How Chemotherapy Affects Your Skin And What You Can Do About It

Chemotherapy uses powerful drugs to destroy cancer cells in the body.

While it can be an effective way to fight cancer, chemotherapy can also have many side effects, including changes to the skin. These changes can occur because the drugs used in chemotherapy can damage healthy cells along with cancer cells. As a result, patients may experience dryness, itching, and redness of the skin. In addition, chemotherapy can cause the skin to become more sensitive to the sun, leading to an increased risk of sunburn and skin damage. Patients may also develop a rash, hives, or other types of skin reactions to chemotherapy. Hair loss, including loss of eyelashes and eyebrows, is another common side effect of chemotherapy that can impact the skin. Furthermore, chemotherapy can weaken the immune system, making patients more susceptible to infections and slower healing of wounds or skin injuries. Overall, the skin side effects of chemotherapy can be uncomfortable and even painful, but there are ways to manage them. Below we discuss some of the major impacts chemo has on the skin and ways you can help reduce the effects.

Dry and itchy skin due to chemotherapy drugs

Itching of the skin is a common side effect of chemotherapy, it is one of the most frequent skin symptoms reported by cancer patients undergoing chemotherapy. It can occur anywhere on the body, including the scalp, face, neck, arms, legs, and tors and can occur at any time during treatment. Some patients may experience itching shortly after starting chemotherapy, while others may not notice it until several rounds of treatment have been completed.

The severity and duration of itching can also vary depending on the individual and the specific drugs used in their chemotherapy regimen. Itching may be caused by the damage that chemotherapy drugs can cause to healthy skin cells, or it may be a result of an allergic reaction to the drugs. Patients may also experience itching as a side effect of other medications they are taking in conjunction with chemotherapy, such as pain medications or antibiotics.

Itching can also lead to scratching, which can further damage the skin, increase the risk of infections, and delay healing. Therefore, it is crucial for patients who experience itchy skin during chemotherapy to discuss their symptoms with their healthcare team, including their oncologist, nurse, or dermatologist who will be able to help.

In addition, there are various strategies that you can try yourself, as below:-

5 strategies for skin self-care during chemo

1. Moisturize frequently: Chemotherapy can dry out the skin, which can exacerbate itching. Therefore, it is important to keep the skin hydrated and moisturized by using gentle and fragrance-free skincare products, such as creams, lotions, or ointments, that contain ingredients like ceramides, glycerin, or petrolatum. Apply them immediately after bathing or showering, when the skin is still damp, to lock in moisture.
2. Avoid irritants: Certain substances, such as perfumes, dyes, or harsh chemicals, can irritate the skin and trigger itching. Try to avoid using these products or wearing tight-fitting clothes that rub against the skin. Instead, opt for loose-fitting, breathable clothing made of soft fabrics, such as cotton.
3. Cool the skin: Applying cool, wet compresses or taking cool baths or showers can help soothe itching and reduce inflammation. Avoid using hot water, which can further dry out the skin and worsen itching.
4. Try relaxation techniques: Stress and anxiety can exacerbate itching and make it harder to cope with. Therefore, it may be helpful to practice relaxation techniques, such as deep breathing, meditation, yoga, or guided imagery, to promote calmness and reduce tension.
5. Stay hydrated: Drinking plenty of fluids, such as water, herbal tea, or fruit juice, can help keep the skin and body hydrated, flush out toxins, and reduce itching. Avoid alcohol and caffeine, which can dehydrate the skin and exacerbate itching.

Cancer treatment and sun sensitivity

Both chemo and radiotherapy can make your skin more sensitive to the sun's rays, leading to an increased risk of sunburn and skin damage. Some chemotherapy drugs, such as fluorouracil, methotrexate, doxorubicin, and paclitaxel, can cause photosensitivity (an abnormal reaction to sunlight that results in skin rashes, itching, and burning sensations).

Photosensitivity occurs when certain chemicals in chemotherapy drugs interact with ultraviolet (UV) light, causing the skin to become more reactive and sensitive. The severity and duration of photosensitivity can vary depending on the drug, the dosage, the duration of treatment, and individual factors, such as skin type, age, and sun exposure.

5 tips to reduce sun damage and photosensitivity during chemotherapy

1. Avoid direct sunlight: Try to stay indoors or in shaded areas during peak sunlight hours, typically between 10 a.m. and 4 p.m. If you need to go outside, wear protective clothing, such as long-sleeved shirts, hats, and sunglasses, that cover as much skin as possible.
2. Apply sunscreen: Use a broad-spectrum sunscreen with an SPF of at least 30 that protects against both UVA and UVB rays. Apply it generously and frequently, at least every two hours or after sweating or swimming. Choose a sunscreen that is free of fragrances, dyes, and alcohol, and that is recommended by your healthcare team.
3. Be extra cautious near water, sand, and snow: These surfaces can reflect and intensify the sun's rays, increasing the risk of sunburn and photosensitivity. Use extra caution and protection when near these surfaces.
4. Avoid tanning beds: Tanning beds emit high levels of UV radiation that can damage the skin and increase the risk of skin cancer. Avoid using tanning beds during chemotherapy and beyond.
5. Check your skin regularly: Be aware of any changes in your skin, such as new moles, growths, or rashes, and report them to your healthcare team promptly. They may recommend further evaluation or treatment.

Chemotherapy and skin injuries

Chemotherapy can sometimes cause skin injuries, such as rashes, blisters, and ulcers, due to its effects on the skin cells and the immune system. The severity and type of skin injury can vary depending on the type of chemotherapy drug, the dosage, and the duration of treatment, as well as individual factors such as age, skin type, and overall health.

Common skin injuries during chemotherapy

One of the most common skin injuries during chemotherapy is a rash that can be itchy, red, and bumpy. The rash may develop into blisters or ulcers and usually appears on the face, neck, chest, or arms. Topical creams, antihistamines, and other medications can manage this skin condition.

Hand-foot syndrome is another skin reaction that affects the palms of the hands and soles of the feet, causing redness, swelling, pain, blisters, and peeling or cracking of the skin. Capecitabine and 5-fluorouracil are common chemotherapy drugs that may cause this condition. Treatment may include topical creams, pain relievers, and modifications to footwear and handwear.

As stated above, certain chemotherapy drugs can make the skin more sensitive to sunlight, resulting in sunburn, rashes, and other skin injuries. To avoid photosensitivity, it is recommended to avoid sun exposure, wear protective clothing, and use sunscreen.

Mucositis is a condition that causes inflammation, pain, and sores in mucous membranes in the mouth, throat, and digestive tract. This condition can make it difficult to eat, swallow, and speak. Chemotherapy drugs such as methotrexate and 5-fluorouracil can cause mucositis. Treatment may include mouthwashes, pain relievers, and modifications to the diet.

If you experience any skin injuries or changes during chemotherapy, it is important to inform your healthcare team. They may recommend topical treatments, oral medications, or other interventions to manage the symptoms and promote healing. In some cases, they may adjust the dosage or type of chemotherapy drug to reduce the risk of skin injuries

Chemo hair loss and skin changes

When undergoing chemotherapy, hair loss can occur, leading to vulnerability and exposure of the scalp to external factors like sunlight, cold weather, and friction from hats and scarves. The absence of insulation provided by hair can cause dryness, itchiness, sunburn, sensitivity, irritation, and infections.

5 tips to help manage chemotherapy-induced hair loss and skin changes

1. Moisturize: To help alleviate dryness and itchiness on the scalp and other areas of the skin, use gentle moisturizing creams or lotions. Avoid products that contain fragrances or other irritants that can further aggravate the skin.
2. Protect from the sun: Protect the scalp from the sun by wearing a hat, scarf, or other protective headwear when going outside. Use a broad-spectrum sunscreen on any exposed skin to prevent sunburn and other skin damage.
3. Be gentle with hair and skin: When washing hair, use a gentle shampoo and avoid harsh chemicals or treatments that can damage the hair or scalp. Avoid using hot tools like hair dryers or flat irons, which can further damage fragile hair. Use a soft-bristled brush to avoid irritating the scalp.
4. Keep the scalp and skin clean: To prevent infections and other skin problems, keep the scalp and skin clean by washing regularly with gentle, non-irritating products. Avoid sharing hairbrushes, hats, or other personal items that can spread bacteria or other pathogens.
5. Consider wigs or head coverings: Wigs, hats, and scarves can help cover the scalp and provide protection from external factors such as sun and wind. Look for head coverings made from soft, breathable materials that won't irritate the skin.
6. Talk to your healthcare team: If you are experiencing hair loss or skin changes due to chemotherapy, talk to your healthcare team. They may be able to provide additional recommendations or prescribe medications to help manage symptoms.

Remember to consult with your healthcare team before trying any new treatments or remedies, and follow their advice closely. By taking good care of your skin and avoiding sun damage, you can reduce the risk of complications during chemotherapy and protect your skin's health in the long term.

Gentle skin care products for chemotherapy patients

Further reading

• How do you prepare your body for chemotherapy drugs?
• How To Prepare For Chemotherapy Treatment | 6 Easy Steps
• What To Pack In A Chemo Bag: 18 Suggestions
• Should I eat before my first chemo treatment?
• What should I bring on my first day of chemo?
• What happens on the first day of (IV) chemotherapy drugs?
• What can you not do while on chemo?
• What should I eat after finishing chemotherapy treatment sessions?
• What is the fastest way to recover from chemotherapy?

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