Askanesthetician's Blog

An esthetician explores skincare issues and concerns

Skincare Tips For Cancer Patients From Dr. Ava Shamban January 26, 2017

Staying together in tough disease

 

It’s been a long time since I’ve posted anything about oncology esthetics.  I was certified in oncology esthetics by Oncology Training International over 4 years ago.  Since moving back to Israel in August, 2012 I have been advancing this esthetics field here in Israel where it is virtually unknown.  This past summer I started a Facebook page in Hebrew about oncology esthetics in order to better serve the Israeli population since there are few resources in Hebrew on this subject.

My last post about oncology esthetics was about how estheticians can help cancer patients.  In an even earlier post I shared skincare tips for cancer patients.   In this post I am privileged to share skincare tips for cancer patients that Dr. Ava Shamban shared with me.  Dr. Shamban is a Beverly Hills dermatologist and the creator of the skincare line SkinxFive.  She’s also the author of one of my favorite books about skincare called Heal Your Skin which includes a chapter all about caring for your skin during cancer treatment. You can read my review of her book here.

I’m sharing Dr. Shamban’s advice here along with some added comments of my own.  My comments are in italics.

The Skin Side Effects of Cancer Treatment:

How cancer treatment affects your skin (hair and nails) will depend on your individual physiology and the drugs you’re receiving. Side effects can occur right away or within several days, weeks, or even months of treatment. Always remember your mantra: take heart! There are ways to cope with even the most severe skin complaints.

Acneiform Rash (Follicular Eruption)

When you are treated with chemotherapy drugs that target the EGFRs you can develop a skin reaction known as acneiform (or acne-like) rash. It can look and feel like severe teenage acne, but it can erupt everywhere.

This skin reaction can look so similar to acne that you might be inclined to want to treat it with strong anti-acne ingredients, but this would be a mistake because your skin can be very sensitive at this time.  If you are confused about how to treat this skin condition be sure to talk to your oncologist or an esthetician trained in oncology esthetics about safe solutions to heal your skin.

 What to do: Acneiform can be tender, burning, and itching. If the rash is mild, you can try an over-the-counter low-strength salicylic acid or benzoyl peroxide preparation followed by a moisturizer that contains ceramides. If the rash doesn’t respond within a short period, ask your doctor about using a topical or an oral prescription antibiotic to relieve the symptoms and lessen the severity of the rash.

Ceramides are an oily wax that is found in the outer layers of our skin.   They are naturally found in our skin and play an important role in helping our skin retain moisture by being part of the “glue” that keeps skin cells together.  When ceramides are depleted our skin has trouble staying moist and can be prone to not only dryness but sensitivity as well.   You can find ceramides in Curel products and in CeraVe Moisturizing Lotion.

Dryness

Extreme dryness is the most frequent skin complaint among patients in cancer treatment. Dehydration, extreme weather conditions, perfumed products, and allergies can contribute to dryness.

What to do: The best way to treat your dry skin is to use moisturizers regularly; Ceramides are a particularly valuable ingredient; they replace a skin lipid that chemotherapy specifically diminishes. Take a short shower or bath, then pat your dry skin with a soft towel and apply a moisturizer immediately. Use only mild, non-perfumed, non-deodorant soaps such as Dove, Basis, Aveeno, or Neutrogena. Wear cotton clothes next to the skin rather than wool, synthetic fibers, or rough clothing. Always wash clothing in a mild detergent and avoid any products that contain perfume, such as bubble baths, soaps, and lotions.

Caution: if you are receiving radiation treatments, do not apply anything to the skin in the treatment area without clearing it with your medical team first. Many common ointments and moisturizers, while nonirritating, may interfere with the ability of the radiation to penetrate the skin and do its work.

Nail Changes

Changes to your nails will depend on the treatment you receive. They are usually temporary, although the nails may take longer to repair themselves than the hair and other skin nails. Nail toxicity can occur weeks or months after you’ve begun a targeted treatment, and it often persists for weeks or months after stopping the drug.

What to do: Nail changes often disappear when the damaged nail is replaced by the growth of a new nail. Good nail care during your treatment can help you to avoid or diminish the severity of side effects.

  • Moisturize the nails and cuticles daily with a nonirritating balm, such as petroleum jelly. You can also use lip balm to soften the cuticles.
  • Do not trim or push back your cuticles. The seal they provide around the nail plate prevents infection.
  • If your nails begin to separate or show signs of breakage, try to keep them in place as long as possible. Even when loosened or shortened, they provide protection for the nail bed.
  • Inflammation can be treated in a variety of ways by your oncology team, such as by the use of topical antibiotic, an antifungal, or a cortisone cream. Wrapping the treated area with a bandage or clear plastic wrap (such as Saran Wrap) will help the ointment to penetrate the area. Some also find it helpful to apply a liquid bandage to the area at the first sign of any cracking skin.

Tips for dealing with hair loss

Keep in mind that you will need to take special care of your scalp. The skin on your head, neck, and forehead will suffer from the same dryness, propensity to irritation, and increased vulnerability to sun damage as the rest of your skin during cancer treatment. In fact, it may be quite tender. Here are some tips for dealing with hair loss:

  • My patients recommend using with hazel or a gentle baby shampoo to cleanse the scalp. Massaging the scalp gently with the fingertips can be soothing.
  • Don’t wear a wig or any other hair covering for too long a period in hot weather. Sweat can build up on your scalp and become very irritating.
  • There are many different options for wigs: real hair, synthetics, different hair colors. The most important aspect is the fabric of the skullcap.
  • Choose soft, natural, and breathable fabrics like cotton jersey for anything you wear on your head.

Rejuvenating Skin During Cancer Treatment:

  • Do not do extractions, exfoliation, or other procedures that might damage fragile skin.
  • Use only the mildest products that are free of irritants and potential allergens.
  • If your oncologist permits professional facials, have them performed in your dermatologist’s office by a licensed aesthetician working under strict sanitary conditions.

 

Always tell your dermatologist or aesthetician that you are undergoing cancer treatment before scheduling facials or other cosmetic treatments.

In addition to Dr. Shamban’s excellent tips, I want to share a few blogs and articles I came across recently.  The blogs and articles all deal with how to look your best while undergoing cancer treatment.  I am a very strong believer in the mind-body connection. When you like, or love, the way you look, it lifts your spirit.  Since cancer treatment can cause many negative appearance side effects I find these blogs and articles helpful in giving assistance and hope to those who need it during a difficult time in their life.

So in no particular order I want to recommend the following blogs and article:

  • Beauty Despite Cancer – this UK site sells products that cancer patients need and has a great blog with real life stories that will inspire you.
  • Someone With – an American website similar to the site mentioned above.  They sell clothes, beauty, and health products for cancer patients.
  • Leo with Cancer – a very personal blog by Dena who has breast cancer.  Lots of beauty tips along with her raw and honest thoughts about her cancer treatment and its side effects.
  • Beauty Products for Breast Cancer Patients has great tips for looking your best during cancer treatment from the perspective of someone who has been there.
  • My Cancer Chic came out of Anna’s need to look her best even while undergoing cancer treatment.  She not only shares her feelings about her cancer journey but beauty and hair tips as well.
  • In this moving article Deanna talks about how drastically her appearance changed while undergoing cancer treatment, especially after she lost her eyebrows.  That experience lead her to help develop a replacement brow.

I have a Pinterest board just for oncology esthetics.  Feel free to follow it.

And many thanks again to Dr. Shamban for sharing her skincare tips for cancer patients with me and my readers!

 

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I Tried It: Micellar Water January 5, 2017

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Micellar waters are not a new skincare product.  They have been used in Europe, from what I can gather mainly in France, for quite some time.  In the last two years or so they became a hit States side, and more and more companies (both large and small) have come out with their version of this cleansing product.  When I first heard about micellar waters I was very intrigued, and when I saw this Garnier one on sale at my local drugstore I had to buy it.

Micellar water is said to gently cleanse the skin and has the added bonus of not having to rinse it off after using (more on that later in this post).  If you are one who likes to go camping (not me!) or spends days at outdoor festivals (once again not me!) having micellar water on hand means you can cleanse your face without having indoor plumbing nearby. It is also a good solution for making yourself presentable after a long flight when you are stuck freshing up in a cramped airplane bathroom.

The use of micellar waters as a skincare cure-all has been catching on recently.  You can find quite a few articles in the mainstream beauty world toting micellar water as the next great thing for your skin for all sorts of reasons such as the hard water you use to rinse your face after washing it destroys your skin so using a micellar water, which you don’t rinse off, is better for your skin.  Or that it must be great if the French love it.

For more information about how hard water affects our skin please see my post Hard Water and Your Skin.

The Science Behind Micellar Water

When I finally learned the in-depth science about micellar water via The Beauty Brains I realized that micellar waters were just mild cleansers.  There isn’t really anything special about them except perhaps for the fact that you do not need to rinse them off after use (once again more on that in a bit).  I suggest listening or reading to The Beauty Brains entire explanation about micellar waters, but I’ll share a few highlights here:

Micelles are structures that are formed when surfactant are dissolved in water. Remember that surfactants, short for surface active agents, are used in beauty products as cleansers and emulsifiers that help mix oil and water soluble ingredients.

If you look at the chemical structure of surfactants they typically have a long oil soluble tail and water soluble polar head group.  When surfactants are present in water at a certain concentration, they begin to assemble into larger structures based on the water soluble/oil soluble parts of the molecule. The oil soluble tails try to group together to get away from the water. The lowest energy state for them is to have all the tails together so they are shielded from water by the polar head groups – which again, water soluble. Think of it as a ball or sphere of surfactant molecules with head on outside, tails facing inside.

These spheres of surfactants are called micelles and the concentration of surfactant required to form them is called the Critical Micelle Concentration or CMC. …

Yeah, if you look at the ingredient list for products that claim to be micellar waters they tend NOT to use traditional, high foaming surfactants. Instead they use a combination of nonionic surfactants, which tend to be milder on skin. One of most common nonionic surfactant used in micellar waters is Poloxamer 184.  …

So overall, yes, these MW products are likely to be milder than many other cleansers. And, unlike traditional foaming cleanser’s they don’t necessarily have to be rinsed. They may even provide more of pleasant after feel than other cleansing products.

I have to say that companies have done a great job marketing these products. Somehow, these seem so special that they should be really expensive.

As you can see from The Beauty Brains explanation marketing hype plays a big part in the popularity of micellar waters.  Yes, someone with sensitive, easily irritated skin could find them to be helpful for their skin, but there are many more mild cleansers on the market that will probably be just as good, if not better, for their skin.

You can also get a great explanation (with helpful pictures) by reading Lab Muffin’s post about micellar water.   This post brings up a good point at the end – do you need to rinse off the micellar water even though it says you do not?  The rinse may be needed because of the surfactants that can potentially be irritating if left on the skin.  My skin never feels great after using micellar water; instead it feels like there is a layer of, well, something still on my skin after using the product, but I only use it as the first step in a double cleanse so I do rinse my skin after using a micellar water.  You need to play it by ear, but if you are using micellar water at home and as your only facial cleanser definitely consider rinsing your face after using it so that the surfactants do not stay on your skin.

My Experience

I use micellar water on a regular basis as the first step in a nightly double cleanse.  As I wrote above when I don’t rinse it off I do not like how the micellar water feels on my skin. I think micellar water is a great way to remove make-up, if you are washing your face with another cleanser afterwards.  I do find using a new cotton pad each night environmentally wasteful; I haven’t found a way around this issue yet.  Micellar water does not do a particularly good job at removing my eye make-up, but in my experience after trying a great number of make-up removers, nothing does.

Bottom Line: micellar waters can be a gentle way to cleanse your face, but they are not a miracle cleanser no matter what some people may claim.  Instead they are simply another mild cleanser.  Marketing hype can definitely blow things out of proportion.

Image from Cosmopolitan

 

 
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