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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Skincare Terms Explained: Glycation May 13, 2013

In July, 2012 I wrote a post all about how terrible sugar is for the skin.  This post is going to expand on the term “glycation” and explain what exactly that process is and how it relates to the skin.  But basically, it all comes back to the same thing again – sugar ruins our skin (and our health).

In her book Heal Your Skin Dr. Ava Shamban explains just what glycation is (page 22 in the paperback edition):

As delicious as sugar may seem to your taste buds, it can be extremely destructive to your skin.  A spike in your blood sugar levels – which can come from eating processed foods or foods with too much refined sugar – can leave too much sugar circulating in your body.  A process called glycation and the formation of advanced glycation end products are the results.

Glycation is a process whereby a sugar molecule, such as glucose or fructose, is added to collagen and elastin fibers, proteins found in the extracellular matrix, which surrounds skin cells.  This makes the collagen stiff, as it is now cross linked in an abnormal way.  In addition, the enzymes that normally remodel collagen no longer have access to the protein, and it can no longer be remodeled in a normal continual fashion.  When the process occurs, the skin appears prematurely aged.

Glycation damages collagen in other organs in the body, too, including the blood vessel walls.  When this occurs, the skin doesn’t remodel in the same way as before, prematurely aging the tissue.

Dr. Peter Pugliese discusses the subject of glycation extensively in his book Physiology of the Skin, 3rd edition (written with Dr. Draelos) in chapters 30 and 31.  A lot of the information from the book was also published in two articles in Skin Inc.: Physiology of the Skin: The Impact of Glycation on the Skin, Part I and Part II.  I urge you to read both articles if you want a very in-depth and scientific description of the glycation process (there are also lots of pictures and chemical equations).  Suffice it to say though Dr. Pugliese’s explanations are welcome they can be a bit overwhelming for those of us who still have upsetting flashbacks to high school chemistry (I still cringe when I think about the periodic table; I was a poor chemistry student to say the least) so I’ll just quote the summary here:

Glycation is the non-enzymatic joining of a sugar and a protein, or a lipid. It is a process that occurs naturally in foods, especially when cooked. The Maillard reaction is one of these processes that starts by forming a Shiff base and proceeds to forming multiple chemicals called advanced glycation end-products, or AGEs, that have adverse effects on a person’s biological processes. AGEs can link up with many proteins and denature them or alter them to be nonfunctional, cross-linked collagens, which is an AGE protein complex responsible for stiffness of the skin.
Skin collagen has a long half-life; these cross-linked forms do not go away and are not fully reversible at present. Elastin is another long-lived protein that is easily glycated and lasts a long time. Denatured elastin is associated with slackened skin. AGEs have cellular receptors known as RAGEs that initiate inflammatory reactions when activated by an AGE complex. These reactions tend to be chronic and are associated with arterial diseases, metabolic disorders and rheumatoid arthritis. Once they are started, the AGE-RAGE system will accelerate and perpetuate itself.
In the skin, glycation accounts for accelerated aging, yellowing and stiffness of the skin, and decreased circulation. Skin cannot look young and healthy with glycation products. Treatment is best started with prevention by diet control, reducing total calories, avoiding high sugar foods and not cooking at high temperatures. Supplements such as aminoguanidine, pyridoxamine, carnosine and benfotiamine are excellent glycation preventors. A new class of drugs called glycation breakers is being developed to correct the existing glycation protein complexes associated with many chronic diseases. They will truly be the youth drugs of the future.

In my previous post about the subject of sugar and how it negatively impacts the skin I shared with my readers how hard I have found it to cutback on sugar in my diet.  I also started noticing how sugar lurks in all sorts of foods; I try to read food labels more carefully now.  But after researching this post I realize that I also have to be careful about the method of how I cook my food since foods cooked at high temperatures (broiled, barbecued) can negatively impact your health and skin as well.  I wish I had the will power (and the time) to become a raw food vegan, but in the meantime I’ll still keep working on cutting down on how much sugar I consume.

Further Reading:

Image from rokderm.com

 

 
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