Skin and nail changes from cancer treatment

Some cancer treatments may affect your skin. Their condition and appearance may change, depending on the drug or treatment you are having. Tell your doctor or nurse about any skin changes.

Your cancer team may give you advice on looking after your skin. They may tell you if there are products you should use or avoid. It is very important to follow their advice

Different cancer drug treatments can make your skin more sensitive to sunlight. Radiotherapy makes the skin in the treated area much more sensitive to the sun.

Certain drugs may make the palms of your hands or the soles of your feet red and sore (palmar-plantar syndrome). If this happens your specialist doctor or nurse will give you advice on how to care for your skin. Depending on how severe it is they may reduce the dose of the drug.

Hormonal therapy drugs can affect your skin, nails and hair. But the effects are usually mild. Hormonal therapies may cause dry skin and rashes. Rarely, they may also cause spots.

Some people have medicines called steroids as part of their treatment. Steroids can make your skin more likely to get spots and change colour in some areas.

Chemotherapy, targeted and immunotherapies, hormonal therapies or steroids can cause rashes, dry skin or spots that look like acne. If you are having immunotherapy treatment and you get a rash, tell your doctor straight away. Targeted therapies and immunotherapies can also make your skin itchy and more sensitive.

Radiotherapy can affect the skin colour in the treated area or cause broken veins to appear later. Your skin may become red, sore or itchy. If you have black or brown skin, it may become darker than surrounding skin. The person giving you your radiotherapy will tell you how to care for your skin during and after your treatment. It is important to follow their advice

We have advice for looking after your skin and nails if it has been affected by cancer treatment.

Rarely, some cancer drug treatments can cause a serious skin reaction that needs to be treated immediately in hospital. Contact the hospital straight away on the 24-hour number if you have any of these symptoms:

• a skin rash that is spreading
• blistering or peeling skin
• flu-like symptoms, such as a high temperature and joint pain sores on your lips or in your mouth.

Changes to your skin are usually temporary and improve when treatment ends.

You might find that learning a few new make-up tips gives you more confidence while going through treatment.  If you have had a skin reaction check with your cancer care team first before using any products. 

As your treatment goes on, you may notice changes in your skin tone or in the brightness of your complexion.

Using foundation

The following tips may help:

• If you wear foundation, you may need to change from your usual shade.
• If your skin appears duller or drier than usual, choosing a foundation with a dewy finish (moist looking) will brighten your complexion naturally.
• When finding the right shade of foundation, choose a base colour that is not visible at your jawline.
• Tinted moisturiser can work well if you are not used to wearing a lot of make-up, or if you prefer not to. Even a sheer or light foundation will help to even out your skin tone.

Applying a bronzer

If you are feeling paler than usual, or feel that your complexion lacks your usual warmth, bronzer is a great way of adding this back in:

• Using a powder brush, apply bronzer lightly to your forehead, cheekbones and down the middle of your nose. This adds a natural wash of colour to the face.
• Start by adding a small amount and gently build this up in thin layers until the desired colour is achieved. Blend in circular motions until there are no obvious lines.

You could ask a No7 Boots Macmillan Beauty Advisor in your local store about other make-up options to improve your skin tone.

Using a concealer

You can use a concealer under and over foundation, or on its own. It can hide dark circles under your eyes or other blemishes, such as marks or dark spots. It is helpful if you need a quick cover-up.

Using cosmetics with more pigment can help reduce the appearance of dark spots, particularly for black or brown skin tones.

A green-tinted primer can help tone down rosy skin and even out the colour on your cheeks, nose and chin. But try to use these products sparingly. When you put on the primer, pat it gently on to your skin. Rubbing your skin can make the redness worse.

If you have flushed skin, try a medium to full coverage foundation with sun protection. Make sure the foundation matches the areas of your face that are less red. Pat the foundation over the primer to avoid disturbing it.

You could ask a No7 Boots Macmillan Beauty Advisor in your local store about using foundation, concealer or toning down flushed skin.

Look Good Feel Better (LGFB) runs free workshops for people coping with cancer treatment. It has trained volunteer beauty professionals who offer practical advice and support. Workshops are available in over 80 hospitals and specialist cancer centres across the UK. Ask your cancer doctor or specialist nurse for a referral.

Some cancer drugs, especially chemotherapy, can raise your risk of getting an infection. Keep your make-up routine as clean as possible with the following tips:

• Wash your hands before applying creams or make-up.
• Do not share towels or flannels with other people.
• Check expiry dates on make-up.
• Do not share make-up brushes, sponges or any other applicators with anyone else.
• If you use mascara, avoid pumping the wand into the tube. This reduces the risk of introducing bacteria.
• Take eye make-up off using a new cotton pad for each eye to avoid spreading any possible infection.
• Clean your make-up brushes or sponges at least once a week, or use disposable sponges.
• Put the tops or lids back on any tubes or jars when you have finished using them.
• Look for the ‘period after opening’ symbol on your cream-based products. For example, you may see a small symbol of a container with 24m written inside it. That means once opened, this product is good for 24 months. After that, you should throw it away.

Cancer drug treatments can affect your nails. They may grow more slowly or break more easily. You might notice ridges or white or dark lines across your nails. Sometimes nails can become loose or fall out. When treatment finishes, any changes usually disappear as the nails grow out.

There are different ways to help care for your fingernails and toenails:

• Wear protective gloves when doing household tasks or gardening. This protects your nails and skin from detergents, chemicals and injury. It also protects your hands from too much exposure to water, which may cause fungal infections of the nail bed.
• Keep your hands and nails clean to help prevent infection, but avoid using very hot water.
• Wear comfortable shoes and cotton socks. Avoid anything that is tight-fitting or rubs against your toes.
• Clip your fingernails and toenails to keep them short. This makes nail changes less noticeable. Do not use scissors.
• Moisturise regularly using a hand, foot and nail cream. Try using a nail-strengthening cream.
• Massage a cuticle cream into your cuticles to help prevent dryness, splitting and hangnails. Do not cut your cuticles.
• Use an emery board to keep your nails short and smooth, and to avoid snagging.
• When filing your nails, only move the emery board in 1 direction across the nail. This stops your nails splitting further. Do not move the board backwards and forwards.

During some types of cancer treatment, it is best to avoid going for manicures or pedicures. This is to avoid the risk of infection as some cancer treatments can weaken your immune system.

Wearing nail varnish is good way to disguise nail changes. But if your nails are split, sore or damaged, do not use nail varnish or false nails.

Here are some tips for wearing nail polish:

• Try water-based polishes, which contain fewer harsh chemicals.
• Use dark nail polishes to help disguise discoloured nails.
• When taking off the polish, avoid using nail polish remover containing acetone.
• Talk to your cancer team about having false nails, gels or other acrylics during treatment, because they may increase the risk of infection.

Tell your cancer doctor or specialist nurse if you notice changes to your nails. They can give you advice or arrange for you to go to a foot care specialist (podiatrist) for advice if needed.