Why does cancer treatment cause skin changes?

When cancer is being treated with chemotherapy and immunotherapy, specific molecules are targeted in tumours. Because those same molecules are also in the skin, hair, and nails, patients may experience side effects in those areas as well.

During radiation therapy, beams of radiation pass through the skin, which can damage both healthy and cancerous cells. If you receive frequent radiation treatments, your skin cells may not have enough time to repair and regenerate between treatments. The exposed skin may peel off faster than it can grow back after radiation therapy, resulting in sores and, in rare cases, ulcers.

By understanding what might happen to your skin, you can reduce the risk of infections and prepare yourself for any side effects that may arise. To learn about all possible side effects of your treatment, contact your doctor.

Prepare for your doctor's appointment by considering the following questions

• What skin related side effects are common for the type of treatment I’m receiving?
• Are there steps I can take to prevent any of these problems?
• What problems should I call you about? Are there any problems that need urgent medical care?
• When might these problems start? How long might they last?
• What brands of soap and lotion would you advise me to use on my skin? 
• Are there skin products I should avoid?

Skin rash & Cancer Treatment  

Skin rashes are a common side effect of certain types of cancer treatments. Cancer treatments that can cause skin rash may include chemotherapy, radiation therapy, immunotherapy, targeted therapy, and stem cell transplants.

It is important to know that a skin rash is an expected and common side effect of treatment and is not considered an allergy or allergic reaction. It is possible for people to develop allergies to treatment drugs, so if you develop a sudden rash, you should contact your cancer care team for advice. This includes symptoms of a rash, regardless of whether the rash is visible or not. 

It is common to find skin rashes on the scalp, face, neck, chest, and upper back. In spite of this, skin rashes may develop at any point during your cancer treatment and anywhere on your body, but are typically more prevalent within a few weeks of your treatment and usually improve after the treatment is completed.

Each Cancer Treatment Can Cause Different Side Effects 

Chemotherapy	There is a possibility that you will experience dry, rough, itchy, or red skin, along with peeling, cracks, sores, or rashes. (Known as chemo rash) Cancer treatment can make the skin more sensitive to sunlight, which increases the likelihood of getting sunburned. The intense exposure to sunlight can also weaken the immune system even more than it has already been weakened by the treatment.
Radiotherapy	Your skin may become red, sore, and itchy during treatment, similar to the symptoms of a sunburn. Additionally, the skin may become darker than usual. This usually begins one to two weeks after treatment begins. Later on, you may develop broken veins.  The person giving you your radiotherapy will tell you how to care for your skin during and after your treatment. It is important to follow their advice.
Stem Cell Transplant	This may cause graft versus host disease,  which can cause skin problems such as a rash, blisters, or thickening of the skin.
Immunotherapy	Immunotherapy can cause a severe and sometimes extensive rash, which can become dry or blister.
Targeted Therapy	Usually, the rash appears as pimples and pus-filled bumps after a few days, and the surrounding skin can feel slightly tender. Rashes can occur within the first few weeks and are usually mild to moderate in severity.
Steroids	May lead to spots and redness of the skin.

 

Treatment for chemo rash and other skin changes  

There are several treatments available for these side effects, depending on the severity and type of the reaction. A corticosteroid cream, along with an oral antibiotic or antibiotic cream, may be prescribed for mild to moderate skin rashes. In the event that the rash is more severe, oral corticosteroids may be administered, and your treatment regimen may be adjusted accordingly. 

Symptoms of skin changes related to cancer treatment and why you should be aware of them  

It is important for you to be aware of the symptoms in order to be able to detect when a side effect is arising, and to change your routine in order to stop the problem and decrease infection risk. When you develop open sores on your skin, for instance, you should carefully clean them with mild soap and water, cover them with a clean bandage, and regularly check for signs of infection, including redness, swelling, drainage, and pus.

Symptoms of skin changes

• Redness
• Swelling
• Pain or Tenderness
• Blisters or Wet Sores
• Peeling skin
• Acne
• Bed sores 
• Burning 
• Dry skin
• Darker areas of skin, tongue, and joints
• Patches of skin that are lighter
• Itchy skin 
• Dome-shaped skin growth
• Photosensitivity - Sunburn
• Rash

Additionally, you should notify your care team if:

• Your rash worsens after prescribed creams or ointments.
• You have itching that lasts more than 48 hours.
• Your rash develops into blisters, becomes bright red, develops pus or crusts over.
• Your rash is painful.

Skin care products for cancer patients

Use un-perfumed bath, shower and skincare products and soap-free cleansers.

Try using a moisturising cream that contains oatmeal, menthol or 10% urea. This will reduce itchiness.

Do not use products containing sodium lauryl sulphate (SLS), especially if you have eczema.

For dry or sore lips, use a lip balm containing moisturising ingredients such as petroleum jelly (Vaseline®), shea butter or glycerine.

Avoid petroleum jelly if you are having radiotherapy to the head or neck, or if you are using oxygen.

To keep extra safe you should buy new makeup to use during and after treatment and replace regularly to reduce the risk of infections.

If you are having a targeted therapy drug, avoid any products containing colouring.

Skincare routine

Pat your skin dry instead of rubbing it.

Always use a clean, soft towel.

Moisturise your skin regularly, to stop dryness and itching. Especially after washing.

Avoid long, hot showers or baths.

 

Learn how to cope with nail changes with our blog - Coping with Nails Changes During Cancer Treatment