What is the Best Skin Care for Cancer Patients?

Skin Care

“In order to succeed, people need a sense of self-efficacy, to struggle together with resilience to meet the inevitable obstacles and inequities of life.” -Albert Bandura

Even when they are young and healthy, women seem to get a boost from beauty products. So it’s no wonder that women who are sick or terminally ill feel the same way. “I’ve heard patients say, ‘I absolutely feel ugly. I don’t want to look at myself. When I look in the mirror I don’t see the same person,’ ” said Marianne Kelly, who founded the first Image Recovery Center, a salon-like facility for cancer patients 19 years ago at Baltimore’s Union Memorial Hospital. One such patient, Kelly, is a licensed cosmetologist, who developed a brain tumor. After 15 hours of brain surgery, she awoke to face 18 frustrating months of rehabilitation, she had to relearn how to walk and feed herself. However, unlike men, who have a harder time dealing with loss of function, it was the changes in her looks that troubled Kelly the most.

“I had always been very particular about my appearance,” Kelly said. “What I discovered [through cancer patient-centered beauty salons] was there was more to healing than medicine,” Kelly said. “Feeling good about yourself played a very big role in my recovery.”

Since cancer patient-focused salons tend to only exist in large metropolitan regions, such as Baltimore, Los Angeles, or New York, and are limited to non-existent in other regions of the country and other nations in general, I thought it was important to write a piece about products that are suitable for cancer patients.

Are there Ingredients Cancer Patients Should Not Use?

The issues with cancer patients’ skin primarily are three-fold: First, the patient is more immuno-compromised that before. This simply means that s/he has a weakened immune system. Secondly, the skin tends to be more dry and susceptible to irritation, particularly if the patient is undergoing chemotherapy or radiation. Third, the skin may also become thinner during this time. For this reason, it may be beneficial to use proven anti-agers like alpha hydroxy acids (which are less drying than retinoids), antioxidants (though in lower doses), and general sun avoidance. So avoid:

Methyl alcohol/methanol, ethyl alcohol/ethanol, SD alcohol 40, or butyl alcohol. Skin care products will sometimes include low-molecular weight alcohols in order to thin the solution and increase penetration into the skin. These low-molecular weight alcohols include methyl alcohol/methanol, ethyl alcohol/ethanol, SD alcohol 40, and butyl alcohol.  Unfortunately, sometimes patients with very dry skin will find these products to be irritating. Keep in mind that not all alcohols are created equal; some alcohols are hydrating and “bulk up” a solution. These include alcohols that begin with an “S,” such as stearyl alcohol, as well as cetyl alcohol.

Known irritants/allergens, like lanolin, idebenone, artificial colors, or fragrances – particularly in the first 5 ingredients of a solution. Even patients who have the thickest, most resilient skin in the world pre-cancer may notice that their skin is thinner, drier, and more sensitive post-chemo or radiation therapy. This is normal: It is well-known in the medical community that chemotherapy and radiation can make the skin more sensitive. That said, you will want to avoid ingredients that are known to be irritants or allergens, especially if they are listed as one of the first five ingredients, which typically comprises 80 percent (or more) of a total formulation. A full list is below.

  1. Acetone
  2. Apricot kernel oil, apricot oil
  3. Benzaldehyde (typically used as a preservative, less than 1% of solution)
  4. Butyl alcohol
  5. Camphor
  6. Castor oil (sulfonated or otherwise)
  7. D+C Red 3, 17, 21, 30, 36
  8. Ethyl alcohol or ethanol
  9. Flowers of sulfur
  10. Idebenone
  11. Lanolin (Ethoxylated, PEG 16)
  12. Methyl alcohol or methanol
  13. Mink oil
  14. SD Alcohol 40
  15. Sodium Lauryl Sulfate, Sodium Laureth Sulfate (SLS). (Sodium Trideceth Sulfate, or STS, on the other hand, is fine)
  16. Wheat germ oil
  17. Xylene

Products with penetration enhancers like butylene glycol or propylene glycol. In general, I love glycols, and I’m not alone. Not only do glycols increase the penetration of beneficial ingredients deeper into the skin so they work better (and for longer), but they also hydrate. According to Dr. Leslie Baumann, M.D., a board-certified dermatologist and author of The Skin Type Solution, “Propylene glycol is a humectant…a water-soluble agent that works by actually drawing water into the skin. This extra moisture causes the skin to plump up a bit, temporarily giving the appearance of smoother skin with fewer wrinkles.” So what’s the issue? My qualm with penetration enhancers for cancer patients is that they tend to enable ingredients to not only get deeper into the skin, but also to remain in the skin for longer periods of time. Given that chemotherapy and radiation therapy can affect cell turnover rates, this can change how your skin reacts to skin care, positively or negatively. Either way, I wouldn’t take the risk. I would stick to skin care solely for sun protection and hydration, and worry about heavy-duty anti-aging treatments (like those with penetration enhancers) once you get better.

Keep in mind other ingredients classified as “toxic” are usually anything but. Political activist groups like the Environmental Working Group or the Campaign for Safe Cosmetics, as well as celebrities trying to sell natural or organic products like Jessica Alba and Josie Maran, often will pronounce non-natural or non-organic ingredients are “toxic.” On a recent infomercial, I heard one woman selling natural and organic products use the word “toxic” over 20 times in one single hour. It’s ridiculous, playing on our sympathies and wont for safety for ourselves, our bodies, and our families. In truth, there is little to no scientific basis for it. Ask any cosmetic chemist: Typically the studies that are cited “proving” ingredients are toxic use tens of thousands to millions of times the exposures of a single use of a cosmetic product. These ingredients, including parabens, have been shown to be cleared from the system in a matter of time. And unless you demonstrate an allergy, you will not become sensitized to an ingredient with repeated exposures over time. That said, if you do experience redness, itching, burning, or irritation after a few days’ of using a product, discontinue use.

Are there Ingredients Cancer Patients Should Use?

Alpha hydroxy acids, though in lower doses than I would normally recommend. While I personally find retinoids work better than alpha hydroxy acids, alpha hydroxy acids do have the advantage of being hydrating, which retinoids do not. When dealing with cancer patients’ thinner, drier skin, use of agents with lower concentrations of alpha hydroxy acids works well, such as 10% or less of lactic acid, glycolic acid, and mandelic acid.

Lower doses of anti-agers. It is true that cancer patients want to look and feel their best. However, increased sensitivity of skin requires that cancer patients consider less concentrated and more soothing treatments than usual. Focus on hydrating, anti-inflammatory ingredients, rather than cell-stimulating ones. Look for products with green, white, black, or red teas; oatmeal extract; white willow bark; and other soothing extracts.

Sun avoidance: hats, clothing, and sunscreen. You may have heard that a little sun is good for you, but cancer patients are especially susceptible to sun damage. Many of the drugs used in chemotherapy and radiation increase sensivity to the sun. Invest in a wide-brimmed hat and close-knit clothing with an established UPF rating, which is like SPF for clothing. I particularly like

Products Recommended for Cancer Patients

Lindi Skin ($39.00 Set; Amazon.com)

If you’re looking for an all-in-one set, it’s hard to beat Lindi Skin. The entire line was formulated to soothe and relieve the skin of chemotherapy and radiation therapy patients (LindiSkin, 2013). The formulations are designed to relieve some of the dry, itching skin; face rash; and radiation burns associated with cancer treatments. Best of all, the products are all mostly free of the ingredients I mentioned to avoid above. LindiSkin products also include soothing and hydrating ingredients like green tea, witch hazel, and shea butter. They’re the best all-in-one inclusive set for cancer patients I have encountered on the market.

Avène Cicalfate Restorative Skin Cream ($19.00, Amazon.com)

It’s hard not to like Avène Cicalfate Restorative Skin Cream. For one, this ultralight cream contains 1% sucralfate, an ingredient that is shown to protect skin from burns following electron beam therapy (Acta Oncologica, 1994) as well as radiation therapy itself (Radiotherapy and Oncology, 2004). Other ingredients include zinc oxide, which provides a small, unquantified amount of sun protection in the product. I’m all for patients using this before and after chemotherapy and radiation treatments – I think it feels soothing and leaves the skin softer afterwards. Definitely a must-buy!
FutureDerm Organic 8 Set ($59.00 starting in November 2013; FutureDerm.com/Shop)

For all of the readers out there who write to me daily, concerned about toxicity and chemicals, I constantly tell them the science says there is nothing to be worried about. Still, the piles of letters persist (and, truth be told, keep growing). So we went to the benchtop and came up with three outstanding organic products: FutureDerm Organic 8 Cleanser, Organic 8 Toner, and Organic 8 Moisturizer. Each contains only 8 organic ingredients – no preservatives, no phthalates, no chemicals whatsoever. Just what you all told me you wanted. 🙂 Best of all, our in-house research shows that it improves skin tone and texture over time. If you’d ike to be emailed whenever it comes out, please email me at nicki[at]futurederm[dot]com. 🙂

Bottom Line

Cancer can be one of the hardest diseases to be diagnosed with in modern society, and my heart goes out to all of the cancer patients out there. My grandmother (who was my childhood best friend) passed away with breast cancer years ago, and I know firsthand that cancer affects more than just your health, it affects families, friends, and colleagues as well. But one thing it doesn’t have to take away is your self-esteem. Through the works of great organizations like the Image Recovery Center in Baltimore and Look Good, Feel Better nationwide in the U.S., cancer patients have the ability to look their best, even during harsh treatments. At home, I recommend skin care with great products like the Lindi Skin or Avène Cicalfate Restorative Skin Cream. If you ever have any specific questions, please feel free to email us; I am Nicki[at]futurederm[dot]com, and we have a number of experts on our team now who can also help to answer your questions. I wish you all of the best.

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