UAB: Comprehensive Cancer Center

Cancer patients undergoing treatment often face nausea, fatigue, pain and other internal side effects. But one of the most common complications is out there for the whole world to see—skin reactions.

“The most prevalent skin complication occurring in cancer patients is hair loss,” says Craig Elmets, M.D., UAB Comprehensive Cancer Center senior scientist and chair of the Department of Dermatology. “But other problems are extremely common. These can be caused by the cancer itself if it metastasizes to the skin, or it can be due to the particular medication the patient is taking.”

UAB dermatologist Lauren Hughey, M.D., sees many cancer patients who are dealing with skin complications caused by their treatments. She says these conditions are the top three complaints:

--Miliaria, or heat rash, and folliculitis (inflammation of the hair follicles) are caused by lying in bed for prolonged periods of time and often affect the back.

--Intertrigo is a mix of yeast and bacteria occurring in moist areas of the body such as under the arms or groin.

--Xerosis, or dry skin characterized by redness and/or inflammation, is particularly common among patients undergoing radiation treatments.

Skin Solutions

The solutions for these skin problems are fairly simple. For heat rash, Dr. Hughey recommends exposing the back to air by taking breaks from lying down—walking around or sitting in a chair or on the edge of the bed. For intertrigo infections, antifungal powders or diaper-barrier ointments can help dry up excess moisture and keep away yeast.

For dry skin, patients have several treatment options, though there are common misperceptions about what works and what does not. Dermatologists recommend the following:

--Provide adequate moisturization for the skin. Drs. Elmets and Hughey suggest using moisturizing creams and ointments on the skin, but not lotions. “Lotions have alcohol and evaporate into the air faster than they are absorbed into the skin,” Dr. Hughey says. Dr. Elmets adds, “Most people use lotions because they’re easy to put on, but they’re actually the least effective solution.”

--Limit the amount of soap used during bathing; less soap is better. “People don’t need to use soap all over their bodies every single day,” Dr. Elmets says. “Two or three times a week is helpful.” Bar soap tends to be better than gels because, like lotions, gels evaporate and take moisture out of the skin. Dr. Elmets also suggests that patients with scalp problems use mild shampoos.

--Reduce the temperature of water used for bathing from hot to lukewarm. Dr. Hughey recommends that patients pat, not rub, their skin to dry it, and apply moisturizing creams within three minutes of showering.

Lasting Impact

A common long-term effect associated with cancer treatment is the development of non-melanoma skin cancers. “There is evidence that some treatments for certain cancer types will suppress the immune system,” Dr. Elmets says. “Because of that, we see skin cancers develop in some patients.”

Dr. Elmets recommends that cancer patients routinely use sunscreens—the higher the SPF, the better. “Most skin cancers are caused by UVB rays, but UVA rays contribute as well,” he says. “The higher-SPF sunscreens block both types of rays.”

Becoming aware of the potential skin problems caused by cancer therapies is a key first step in treating them, Dr. Elmets adds. “There’s really no way to prevent these skin complications,” he says. “The most important thing is to recognize when there is a problem and establish the diagnosis. That means going to a dermatologist for prompt treatment.”

UAB Skin Cancer Clinic

The Kirklin Clinic, 3rd and 4th Floors

(205) 996-SKIN (7546)