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Oncology Skincare: The Basics

by Sarah Buonocore

Years ago, before the world shut down and after some long-winded health events of my own, I became certified in Oncology Skincare. Unfortunately, there is an ever-growing need for information and care outside the brick hospital walls, where those going through treatment can learn how to navigate skin challenges in a relaxed and peaceful setting.

The pandemic put a long pause on Oncology Skincare in the treatment room, but I am now seeing a steady increase of clients receiving cancer therapy returning, eager to learn how to care for their skin, along with receiving much-needed self-care and relaxation.

My approach to oncology skincare is similar to regular skincare. I start by fortifying and protecting the skin at all costs, especially if my client is in the midst of treatment. Proper education during this time is paramount, so we build a solid foundation.

A Basic Lesson in Skin Anatomy and Physiology

Let's start with a few facts:

  • The skin is our largest organ, covering the entire body.

  • An adult's skin weighs roughly 20 pounds.

  • It has two major layers: the dermis and epidermis.

  • The dermis is the basement layer providing structure and containing connective tissue.

  • The epidermis is the top layer, only 2-3mm thick, where a skin cell's entire life cycle takes place.

  • The skin is our first line of defense with functions including protection, sensory, heat regulation, vitamin D synthesis, preventing dehydration, waterproofing, and eliminating waste.

Next, let's cover the most common epidermal skin cells. Understanding these will help identify when they're affected by cancer therapy.

Keratinocytes: The basic building blocks making up 80% of the epidermis. If your skin feels rough or the texture is off, it can signify these cells aren't shedding properly, which often happens during cancer therapy. The best way to manage this is with mild exfoliator such as the hydrating clay mask on the face, or by using a gentle washcloth and warm (not hot) water on the body. Abrasive scrubs, loofahs, and brushes aren't ideal as they can scrape and harm delicate skin.

Melanocytes: These provide our skin's pigment, enabling tanning. When keratinocytes are threatened (e.g. by too much sun), melanocytes inject them with pigment to protect their DNA, resulting in a tan. When damaged, melanocytes can leak or overproduce pigment. Skin darkening is common during certain treatments, especially radiation, as the melanocytes are overly stimulated. With proper sun care and fortifying topical vitamins, like mela even cream, your skin should return to normal over time. Remember, pigment cells sit at the bottom of the skin, so pigmentation can take months to correct. Be patient, kind, and consistent to your skin with homecare.

Langerhans Cells: Part of the skin's immune function, patrolling for invading bacteria. If invaders are detected, they signal the body to attack. If compromised, your skin is vulnerable to infection, which may present as redness, inflammation, and itchiness.

Using healing topicals like colostrum and antiox gel, will help boost the skins immune function, calm the inflammation, and reduce the redness.

Barrier Function AKA Acid Mantle: This protective layer on top of our skin (like cling wrap) is most affected by cancer therapy, causing unpleasant side effects. Its main roles are protection and maintaining skin homeostasis. Slightly acidic, it can kill bacteria, protecting us from contaminants. It also regulates water content, keeping out excess while retaining enough to prevent dehydration. Without it, our skin becomes sensitive, dry, and inflamed. The acid mantle can be compromised by cancer therapies. Our goal is keeping this layer intact; if damaged, we fortify and mimic this vital protective layer with a gentle plant based vitamin A serum (AVST gel) along with an occlusive moisturizer like super-moisturizer.

 In Summary:

  • If therapy is making your skin feel rough, mild shower exfoliation on the body and hydrating clay mask on the face will help.

  • You may notice darkening skin in treatment areas from compromised melanocytes. Using mela even cream regularly can help fade this quickly.

  • If areas are extremely sensitive, red, inflamed, or itchy, your skin's immune function may be compromised. Healing topicals like colostrum and antiox gel can strengthen defense and reduce inflammation.

  • Extremely dry, flaky skin is a common side effect. Regularly using a high-powered vitamin enriched serum like AVST gel layered under an occlusive application of super-moisturizer can help restore the barrier function and acid mantle, returning your skin to homeostasis.

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