Skin Care

Let’s talk skincare: chemo can do all kinds of things for your skin from acne rashes, to Mohave-level dryness, to really strange discoloration, and terrifyingly increased sun sensitivity. The active ingredients in skincare can help with these issues or exacerbate them terribly. If you are thinking of using anything with an active ingredient you gotta run it past your medical oncologist and pharmacist. You don’t want to accidentally give yourself skin cancer by trying to treat your acne. These warnings were in my binder from the hospital and included who to speak with to make the safest decisions.

Chemo, especially paired with Herceptin, can give you what is called an ‘acne rash’. I thought this meant a rash with some pimples in it. But no, it left me looking like I’d been overdoing the meth for a good long while. Like, cautionary tale to scare you straight, level of bad. To pile on, I had chemotherapy in the winter in the Midwest which made my skin even worse because of the dry air. My skin looked so epically terrible after 2 weeks that I was worried that the rashes would get infected and my blood counts would tank and I’d end up in the hospital needing a transfusion because of a damn pimple. Could I ever live something like that down? I’m not sure it’s possible.

For the first time in my life, at over 40, I had to get a skin care routine. I’d been washing my face with hand soap and using free moisturizer samples up until now so I had absolutely no idea where to start. My first stop was the skincare reddit, which is 100% overwhelming – too much conflicting information and too hard to follow in my chemo fog. So I turned to YouTube videos. There were so many, just, so very many. Loads giving terrible advice about DIY hacks and insanely expensive recommendations. Then I found James Welsh, Skincare by Hyram, and Doctorly, who are cheerful, snarky and love inexpensive products and simple routines. It was a nice distraction, to be honest.

If you, unlike me, were already taking good care of your skin, you might need to change it up during treatment, especially if you’re into “clean beauty”. The essential oils and alternative preservatives are possible irritants on a good day, during chemo, they might cause you some serious issues. And if you are using active ingredients, check with your team. You want to be sure that any new irritations are from your chemo and not your skincare.

Active Ingredients and Interactions

Lots of skin care products promoted by influencers, especially the dermatologists, have active ingredients that go deep into your skin and do nice things for you above and beyond keeping you clean and preventing your skin from drying up – minimizing fine lines, getting rid of dark spots, clearing up acne and rosacea. Since these things actually sink into your skin, there is a risk of an interaction with one of your medications. There is also a risk that a side effect of a skin care product might exacerbate a side effect of your chemotherapy – like sun sensitivity. And even if they don’t, any skin care product can cause irritation. So, on top of drug interactions, you need to keep an eye out for irritants – the most common ones are fragrances and essential oils. This is going to rule out using most products marketed as “green” or “clean” – these also tend to have unusual and less effective preservatives, which can cause irritation and potentially the product going bad more quickly than one preserved with scientifically developed ingredients. And with your newly compromised immune system, you might not be able to tolerate this anymore… check with your medical team and patch test before and after starting treatment.

Basic Skincare Routine

Following the sound advice from YouTube, I had 4 steps:

cleanse
treat
moisturize
sunscreen

Cleanse

My routine started with a CeraVe face wash, which is pretty much what every dermatologist recommends. It’s boring but it is gentle, fragrance-free, reasonably priced, and gets you clean. I got the rest of my family to start using it and I will absolutely keep using it when treatment is over. No more hand soap for me. I

Treat

My oncologist and pharmacist said it was ok to use salicylic acid and retinol, but I opted to try without any actives at first. The Ordinary’s Peptide Serum + hyaluronic acid, which helped a bunch with how dry everything was. After trying a few other products, I was pretty happy with the La Roche-Posay Effaclar Adapalene Gel for keeping the acne under control.

To deal with the acne rash pimples, I used Mighty Patch from Hero Cosmetics; they were the only hydrocolloid pimple patches at Target that didn’t have active ingredients. They are magical and kinda gross since you can see how much goop is in a pimple, which is something I would not have minded to never know. But they work a treat to heal your pimple a lot faster and protect the pimple from the dirt and germs of the outside world when it’s at its worst. There are loads of pimple patches that have salicylic acid, niacinamide, and others which perform some overnight magic, but, some of those might not play well with your chemo.

Moisturize

Since I was sooooooo dry my first attempts with standard moisturizers were woefully insufficient. For that first winter, I used and the NIOD Hydration Vaccine and later the SkinFix Triple Peptide Barrier Cream. They were way too expensive but nothing else was helping and my skin hurt and was cracking, and I figured, if there was one time in life to buy an overly expensive but really helpful product, this was it.

Eventually even this wasn’t enough for how dry my skin got and I put straight Vaseline or Diprobase ointment on my face and eyelids at night.

Sunscreen

Wear it. Sunscreen is regulated as a drug in the US and your doctor is going to have suggestions and what you should be wearing. I’ll steer clear of making any product recommendations. If your doctor doesn’t have a preference, just know, there is a world of dedicated to folks opinion on sunscreens. If you want to learn more about sunscreens, Lab Muffin Beauty Science is funny and engaging with the right Ph.D. to be giving explanations and advice.

There are thousands of skin care options out there for you and I’ll admit, I found researching for them to be a nice distraction during the weeks when I was basically sleeping or bed bound. Unlike the makeup and wigs, I think I’ll keep this up when chemo is done.