Skincare during radiation and chemotherapy

I received a recent comment that was so good- my reply turned into an entire post. Radiation and chemotherapy can be very hard on the skin. Radiation can cause rashes (called radiation dermatitis) or even burns to the skin. Chemotherapy can cause changes in the skin due to blocking hormones (such as those use for breast cancer), severe acne eruptions (steroids and many new antibodies drugs), or extensive rashes.


While radiation has gotten much better and targeted, it can still be very hard on the skin within the radiation field. Treat this skin with extra gentle products- like you would treat a baby’s skin. Avoid soaps or only use Cetaphil gentle cleanser. Use bland moisturizers such as Vaseline or Aquaphor after your treatment. Ask you doctor for a prescription hydrocortisone in case you get radiation dermatitis- this can be very helpful to decrease the inflammation. At the time of your treatment avoid putting anything on the skin as it can affect the radiation or even contribute to burns. If you get a burn or have open skin, ask your doctor if a product like silvadene (a burn cream) would be helpful. For breaks in the skin using a barrier paste such as Triple Paste diaper cream can help the area heal. Cover the area with a non-stick pad such as Telfa to keep it protected. If the area is too large to cover try to wear loose and soft clothing. Keep radiated areas out of the sun as the skin will be extra sensitive to the sun and the combination of radiation and sun can cause a rash. Remember that light colored clothing provides very little sun protection, so wear darker clothing if you are out in the sun. Wear a large hat if the radiation was to the face or neck.


All types of chemotherapy can be hard on the skin (and the hair). Estrogen blockers (such as Herceptin and Letrozole) can suddenly drop estrogen levels, leading to changes seen in low estrogen states such as dry skin and hair, increase skin wrinkling and sometimes acne. Prednisone can cause acne and growth factor inhibitors (gefitinib and cetuximab are two examples) can cause severe folliculitis that resembles acne. Both of these conditions are treated like acne, but usually need prescription medications. Chemotherapy can also affect the nails (slowing growth or causing lines) and many types of chemotherapy cause the hair to fall out. Most types of chemotherapy can cause inflammation of the mucosal membranes – the mouth, nose and genital area. The changes from chemotherapy can be varied and severe in some people, often you will benefit from a dermatologist consultation. A great source of information for the specifics on chemotherapy and the skin can be found at DermNetNZ. topic: Skin toxicity of chemotherapy drugs.

Hopefully this post provided useful information. Thanks for the topic Heather!


Winter Skin

The days are shorter and there is more (lots) rain than sun in Seattle these days. Slowly I have noticed the signs of winter skin creeping in. For most people winter skin = dry skin, and mine is no exception. For those with sensitive or acne prone skin it can be a trying time- trying to keep the skin moisturized without causing irritation or acne breakouts.

Some tips that I find helpful to keep my skin looking bright and hydrated during the winter.

1. Decrease use of anti aging and acne products. Anti-aging and acne treatments can be drying to the skin. It is important to keep them in the regimen- but decrease the frequency. Alternate your washes, using a very gentle wash (I like Cetaphil gentle skin cleanser or Neocutis gentle cleanser) on most days and your more aggressive washes (anything with salicylic acid, benzoyl peroxide or hydroxy acids) only a few days per week. This gives you the benefit of the treatment washes without the irritation.

2. Change to more gentle anti-aging products. During the winter I rarely use a prescription retin-A, relying instead on a less drying retinol such as the skinceuticals retinol or Beauty Pacifica Super 3 Vitamin A or Neocutis Nouvelle (retinol).  These give the benefit (treating wrinkles and acne) of a retinol without the drying. I also rely more on peels- which give you the peeling/dryness all at once (over 3-5 days)- instead of every day.

3. Find a good moisturizer and eye cream. I need to switch to a more hydrating moisturizer during the winter. I have acne/rosacea prone skin- which can make moisturizers difficult to find. In the summer I use EltaMD and in the winter often use Neocutis Biogel or Biocream (sometimes both) for extra moisture. My skin tends to breakout with topicals that contain hyaluronic acid, but if your skin is ok with this product the can be very hydrating.

4. Take care of your hands. We often neglect our hands until it is too late. Use a good moisturizer (I like Cerave hand cream and Neutrogena Norwegian hand formula) and rub into the nails as well. Carry a non irritating hand sanitizer such as Avagard D to avoid washing hands too much and harsh sanitizers such as Purell. At night I coat my hands with vaseline and rub vaseline into my cuticles. In the winter I avoid wearing rings because I get eczema underneath- sometimes I even need to take off my wedding ring. If you get a rash under your ring in the winter it doesn’t mean you have an allergy- more likely irritation from water and eve sweat that gets trapped under the ring.

5. Wear your sunscreen!  UV light penetrates through the clouds and can be very intense when reflecting off the snow. I carry my sunglasses and hat even during the winter. When skiing make sure to apply a high SPF sunscreen every 1-2 hours.

6. Take care of your lips. I always have a little pot of vaseline with me during the winter. Be careful with deeply pigmented and long wearing lipstick as they can be very drying to the lips.

7. Hydrate your body. This is a hard one for me- I love coffee! Try to increase your water intake or at least drink one glass of water for every cup of coffee or alcoholic drink.

Hopefully these tips will help keep your skin bright and glowing during the winter months. Please share any winter skin tips that you have or winter skin products.