the course of the treatment.^(4, 5)

There are many things you can do to prevent your skin from drying out. Most people simply assume that dry skin is a cosmetic issue. However, the fact is that while undergoing cancer treatment, dry skin can become so severely dry that it becomes inflamed, thus increasing your susceptibility to infections.⁽⁶⁾ Here are some tips to prevent skin problems while undergoing chemotherapy:

• Avoid taking long, hot baths or showers.
• It is best to use fragrance-free and gentle soaps and laundry detergents so that they don’t irritate your skin.
• Use moisturizers, especially ointments or creams, instead of lotions because these have a thicker consistency. Using a thicker consistency cream works better at preventing skin from becoming dry. Apply the ointment or cream within 10 to 15 minutes of taking a bath or shower. It is also recommended that you reapply the moisturizer at night before going to bed and keep moisturizing your hand each time you wash them.
• If due to the treatment, your skin has become severely dry and flaky, you can use an ammonium lactate cream to boost the moisture. These creams can be bought over the counter and are also available on prescription.
• There are certain chemotherapy drugs that make the skin more vulnerable to sunburn. This is why you should always use a sunscreen with at least an SPF 30, especially while stepping out of the home. Also, make sure that the sunblock provides protection against both UVA and UVB rays. You can check this by looking for ingredients like zinc oxide, avobenzone, or titanium dioxide, which provide protection against UVA.⁽⁷⁾

Patients undergoing cancer treatment, especially chemotherapy, do not need to avoid going out in the sun. You just need to be wise about managing sun exposure. For example, wearing an SPF of at least 30 and reapplying it every two hours if you are outside and more if you are swimming or sweating. You should also wear clothes that protect you from sun exposure and use a wide-brimmed hat. These are all easy things you can do to keep yourself safe from sun exposure.

In many cases, developing itchy skin is a common side effect, and it can happen because of multiple reasons, including the chemotherapy medicine, naturally dry skin of the patient (commonly observed in people over the age of 50), and sometimes even as a symptom of the actual cancer.

Most patients experiencing itching usually turn to use over-the-counter hydrocortisone creams to get relief from the itch, but these are generally too weak to work. Instead of this, doctors prefer to treat itching with anesthetic or steroidal medications that are applied directly to the skin. If you find that the itching disrupts your sleep, you might have to take oral medications.

It is important to be aware that your skin is also likely to go through many color changes during the course of your cancer treatment, especially if you have colon or breast cancer. In some cases, the face or hands get affected, which can make a person become very self-conscious. If this happens to you, you can use exfoliants and bleaching creams that contain salicylic acid. Some of the newer chemotherapy drugs can also cause rashes to develop. ⁽⁸⁾ If you develop rashes, you should consult your doctor once. In such cases, you can carry on with activities like swimming, but only if there are no open sores on the skin. You should, however, avoid using hot tubs as they will increase the blood flow to the skin. This causes more amount of blood to flow to the areas that are already inflamed, often making your skin condition worse.

During cancer treatments, your nails become brittle and dry. They may also develop ridges and lines. Some chemotherapy drugs can sometimes cause the nails to darken. Though these side effects are temporary, but they can still last for several months.^(9, 10)

Some chemotherapy drugs known as taxanes, which are often used in the treatment of prostate, lung, and breast cancer, are commonly linked with nail problems. In some cases, the nail can even separate from the nail bed. To reduce the impact of taxanes on the nails, as well as manage the blood flow to the hands and feet. Some people even use special cooling gloves to cool their hands and feet during the infusion process of the drugs.^(11, 12)

Any type of inflammation on the nail, or any kind of rash on your skin that changes in size or color, becomes open, or starts producing discharge, should be a warning sign that something is not right. This can be an indication of an infection, and you should show it to a doctor at the earliest so that, if needed, the right treatment can be administered, such as antibiotics.

Apart from issues with skin and nail, it is common to experience hair loss with cancer treatments like chemotherapy. In fact, they don’t just lose the hair on their scalp but also on their eyelashes, eyebrows, and the rest of their bodies. This is because many of the chemotherapy drugs work by attacking the rapidly dividing cells present in the body.

Cancer cells or tumor cells are one such type of cells that divide rapidly, and hence the drug targets them. However, there are many normal cells in the body as well that divide rapidly, such as the hair follicles. As a result, chemotherapy drugs affect these normal cells as well, causing hair loss.^(13, 14)

At the same time, some chemotherapy drugs cause more hair loss than others. This is why it is best to ask your doctor about the possibility of hair loss before you begin your cancer treatment so that you are mentally and emotionally prepared for what to expect. Once the chemotherapy sessions start, hair loss tends to progress quite quickly. Usually, patients notice the hair loss when they get up in the morning and see their pillow covered in hair. When they start brushing their hair, they will find it coming out in clumps. This can be an emotionally challenging process for those losing their hair. You can consider wearing a wig or a cap to feel better about yourself.^(15, 16)

Cancer treatments can cause many changes in your skin and nail. Before beginning treatment, it is a good idea to talk with your doctor about what side effects you can expect during the course of your cancer treatment. While skin problems caused by chemotherapy and radiation therapy are usually mild, they can be more severe in cases where you receive targeted therapy, immunotherapy, or a stem cell transplant. If you notice any kind of changes in your skin and nails, you should inform your healthcare team at the earliest.

References: