Skin Treatments for Oncology Patients

Skin Treatments for Oncology Patients

Cancer treatments such as chemotherapy, radiation therapy, and immunotherapy play a critical role in saving lives, but they can often lead to significant side effects, including profound changes to the skin. These treatments disrupt cellular turnover, damage the skin barrier, and alter lymphatic flow, resulting in issues such as extreme dryness, heightened sensitivity, inflammation, radiation dermatitis, and lymphedema. Additionally, oncology patients are at an increased risk of infections, making appropriate skincare and skin management essential, not only for comfort, but also for overall health. 

The psychological impact of skin concerns in oncology patients should not be underestimated. Visible skin changes can affect self-esteem and mental well-being during an already challenging time. Therefore, providing compassionate and effective care is essential. 

To help offer treatment recommendations for these patients, I have put together a guide that is designed to support clinicians, nurses, dermal therapists, and beauty professionals in offering evidence-based, non-invasive treatments and personalised skincare protocols. The guide covers common skin concerns encountered in oncology patients, practical treatment protocols using LED therapy, manual lymphatic drainage (MLD), and safe skincare products. It also highlights the importance of patient education and collaboration with other healthcare providers to ensure holistic care. 


Common Skin Concerns in Oncology Patients

Cancer treatments often create a ripple effect throughout the body, and the skin is one of the most visibly affected areas. Being our largest organ, the skin serves as a protective barrier and is crucial for regulating moisture, temperature, and immune defence. However, the physiological stress of cancer therapies, combined with the body’s altered immune and hormonal responses, can significantly impair the skin’s ability to function optimally. 

Oncology patients frequently experience skin-related side effects that range from mild discomfort to severe complications. These changes not only impact their physical comfort but can also affect their self-esteem and emotional well-being. Understanding the underlying causes of these issues is key to developing effective, compassionate treatment plans. Below are some of the most common skin concerns faced by oncology patients and the mechanisms behind them: 

  1. Dryness and Dehydration: Systemic cancer treatments such as chemotherapy often disrupt the skin’s moisture balance. These treatments can impair the sebaceous glands and reduce the skin’s natural lipid production, leaving it dry, flaky, and prone to irritation.

  2. Inflammation and Sensitivity: Cancer therapies weaken the skin barrier, making it more susceptible to external irritants and environmental aggressors. This compromised state can lead to heightened sensitivity, redness, and chronic inflammation, which further exacerbate discomfort.

  3. Radiation Dermatitis: Patients undergoing radiation therapy often develop radiation dermatitis, a condition marked by erythema (redness), peeling, and in severe cases, burns. The intensity of this condition depends on the treatment area, dose, and duration, with symptoms sometimes persisting long after therapy concludes.

  4. Lymphedema and Fluid Retention: Surgeries and radiation treatments that affect the lymphatic system can lead to lymphedema, a buildup of fluid that causes swelling, particularly in the limbs. This condition not only affects mobility but can also compromise skin integrity, increasing the risk of infection and other complications. 

Evidence-Based Treatment Protocols

1. LED Light Therapy

Indications: Inflammation, barrier repair, wound healing.

Mechanism:

  • Red Light: Enhances collagen synthesis and reduces inflammation.

  • Blue Light: Targets bacteria and minimises infection risks.

Protocol:

  • Frequency: 2–3 sessions per week.

  • Duration: 10–20 minutes per session.

  • Contraindications: Avoid with open wounds or photosensitivity.

 

Expected Outcomes: Reduced redness, improved tissue repair, and enhanced patient comfort.

2. Manual Lymphatic Drainage (MLD)

Lymphatic health is critical for maintaining fluid balance, supporting immune function, and removing waste from the body. However, oncology treatments such as surgery and radiation therapy can significantly disrupt lymphatic pathways, leading to conditions like lymphedema—an accumulation of lymphatic fluid that causes swelling and discomfort. This is particularly common in patients who have undergone lymph node removal or radiation near lymphatic structures. 

Manual Lymphatic Drainage (MLD) is a specialised, non-invasive massage technique designed to stimulate the lymphatic system, promoting fluid drainage and reducing swelling. Unlike traditional massage, MLD focuses on gentle, rhythmic movements that encourage the flow of lymph toward functioning lymph nodes. It is especially beneficial for oncology patients dealing with lymphedema, as it provides both physical and emotional relief. MLD not only helps reduce physical symptoms but also fosters a sense of relaxation and well-being, which can be vital for patients coping with the stress of cancer treatments. Below are the key indications, mechanisms, and protocols for effectively incorporating MLD into oncology care. 

Indications: Suitable for managing lymphedema, swelling, and fluid retention commonly associated with surgery or radiation therapy. 

Mechanism:

  • Stimulates lymphatic flow, helping to clear excess fluid and reduce oedema.

  • Enhances circulation, improving tissue oxygenation and waste removal. 

Protocol:

  • Technique: Gentle, rhythmic pressure applied along lymphatic pathways, customised to the patient’s anatomy and condition.

  • Duration: Sessions typically last 20–30 minutes, allowing sufficient time to stimulate drainage without causing fatigue or discomfort.

  • Frequency: Often performed weekly, or as needed, depending on the severity of lymphedema or fluid retention.

  • Contraindications: Should be avoided in cases of active infection, untreated malignancy, or other medical contraindications. 

Expected Outcomes

  • Reduced swelling and fluid retention. 
  • Improved lymphatic function and circulation. 
  • Enhanced relaxation, helping to alleviate physical and emotional stress. 

By incorporating MLD into the treatment plan, practitioners can offer oncology patients relief from the physical discomfort of lymphedema while contributing to their overall recovery and wellbeing.


Why Skincare for Oncology Patients is Important

Cancer treatments such as chemotherapy, radiation therapy, and immunotherapy can have a profound impact on the skin. These treatments often disrupt normal skin function, impair the skin’s barrier, and reduce its ability to protect against environmental aggressors. This makes skincare an essential component of oncology care—not just for aesthetic purposes but as a vital aspect of health, comfort, and quality of life.

Indications: Dryness, irritation, and a weakened skin barrier.

Recommended Products:

  • Cleanser: Sulphate-free, fragrance-free, pH-balanced.

  • Hydrating Serum: Hyaluronic acid-based.

  • Barrier Cream: Contains ceramides and niacinamide for repair.

  • Sunscreen: Mineral-based SPF with zinc oxide or titanium dioxide.

Protocol:

  • Morning: Cleanse → Hydrating serum → Barrier cream → Sunscreen.

  • Evening: Cleanse → Hydrating serum → Barrier cream.

  • Avoid: Alcohol-based products, harsh exfoliants, and synthetic fragrances.

Expected Outcomes: Improved hydration, strengthened barrier, and reduced irritation.


What is Radiation Dermatitis?

Radiation dermatitis is a common side effect of radiation therapy, which is used to treat various cancers. This condition occurs when the skin in the treatment area reacts to the high-energy radiation designed to destroy cancer cells. While radiation is targeted, it can also affect healthy skin cells in the process, leading to inflammation, damage, and visible changes in the skin. Radiation dermatitis can range in severity from mild redness to severe burns, depending on the dose, frequency of treatment, and the patient’s individual skin sensitivity. 


Management of Radiation Dermatitis

Indications: Erythema, peeling, and burns from radiation.

Protocol:

  • Cooling Compresses: Sterile water compresses to reduce inflammation.
  • Hydrogel Dressings: Provide moisture and protect damaged areas.
  • Barrier Ointments: Non-petroleum-based and fragrance-free.
  • LED Therapy: Introduced after skin stabilizes to aid repair.
  • Clothing: Loose, breathable fabrics to minimize irritation.

Expected Outcomes: Reduced erythema, protection from infection, and enhanced healing.

Additional Considerations

  1. Patch Testing: Always patch-test new products before full application.

  2. Infection Risk: Maintain proper hygiene and use sterile tools during treatments.

  3. Patient Education: Teach patients to maintain a simplified, gentle skincare routine.

  4. Referral: Severe cases (e.g., advanced radiation burns) may require specialist care.

Recommended Equipment and Tools

  • LED Devices: Medical-grade devices with adjustable settings.

  • MLD Techniques: Performed by oncology-certified practitioners.

  • Hydrogel Dressings: Ideal for burns and peeling areas.

  • Skincare Products: Oncology-safe, free of synthetic irritants.

Always educate your patient with important tips that are simple and easy to follow.

  • Use lukewarm water and gentle, non-abrasive cleansers.
  • Apply skincare with clean hands to prevent infection.
  • Monitor for signs of complications such as redness, warmth, or discharge.
  • Seek professional advice for persistent or worsening symptoms.

Expected Outcomes

  • Improved hydration and overall skin comfort.
  • Reduced redness, inflammation, and swelling.
  • Enhanced lymphatic flow and relaxation.
  • Effective protection and recovery for radiation-damaged skin.

In Conclusion

Oncology patients face unique skin challenges due to the effects of cancer treatments such as chemotherapy, radiation therapy, and immunotherapy. These challenges, ranging from dryness and inflammation to radiation dermatitis and lymphedema, require careful, individualised care to ensure both skin health and overall wellbeing. By employing non-invasive treatments such as LED therapy and manual lymphatic drainage, coupled with oncology-safe skincare regimens, clinicians can provide significant relief and improve the quality of life for these patients.

Beyond the physical benefits, addressing skin health in oncology patients has profound emotional and psychological impacts. By helping patients feel more comfortable in their skin and mitigating visible treatment side effects, we can support their confidence and mental wellbeing during their difficult journey. This guide equips professionals with the tools and knowledge to deliver thoughtful, evidence-based care that meets the unique needs of this population. 

I have written a course for this subject for the Skin Success Community. If you would like further information on SSC, click here: www.skinsuccesscommunity.com

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