It is common for cancer-related treatments to compromise the quality of our hair, skin, and nails. Taking steps to improve their condition and appearance makes us look healthier and can help us feel more vibrant and confident. Here’s what you need to know about cancer-related damage and how to heal, one step at a time.
What causes cancer-related damage?
There are a few reasons hair, skin, and nails can get damaged from cancer treatment.
According to the American Cancer Society, many cancer treatments—including chemotherapy, targeted therapy, radiation therapy, and stem cell transplants—work by killing any rapidly-dividing cells in the body (like cancer cells). Unfortunately, this means normal cells that regenerate quickly, like hair follicles, skin cells, and nails may also be affected.
Some chemotherapies attack specific proteins, which tumors need to form blood supplies. But this can affect our hands and feet, which also rely on small blood vessels.
Many hormone suppression therapies slow or stop the growth of hormone-sensitive tumors by blocking our body’s ability to produce hormones like estrogen or progesterone. But suppressing them can cause hair thinning, dry skin, and vaginal dryness because these hormones help our bodies produce collagen and oils.
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Hair Changes During Cancer
Hair loss and changes are often some of the most distressing side effects for people undergoing chemotherapy treatment and other anticancer therapies. It’s one of the most well-known effects of cancer treatment, and is related to how a chemotherapy drug will attack rapidly growing cells with the intention of eliminating cancer. As hair cells also fall under the umbrella of rapid growth, treatment also affects them.
Some of the common hair changes during cancer include:
- Hair loss on scalp
- Hair loss on the face (eyelashes, eyebrows, etc.)
- Loss of body and pubic hair
- Thinning hair
- Graying of hair or other hair color changes
- Dry hair
- Changes in hair texture (straight hair becomes curly; known as “chemo curls”)
- Weak or brittle hair
Many people experience short-term hair loss or thinning as a result of treatment. However, there are also those who experience long-term changes. Talk to your healthcare professional about how your specific treatment could impact your future hair growth.
Managing hair changes during cancer
There’s nothing you can do to prevent chemotherapy-induced hair loss if your body responds that way. However, you can nourish your hair and scalp to encourage future hair growth and offset hair-thinning.
Minimize stress on your scalp and hair
Start by minimizing stress on your hair by reducing the use of hot tools like hair dryers, flat irons, and curling irons. It’s also best to avoid hair dye and bleach during this time.
Protect your scalp with an SPF sunscreen and head coverings as you venture out into the sun. This newly exposed skin will be more sensitive to the sun’s harmful rays. Additionally, one of the common side effects of some treatments is photosensitivity, which makes it easier to get a sunburn. Head coverings can also keep your head warm while you sleep during the colder months.
Use gentle hair products
Switch to a mild shampoo or baby shampoo and conditioner. Use a mild conditioner or massage oil to nourish your scalp to promote hair regrowth. Show your scalp some extra love with a gentle massage to increase the blood flow to your hair follicles. Use a soft brush and brush your hair from the ends to the roots to prevent pulling.
Consider a scalp cooling system
You can talk to your treatment team about using a scalp cooling system during chemo treatment. Scalp cooling introduces a liquid coolant through a cap and is meant to offset chemotherapy-induced alopecia. However, there are concerns that scalp cooling minimizes the effects of treatment in that area. It’s important to have this conversation with the treatment team before making a decision.
Shaving your head
Shaving your head is a personal decision. Some people find that this experience helps them take control. Depending on the severity of hair loss, others prefer to try short hair instead.
What to ask your cancer care team about cancer-related hair changes
Your cancer care team can tell you about your treatment plan and the likelihood of hair loss. You can also ask about permanent hair loss in relation to your treatment. They can also provide hair care tips and products to help during treatment and in the months after chemotherapy.
Read our full article on navigating cancer hair loss here.
Skin Changes During Cancer
It’s common to experience many skin changes during cancer, primarily in relation to treatment. These effects could immediately follow a dose of radiation or chemotherapy or could continue as the body recovers.
Here are some of the most common skin changes during cancer:
- Burns from radiation treatment and other radiation-induced skin reactions (i.e., acute skin toxicity)
- Oral ulcers from chemotherapy
- Vaginal dryness
- Blisters or sores on palms, knuckles or soles of your feet
- Dry, itchy skin
- Sensitivity to commercial skin products
- Dull-looking skin
- Skin irritation or rashes
- Sensitivity to hot water
- Skin thickening (common in patients with breast cancer and after stem cell transplants)
The effects of radiation therapy, chemotherapy, and other types of cancer treatment look different in everyone. Do not be alarmed if the effects you experience are different from others.
Managing skin changes during cancer
The best way to manage skin changes during cancer and offset the long-term skin changes after chemotherapy is to be gentle with yourself. Use natural skin products designed for sensitive skin: mild soap, unscented laundry detergent, etc. You can use coconut oil for radiation burns and to help nourish the skin when experiencing the effects of radiation therapy.
Use warm water rather than hot water after treatment and choose non-abrasive materials. Loose, cotton clothing and microfiber towels can give your skin space to breathe without irritating acute skin reactions after treatment. Try to keep areas with broken skin dry to let new, healthy cells grow and help you heal.
What to ask your cancer care team about cancer-related skin changes
If you have any concerns about your skin, bring them to your cancer care team. This is especially important when experiencing acute skin reactions after treatment. It’s incredibly important to talk to your cancer care team if you experience broken skin in the form of blisters or ulcers, as these can become infected.
Nail Changes During Cancer
Like the hair and skin, nails also react to chemotherapy drugs and other forms of treatment. Here are is some of the common cancer-related damage to look for in your nails.
- Weak, dry, brittle nails
- Nail loss
- Nails that split, lift off or develop ridges
- Swollen, red and painful sores around nail beds
- Beau’s lines (white lines or ridges)
- Spoon nails (Koilonychia)
- Increased risk of infection around nails
The effects of chemotherapy and other cancer treatments impact everyone differently. You could experience nail loss or just textural changes, sending on your type of treatment and unique physical makeup.
Managing nail changes during cancer
When trying to determine how to save your nails during chemo, follow the same habits as you do for hair and skin protection. Avoid using chemical-ridden products, opting for chemical-free nail polish instead. Use nourishment, such as coconut oil or olive oils, to rejuvenate your nails and promote nail growth. You can also find a hydrating nail solution to improve nail strength.
You may want to try fake nails to help you feel better during treatment. However, some types of artificial nails can cause more damage to the nail underneath. Talk to your cancer team and make the choice that’s right for you.
You can also talk to your cancer team to determine if you should be using cold therapy for your hands. The best cold therapy gloves act similarly to the scalp cap, using a cooling system to minimize the effects of treatment on your hands. Another option is using frozen gloves or wearing cotton gloves with an icepack over top.
What to ask your cancer care team about cancer-related nail changes
It’s important to address any signs of nail infection or other ongoing issues with your healthcare team. As cancer treatments cause immunosuppression, a minor nail issue like a fungal infection can become a significant concern.
Read our full article about cancer skincare here.
Why is addressing cancer-related damage important?
We tend to equate thick or shiny hair, long nails, and soft skin to youth and vitality. When they’re damaged, they become visual cues that we’re vulnerable or ill. They also remind us of the possibility of a foreshortened future. Because outward physical deterioration can make us feel vulnerable, minimizing outward signs of an illness can help with our mental health.
What can we do about hair, skin and nail damage?
Luckily, most hair, skin and nail side effects are temporary. Cancer-related damage usually corrects itself after treatment ends. In the meantime, we have strategies to help you manage them.
Hair, skin and nail damage can take a toll on our body image. If you feel persistent or debilitating emotional distress about the way you look, consider talk therapy. Talk therapy is also a good idea if a mental health concern from the past, like an eating disorder, resurfaces. Cognitive behavioral therapy (CBT) is a type of therapy that’s scientifically supported for helping with this kind of emotional distress. CBT is an umbrella term for many variations of short-term therapy that focus on helping you reframe your thinking to help you cope.
Many of us find relief in support groups. They’re a safe place to talk about concerns you may not be comfortable sharing with friends and family. Simply knowing others face similar problems, like cancer-related damage, can help us feel less alone. In groups, we also learn what worked for others. If you’re interested in a support group (not everyone is and that’s OK), check with your hospital medical team. They may know local groups for people with cancer.
Online support communities can also be a valuable source of advice and comfort. We started a Facebook community that may help as a first step.
For any hair, skin, or nail problems
- Stay hydrated.
Fill up three, 8 oz. glasses or bottles of water each morning and place them strategically around your home or office. Try to drink them all before the end of the day. At meals, drink two glasses of water (at a minimum).
- Limit alcohol and caffeine.
They’re drying and worsen hair, skin, nail, and mouth problems. Quit them—or at least cut way back.
- Eat the rainbow.
Brightly-colored vegetables and fruits give our bodies the natural nutritional support they need for healthy hair, skin, and nails.
- Try a full-spectrum, high-quality beauty supplement. It can add a nutrition boost and help play offense and defense against damage.
How friends, family, and colleagues can help with cancer-related damage
There’s a lot you can do to help your friend or loved one cope with hair, skin, and nail problems.
- Offer to join your friend if they decide to cut their hair, try on wigs or shop for scarves. These can be emotional events. Social support can be a huge help.
- If your friend has hair that’s growing in, treat them to a haircut with a premium stylist. The transition from bald to “normal” hair is challenging. A special haircut can make a difference.
- Create or send a care package filled with gentle, non-toxic, alcohol-free hair care or health and beauty products.
- If your friend’s healthcare team recommends certain products or treatments for hair, skin, or nail damage, find the products or go with your friend to buy them.
- Treat your friend or family member to a facial or hand massage.
- Help your friend stay hydrated. Make or buy flavored waters, teas, or similar drinks. Buy an attractive new pitcher, water purifier, teapot, or tumbler—anything to make hydration more appealing.
- If your friend is open to connecting with other people who are coping with cancer and may be dealing with similar side effects, offer to find support groups.
- Be ready to listen. Your loved one may want to talk about problems with body image or emotional distress from side effects. Try not to minimize their concerns. Before sharing your ideas, ask if it’s OK and whether they would be helpful.
Care for your body to calm your mind
When life feels challenging, sometimes simple physical self-care can help us feel more optimistic and nourished. But don’t feel pressured to meet the expectations of others. If pampering and new beauty routines help, great. If they don’t, skip it! Click here if you are interested in more tips on hair loss, skin vitality, and nail problems.
Tammy Phillip has a PhD in Clinical Psychology from Ohio State and is a former Clinical Research Psycho-Oncology Fellow at Memorial Sloan Kettering Cancer Center.
Lisa Lefebvre is the Founder of Mend Together. She has experience recovering from 8 cancer-related surgeries, chemotherapy treatments, radiation protocols and hormone suppression therapy.
Information provided here is not a substitute for medical advice. Please consult your healthcare team for advice tailored to your personal diagnosis and treatment.