Q: I have a client who just started chemotherapy. Are there special issues I should keep in mind when I treat her skin?

A: Absolutely. Dr. Christine Rodgers, a Denver cosmetic surgeon who works with cancer patients, says: “Women going through chemotherapy definitely have more sensitive, drier skin. Skin turnover is more rapid—that’s what chemotherapy does.” A lot of chemotherapy or drugs like tamoxifen (prescribed to help prevent breast-cancer recurrence) throw a woman into menopause, creating hormonal imbalances that also affect skin.

With chemotherapy, women can get hyperpigmentation, itchy skin, and sebaceous hyperplasia, which are acne cysts that don’t rise to the skin surface.

“Because the skin is so sensitive, you need to treat it with great care,” Rodgers says. “Watch what products you use. Everybody’s skin is different, so mix and match products depending on where your client is. I like products with vitamins A and C, which are natural brighteners, good for patients whose skin gets dull and flaky. Avoid hydroquinone and heavy peels, like glycolic acid. Moisturizer and sun protection are mandatory.”

With chemotherapy or radiation treatment, skin becomes very sun sensitive. A product with an SPF of 15 is wonderful; 30 is better. A foundation with an SPF of 15 is not enough; sunscreen is needed, too.

“The key things are hydrating, gentle products, and sunscreen,” says Teresa Lopuchin, a Philadelphia esthetician. “Advise clients to avoid soap. Instead use a cleanser for the face, and a moisturizing bath or shower gel for the body, then moisturize.”

Lopuchin advises skin care therapists to keep in mind some women become sensitive to fragrance, so use unscented or lightly scented products. “Also, because of the dryness, avoid astringents, anything with alcohol in it, and opt for a freshener or toner instead,” she says. “Use slower movements, and do everything gently.”

What to Avoid

Therapists should stay away from alpha or beta hydroxyl peels or glycolic acid, and retinols. If a patient’s dermatologist wants her to continue with a prescribed product, that’s fine. But if she hasn’t used any of those products before, now is not a good time to start.

“Because patients are prone to hyperpigmentation, don’t exfoliate,” Lopuchin says. “Two things can happen—skin can get better—or worse. You don’t know how her skin will react.”

Also, lips and cuticles get dry, so clients need a lip-hydration product and a cuticle cream. But don’t cut cuticles, since that can cause infection and the body’s ability to fight infection is already impaired. As for salon manicures, some practitioners suggest clients bring their own tools for the added peace of mind that everything is sanitary.