The Oncology Aesthetics Podcast

Chemotherapy and your Skin

• Ricardo Fisas Natura Bissé Foundation • Season 1 • Episode 5

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Chemotherapy's effects extend far beyond targeting cancer cells, impacting the body's fastest-growing tissues including skin, hair, and nails. Oncology nurse navigator Lauren Stafford walks us through this journey with expert compassion and practical wisdom gained from guiding countless patients from diagnosis through survivorship.

Lauren unpacks the science behind why chemotherapy causes specific side effects, explaining how treatment targets rapidly dividing cells throughout the body. She shares valuable insights into managing hair loss, including the potential benefits and limitations of cold cap therapy—a technique that reduces blood flow to hair follicles during infusion. "It reduces the blood perfusion to the skin, which allows for the chemo to essentially not go all the way to the hair follicles on the scalp," Lauren explains, while cautioning that patients should maintain realistic expectations about its effectiveness.

The conversation explores practical strategies for skin and nail care during treatment, emphasizing gentle moisturization, sun protection, and avoiding potentially harmful beauty treatments like manicures and pedicures. Lauren's most powerful insights, however, center on maintaining identity through the cancer journey. "It is so important to make sure that they are seeing themselves outside of cancer," she emphasizes, highlighting how simple self-care routines can help patients reconnect with themselves beyond their diagnosis. Her compassionate approach acknowledges both the temporary nature of treatment and the very real challenges patients face balancing independence with accepting necessary support.

Whether you're a patient, caregiver, or healthcare professional, this episode offers valuable guidance for navigating chemotherapy's side effects while preserving dignity, comfort, and sense of self. Subscribe to our podcast for more expert conversations on enhancing well-being during cancer treatment and subscribe to get notifications about future episodes focused on navigating cancer with confidence and grace.

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Raejan:

This podcast is brought to you by the Ricardo Fisas Natura Bisse Foundation produced by Lyons Creative. All the information contained in this podcast is intended only to provide general skincare guidance. The information is not a substitute for consulting with a physician or other qualified medical professional. Welcome to the Oncology Aesthetics Podcast, where we explore ways to enhance well-being, self-esteem and resilience while navigating cancer. We bring you expert skincare tips, practical self-care strategies and inspiring stories to help you rediscover strength, radiance and joy. Welcome back to the show everyone. My name is Raejan. I'm the National Educator with the Ricardo Fisas Foundation. Today I'm here with Lauren Stafford. Lauren, welcome to the show. We are so happy to have you. Can you explain a little bit about your role?

Lauren:

I am an oncology nurse navigator. Basically, I meet patients at the beginning of their treatment and then follow them all the way through to survivorship, providing them with support, education and resources. Basically it's support and best friend through the process. You know someone that patients can reach out to and we help coordinate their care.

Raejan:

So you're very involved, really from point A to point Z and everything in between. Yes, I try. Well, we've always heard such fantastic things from your patients that you send to us and we're just so excited to have you on the show. I would love to hear a little bit more of a deep dive into chemotherapy. You have some really great and extensive experience with people while they're going through chemotherapy. Tell us a little bit about what chemotherapy is and its role in the treatment process.

Lauren:

So chemotherapy is given IV intravenously and it does get absorbed throughout the body systemic absorption and basically it is attacking those fastest growing cells. Unfortunately, that does attack other cells as well, like your skin, hair and nails. So there are side effects that we can't terribly avoid but, there's ways to mitigate those results.

Raejan:

Okay, that makes sense. We do see a lot of side effects from chemotherapy on the hair, skin and nails. So you're saying that it affects those things because those are also fast-growing cells.

Lauren:

Yes, the cancer is fastest growing. It's using glucose in the body to grow and replicate. So we want to attack those cells and get rid of them as soon as possible so that they're not able to grow and move around in the body.

Raejan:

And when you talk about those side effects specifically really on the hair, skin and nails, are they typically an average sort of severity or does it kind of you know, have a scale from sometimes people have less severe side effects, sometimes people have more, or is it typically all within the same category?

Lauren:

There is a general commonality with symptoms. However, everybody is different. You can't totally say everything is quote-unquote, normal. You do want to make sure that the patient is aware of their symptoms and side effects and that they keep an open communication with their doctor, nurse, navigator and whoever else to make sure that any symptoms that do come up they can handle those to the best of their ability. Sometimes that's with medications to reduce the symptoms, but otherwise, You know there's comfort care and managing with moisturizing hydration, so that there's not as much reaction. Some of those reactions look like general inflammation, tenderness to the skin, specifically to the nails, you know neuropathy, so painful, numbingness and changes to the nail color of the bed as well. Pain and sensitivity is definitely something that they notice as well as just overall dryness.

Lauren:

Rae: And what's some of the advice that patients will typically receive more towards the beginning of their journey. Lauren: In regards to these skin care side effects. Definitely doctors will try to head off the chance of reactions with things like steroids, but of course then that does dry out the skin even more. You know they do encourage a lot of hydration and nutrition to give the body the building blocks to handle the symptoms that come. But definitely following with the general skincare routine that does de-escalate or calm the skin is important.

Raejan:

Absolutely. We see a lot of that in our practice of trying to kind of soothe the skin a lot and bring that hydration. What are some of the tips and tricks that you typically give to your clients when they are in need of hydrating, either really internally or even on their skin Right?

Lauren:

Though I do encourage both. aving a regular routine of hydration, water, electrolytes can be helpful, but there is a very common symptom of nausea with a lot of chemotherapy and there may be times where you can't totally ingest as much hydration to meet the needs, especially when then your skin is taking the brunt of that reaction. So you do want to follow up with moisturization, gentle moisturizers to the skin. That's safe for you, nothing with a high exfoliant, so it's just basically calming and locking in that moisture.

Raejan:

Yeah, that's a good perspective to have, kind of coming at it from the internal hydration and the external moisturization. What should patients know about caring for their hair and their scalp?

Lauren:

So, just in the same way with nails and skin, your scalp does become affected by this, especially your hair. Not that we would think so, but hair is part of that faster growing cells in your body. So the first symptoms that people will see with chemotherapy is hair loss. It is important to, trim your hair prior. There's different ways to reduce hair loss, of course, but definitely, you know, not being afraid of it and also just keeping an eye on your scalp, knowing that it's part of your overall skin health. Keeping it moisturized with conditioners and keeping an eye on things is important too.

Raejan:

Lauren, you mentioned that there are some ways to reduce hair loss. Does that include cold caps?

Lauren:

Yes, definitely that is. A technique to reduce hair loss is by using creating a cold environment for the scalp. It reduces the blood perfusion to the skin, which allows for the chemo to essentially not go all the way to the hair follicles on the scalp. It is not completely 100% foolproof, though. Definitely, patients can lose about 50% of their hair, so they got to know going in that there is a potential to have much thinner hair. But they preserve the hair while they're going through treatment and then also as they complete that each time with their cycles of chemo, once they're all done, that does create an environment for their hair to grow back even faster.

Lauren:

Rea: That is really interesting.

Lauren:

Lauren: Yeah, it definitely is important, though for patients to monitor that. There's different techniques for cold capping. Sometimes there's a cold water that's run through the cap that's fitted specifically to their head. However, other times you can get pre-frozen caps that people bring in little coolers and then apply. But it's important to not overstress or freeze the scalp too much, because then you can actually have an opposite effect, where it essentially causes freeze or burn to the skin. So I do just advise everybody to be cautious, cold, but not too cold, and then to keep an eye on the skin. Certainly, if there is any breakdown in the skin, they need to, you know, take a step back, moisturize, keep an eye on things. But it can really help someone maintain hair during their treatment without needing things like wigs, which does give them some self-control, you know, and sense of identity.

Lauren:

Rea: Yeah Yeah, that seems like a great resource

Lauren:

Lauren: definitely. It's important, if patients are interested in that, to ask their medical oncologist. They can give more resources. There are different machines and companies that the medical oncologists will have in their infusion rooms that are available to patients

Lauren:

.

Raejan:

Wow, thank you so much for sharing that with us. I would love to touch base on nail care. What are some of the side effects that you see on nails and what do you typically advise to help mitigate those side effects?

Lauren:

So that is important also to keep an eye on how your nails are handling the chemotherapy. There are some types of medicines not all that do cause quite a bit of neuropathy. That can show up like darkening or hardening of the nails. That also brings with it numbness and tingling. It is important to catch these symptoms early, always be talking to your medical oncologist as you start to see symptoms. A lot of times they can either change doses or medicines altogether. .

Lauren:

But in the same way, keep your hands hydrated, gently massage to allow for pain relief. You can also talk with your doctor about getting set up with physical therapy or occupational therapy, because that can also help you maintain balance, pain control overall while you're going through treatments, as well as, of course, making sure that you do keep up a good diet whole grains, cooked vegetables, lean proteins and hydration as well. I do advise that people keep their nails trimmed, but avoid things like cuticle trimming, because that can be too irritating to the skin and since chemotherapy does decrease your immune system, it's the potential to get infected is there? Definitely avoid manicures and pedicures during chemotherapy and just keep a gentle hydration. I would do it multiple times throughout the day.

Raejan:

What are some of the reasons why someone would avoid getting a manicure or pedicure during this time?

Lauren:

So pain definitely is part of that. It's too harsh to the skin and the nail bed, but also you can have brittle nails and they can also peel and break brittle definitely. So I would just make sure to if you do have to or want to have nail color, do a lacquer-based gentle nail polish. I think this is important too.

Raejan:

and moisturized? Have you seen it mitigate some of those side effects?

Lauren:

Yes, especially when they're getting rashes. Have you seen it mitigate some of those side effects? Yes, especially when they're getting rashes. Sometimes it's not always that obvious, or on the face, where they see it more, but it's in the scalp and you can have significant acne, even from chemotherapy. So the skin is just constantly being inflamed and irritated. So following up with that, keeping of course it clean and then hydrated is really important.

Raejan:

Absolutely Clean and hydrated and I would go ahead and add protected as well. Yeah, I find so often that we have patients come to us that wouldn't have even thought to put sunscreen on their scalp because they're so used to having hair.

Lauren:

So it's kind of this new idea of oh right, the sun can still burn my scalp. That's so true, especially when that skin has not seen the sun, like you've said, and so then it's going to be the first part to burn Absolutely.

Raejan:

Does chemotherapy make the skin more susceptible to sunburns it?

Lauren:

definitely does. So part of what we tell patients is to make sure that they're covering, not only using the sunscreen but wearing longer sleeves, hats, that kind of thing, Especially when they're out in the sun for any kind of extended amount of time Sounds like a lot of lifestyle changes that people have to manage. It does, and it definitely, of course, does work on the self-esteem and self-perception of everything too, so it's important for them to acknowledge that and do what they can to still feel you know themselves.

Raejan:

Absolutely, and I can imagine that it would be kind of difficult to keep more of that hopeful or positive outlook. How do you approach that with your clients, with your patients, within your navigation?

Lauren:

I mean it is so important to make sure that they are seeing themselves outside of cancer. You know you don't want to identify yourself as being cancer, having cancer always. You know it is something that you're going through and it is a life-changing experience for sure. But definitely taking time for yourself something as simple as daily moisturizer, you know, skin treatments and stuff to make you feel more you and comforted is so important.

Raejan:

Absolutely. I love that you touched on that. One of the things that I try to emphasize with educating in skincare is the importance of that self-touch. You know, I think so often we kind of only are looking at ourselves even to find those flaws, and just taking a moment to do something, an act of self-care, by putting on a little bit of hydration, feeling better and then kind of really connecting back to the self. That's so important.

Lauren:

Yeah, I mean, you're worth it. You've got to take care of yourself. How can you take care of others if you can't take care of yourself?

Raejan:

Absolutely, it's definitely important, yeah, and unfortunately, during cancer, the rest of life doesn't go on pause. So there's still those things to take care of to your point.

Lauren:

Yes, definitely that is part of it. You know patients have kids, lives, people they depend on and also jobs. You know people can't just take time to just totally, you know, step away. It definitely is a lot to manage, but making sure that you take care of yourself is so important, absolutely.

Raejan:

, do you have tips or tricks, any advice see, you give to your patients, maybe more specifically geared towards chemotherapy and its impact?

Lauren:

towards chemotherapy and its impact. I do believe that you know it is important to just see the I guess you would say light at the end of the tunnel. You know it sounds cliche for sure, but it is important to see outside of this cancer struggle and know that it's temporary. A lot of people do get swallowed up or overwhelmed by you know what is their day-to-day right now and that is totally valid. But just knowing that you will get through this and keep seeing forward, using those around you as well for the support, you know you may not want to feel like you're taking a handout or support from others. You want to be independent and that is important. But it's also important to let people help you when they can. You know different resources, skincare, tips all of that can help you feel like you through the process and then feel more victorious at the end when you're all done.

Raejan:

Oh, beautifully said. Lauren, thank you so much for everything you do. Thank you for your expertise, for walking alongside us and for being on the show. We can't wait to have you back. Thank you for joining us. We hope you found this information helpful. It's your reviews and feedback that help make this podcast even better. If you enjoyed this episode, please subscribe, leave a review and share it with someone who might benefit. Until next time, take care, stay radiant and we'll see you soon. Thank you.