As we age, we see the signs of time, such as wrinkles, puffiness, loss of muscle tone, dehydration, dry skin, hyperpigmentation, and volume loss. People who have or have had cancer often see this process occur at a younger age, due to chemotherapy and the drugs used in hormone therapy.
In this article, we will elaborate on the two main agents in the treatment of cancer: chemotherapy and hormonal therapy we will also see the impact of these on the skin, but also what to do and what to use to improve skin health.
Chemotherapy is a type of cancer treatment that uses drugs to destroy cancer cells. These drugs can also affect any healthy, fast-growing cells. So it’s not surprising that many people feel like they age considerably during chemotherapy.
During treatment, the epidermis loses its ability to retain moisture, resulting in fine lines on the skin’s surface. In the dermis, collagen, and elastin break down, weakening the skin’s support structure. At the same time, the subcutaneous tissue begins to disappear, especially if the client has nutritional deficiencies, which frequently occur with aggressive chemotherapy.
Clients should be encouraged to drink water, as the enzymatic functions of the skin are dependent on water intake. Alcohol, coffee, and other factors that cause chemical and physical dehydration should be reduced. Any fat-free diet is a major problem, as it can lead to a deficiency of essential fatty acids, which compromises the health of the keratinocyte cell membrane due to the low lipid content of the epidermis.
Regardless of skin type, chemotherapy tends to make the skin drier because some drugs can interfere with the sebaceous and sweat glands. It is therefore important to keep the skin well moisturized and hydrated during treatment. Skin care during chemotherapy should focus on soothing, moisturizing, and strengthening the skin barrier.
Frequent application of moisturizers with healthy, non-irritating ingredients can prevent excessive dryness and itching of the skin. Be very careful about what is applied to the skin of an immunocompromised person, as they are more susceptible to developing infections. Pay attention to dry lips, as many medications can also cause dry mouth. In addition to moisturizing the skin, it is advisable to use care with an aesthetician and at home that strengthens the skin barrier to promote moisture retention, here are some examples:
- Use a cleanser rich in emollient oils (Organic Swipe biphasic cleanser)
- Exfoliate the skin with a gentle exfoliator or an ultrasonic device (B-Box Ultra-Derma)
- Use an essence instead of a toner, as it contains more active ingredients (Total PH Essence)
- Use a serum that promotes the health of the microbiota to maintain a healthy and effective skin flora (Sérum Bio Prébio-Boost)
- For the eye contour, use a product containing hyaluronic acid (Ha+ÔL Organic Eye Contour Cream)
- For the treatment cream, make sure it contains softening, soothing, and moisturizing active ingredients (Émulsion Bio Kalm)
- Apply moisturizing sheet masks twice a week. (Hydra Velvet Mask)
It is imperative that the client undergoing chemotherapy never uses products or undergoes aggressive aesthetic procedures. This client should also use an effective mineral sunscreen (Tizo3 and Tizo Liptech), as the skin can be sensitive during chemotherapy and more prone to burns. Chemotherapy drugs that cause a photosensitive reaction may include 5-fluorouracil (5-FU, Efudex, Carac, Fluoroplex), vinblastine (Velban, Velsar), and dacarbazine (DTIC-Dome).
Once the client has completed chemotherapy and the skin begins to recover to its normal state, it will then be possible to begin incorporating more intense anti-aging actives such as retinoids. Estheticians can then begin working with products containing antioxidants and/or exfoliants once the client has recovered. Ingredients such as topical retinoids, L-ascorbic acid, alpha hydroxy acids, polypeptides, and various plant extracts can be used to rejuvenate and restore the skin. Estheticians need to be familiar with these ingredients and know how and when to use them effectively.
Hormone therapy medications are given for breast, prostate, endometrial, and adrenal cancers. These clients have an excessive amount of hormones in their bodies, and these hormones are the cause of their cancer. The goal of these drugs is to inhibit the synthesis of the hormone and/or to prevent the hormone from binding to the corresponding receptor on the surface of the cancer cells.
Hormones are chemical messengers that have specific effects on certain cells in the body. Hormones, which are produced by the endocrine glands, are released into the bloodstream where they are transported to all parts of the body. But they only affect cells that have specific receptors for that particular hormone. Hormones can only have an effect if they can bind to a receptor. If they cannot bind to a receptor, they will have no effect, no matter how high the hormone levels are. The skin contains receptors for several types of hormones, but this article focuses on estrogen.
The beneficial effects of estrogen on the skin include increasing the rate of cell turnover in the basal layer of the epidermis. It reduces the size and activity of the sebaceous glands, keeps sebaceous secretion fine and less oily, and increases the action of the enzyme hyaluronidase, which produces hyaluronic acid and keeps the skin metabolically active. Hyaluronic acid gives the skin its ability to resist stretching and keeps the skin firm and moist, giving the skin a smooth feel. Estrogen may also accelerate skin wound healing, improve inflammatory skin disorders, and provide some protection against photoaging of the skin and some mortality from skin cancers, both melanoma, and non-melanoma.
Estrogen deficiency in women causes the skin to look dull, thin, and finely wrinkled, with some loss of tone. A lack of estrogen also leads to a reduction in the action of the enzyme hyaluronidase. Low levels of dermal glycosaminoglycans (hyaluronic acid makes up a large percentage of these substances) mean that the skin becomes thinner and loses its supple texture. The skin may remain soft to the touch but may appear less smooth. There is also a decrease in the reflection of light off the skin, making the surface look dull and dry. In the absence of estrogen, the skin may age more rapidly.
Some hormone therapy medications can induce menopause, which then triggers a sudden onset of skin aging a few months after the onset of menopausal symptoms. Menopause causes hypo-estrogenism, which accelerates age-related deterioration and leads to thinning of the skin, an increase in the number and depth of wrinkles, increased skin dryness, and a decrease in skin firmness and elasticity.
How to take care of your skin without the support of estrogen:
It is necessary to use gentle cleansers and soothing products without synthetic fragrances or other irritating ingredients. The client should moisturize her skin at all times and avoid activities that may aggravate dryness (sauna, jacuzzi, swimming pool).
A report published in the Journal of Clinical Oncology warns that anti-aging skin creams often contain estrogen. 40% of the creams tested contained what the researchers call significant amounts (up to 0.61%) of estriol or estrone, two potent forms of estrogen. Estrogen helps the skin retain water and can improve skin tone in a limited way, but at what risk to the client? Clients with a history of breast cancer or who are undergoing treatment for breast cancer should be particularly concerned about any product that may increase estrogen levels in the bloodstream through commercially available topical moisturizers. Endocrine disruptor-free formulas should be preferred. At B-box Beauty, our complete B-Box Bio line is free of synthetic fragrances and endocrine disruptors
Whether you are undergoing cancer treatment or in remission, it is important to stay well hydrated by drinking water or beverages with electrolytes, to adapt your diet to foods or beverages rich in proteins, and to use healthy skin care products without endocrine disruptors and well-adapted to your skin condition. A good and competent esthetician will be able to guide you in this process.