Before you start chemo, they present you with a very long list of potential side effects. Most of them contradictory. As well as losing your hair, you could get diarrhea, become constipated, get dry eyes, develop watery eyes, break out, get dry skin, have hot flushes, lose your nails, develop mouth ulcers, swollen fingers and toes and lots more.
I wrote a story about how to care for your body during chemo, covering skincare, nails, hair and oral health for The Daily Telegraph. But I was restricted by a word count, so here’s a – very long – post that combines the story plus are a few other things that have helped or are currently helping me.
Feel free to comment on what works for you.
Hands and nails
Sally Hansen nail expert, Alison Bowhill-Hayes says side effects can include lines or ridges, brittleness, discoloration, frayed cuticles and even nail loss. Skin openings in frayed cuticles are also prone to infection.
“Keep nails short and don’t use scissors or clippers, just a disposable emery board or file,” Alison says.
“Wear gloves when doing chores and invest in really good hand creams and cuticle oils, moisturizers are the best protection. Avoid professional manicures, pedicures and definitely no acrylic nails.”
If they fall off, nails usually starts to grow back a few weeks after the final chemotherapy session and take about six months to reach full length.
While you can’t prevent nail loss, Alison recommends wearing black nail polish.
“It is great at protecting the nail from UV light, reducing the risk of infection. Also as nails can become discolored you may feel more comfortable covering them up,” she says.
I’ve just had my second round of docetaxel and the side effects ramp up with each session, my fingers are swelling, my hands are a lot more sensitive, my fingertips have started to crack and my dry skin is peeling. I keep hand cream in every room of the house, plus various handbags, so I apply whenever I remember.
I also apply cuticle oil several times a day to prevent them from splitting.
I’m using dark nail polish as well, to protect them from UV light.
During docetaxel, they give you ice gloves to wear. This helps numb the nerve endings in your fingers and help save your nails. I found it’s a lot easier if you keep one hand in for two minutes and then swap. Much easier than chilling both at once.
I’m getting the same swelling and sensitivity as my hands, so using moisturiser with peppermint to help cool them.
Avoid long walks on hot days, I took Scoo for a two hour walk on a 30C day and couldn’t walk the next day. Once the swelling went down, I counted 11 blisters.
Dr. Spiller skincare expert, Sue Dann, says chemotherapy can result in a range of skin issues, including dehydration, discoloration, bruising, infection, itchiness, dryness, peeling and acne.
Skincare should extend to the whole body, including the scalp.
“It is important to switch to a good moisturizing body cream, one preferably with shea butter, because it sits on the skin and acts as a protective shield. In case of extreme dryness a body oil is beneficial,” she says.
Registered nurse and co-founder of skincare specialists, The Clinic, Kaye Scott recommends preparing the skin before chemotherapy with lots of hydration and antioxidants.
Swap your regular moisturiser for a paraben and preservative free formula that contains calming ingredients such as sea buckthorn, chamomile, Vitamin E and aloe vera such as Cosmedix Rescue+ and Aspect Dr Redless oil.
“Avoid harsh products and active ingredients such as Vitamin A as skin is compromised, with a high tendency towards dryness and irritation,” she says.
To add insult to injury, corticosteroid drugs such as dexamethasone which are prescribed to combat nausea, can cause breakouts.
“You must be very careful to avoid alpha hydroxy acids and salicylic acid which are found in acne treatments as the skin is fragile. If you experience a large amount of breakouts, speak with your oncologist,” Kaye says.
My once oily skin is now dry, irritated and tight so I’ve had to switch my skincare regime.
I use a thick, creamy cleanser in the mornings, layer anti-redness and hydrating serums and a thick layer of skin balm rather than regular moisturiser.
Sunscreen is also important, your skin is more likely to burn during chemo.
At night, I use a cleansing oil to get rid of sunscreen and make-up. It’s thick, soothing and doesn’t strip my skin.
Then I started breaking out, lots of little red pimples that wouldn’t come to a head so it looked like a red rash across my cheeks and forehead.I thought it was because I was over-moisturising, but it was the steroids. Not much you can do about it. My skin was too sensitive to exfoliate or use acne treatments, so I just had to roll with it.
My complexion has two settings at the moment, red or yellow.
Redness is best covered with a mineral powder foundation that you buff into the skin. I haven’t found anything else that works as well. You could do a two-step system where you use a green colour corrector under foundation, but that’s a lot more work.
For powder foundations, be careful that your skin isn’t dry or flaky as it gets stuck in broken skin. Not a good look.
I’ve lost my olive skin, it’s been replaced but a somewhat jaundiced yellow hue so I have been using highlighters and luminizers to bring my skin back to life. It needs glow.
When it comes to make-up, keep your layering consistent for the best finish. If you are using a liquid base, go a liquid or cream blush, bronzer and illuminizer so you’re applying like on like.
I like Revlon Skinlights, it’s cheap, comes in a few shades and is easy to blend on its own or just mix into your moisturiser for an all over glow.
Powderwise, I Bobbi Brown’s Shimmer Bricks and I’ve heard good things about Hourglass Ambient Lighting Powder, but haven’t tried it.
Special needs dentist, Dr Sharon Liberali from the Australian Dental Association says the tissues of the mouth and saliva can be affected.
“With less saliva, your mouth may feel dry and uncomfortable, making it difficult to eat dry, spicy or acidic foods” she says.
“Some chemotherapy drugs affect white blood cells which fight infection, increasing the risk of bacterial and fungal infections and ulcers.”
Sharon recommends a mouthwash that contains chlorhexidine, such as Curasept, which is alcohol free and is antiseptic, antibacterial and antifungal. Difflam oral rinse contains benzydamine which helps with inflammation and pain, while Biotene is alcohol free and help dry mouths. Salt water and baking soda rinses are also great.
“Salt is a natural antiseptic while bicarbonate is alkaline and effervescent. Dry mouths are often acidic so neutralising the mouth’s acidity will decrease the risk of bacterial overgrowth and thrush organisms. Flat soda water is also effervescent and the bubbles give comfort while removing food stuck on teeth,” she says.
I’m thankful that so far I haven’t lost my sense of taste. I love eating and the idea that I could lose that pleasure was just too much.
But I’m not out of the woods.
I survived FEC ok but my mouth is super-sensitive the week after docetaxel.
I can’t drink coffee, it just dehydrates my mouth.
All alcohol tastes metallic, so drinking is out.
Acids and chilli also irritate.
For the first week I’m all about soft bread, pasta and creamy butter, foods that soothe and calm my mouth. Chocolate is also good, it’s all about a rich, creamy, fatty coating on my tongue and the roof of my mouth.
I saw a dentist before I started chemo who put me on a strict oral hygiene regime, which included a sensitive electric toothbrush, fluoride toothpaste, tooth mousse and piksters rather than floss.
I rinse my mouth with warm water and salt or bi-carb after each meal, or if I’m out I have a small bottle of Biotene, a moisturising mouth wash.
Moisturising mouth strips also help.
I couldn’t find Curasept in a local pharmacy, so have ordered it online. The key ingredient, chlorhexidine, can stain your teeth and although you can find it in other brands, Curasept contains an anti-staining agent.
I read about oil pulling, an ancient ayurvedic treatment where you swish coconut oil around your mouth for 20 minutes first thing in the morning to remove toxic build-up. I ran it by my dentist who said it couldn’t hurt. Rather than ridding your body of toxins it’s moisturising your mouth first thing in the morning, when it’s driest, which helps protects your mouth, teeth and gums. It’s not the most pleasant experience at first, but you slowly get used to it .
Losing your hair is one of the most traumatic parts of chemotherapy and getting a wig can bring some normality to your look. A lot of hospitals have wig libraries, where you can borrow a style for the duration of your treatment but options are limited.
Wigs are made from synthetic strands or human hair. The former are cheaper, but you can’t style them with hot tools and while the latter look a lot more natural, they can cost in the thousands.
Whatever type you choose, stylist Anthony Nader recommends going lighter than your natural shade and, to make it look as real as possible, getting it cut to suit you.
“Your complexion fades during chemo, so you need to adapt your hair colour,” he says.
“Wigs are hard to manicure, so find someone who has experience working with them. The key is combining jagged, textured edges, blending every line and tailoring it to make it look natural.”
I was fixated on the idea of a wig before starting chemo, it was my security blanket, but I found I haven’t worn it as much as I expected.
In an Australian summer it’s just too hot. Plus, as you get used to being bald, it becomes less of a thing.
I prefer a faux fringe + headscarf combo.
Saying that, I’m glad I had it for the first few weeks and that my hairdresser cut it to fit so that it helped me feel more like me.
On the first 30C+ weekend in Sydney I broke out with red welts all over my legs and thought I had been bitten by something at the beach. Then I saw the same welts on my waist and inner arms.
Turns out it was heat rash, something I didn’t think about because I’d never had it before.
Your core body temperature rises, so keep cool in natural, breathable fibres such as cotton and linen. Polyester is not your friend.
And swap your regular body moisturiser for a body oil. Your skin will just soak it all up.
Brows and lashes
Just because your lose your hair doesn’t mean you’ll lose all your brows.
If they’ve thinned, Amy Jean Eye Couture’s founder and brow expert Amy Jean Linnehan recommends drawing them in with a brow powder, which gives the brows volume. If there’s no hair, an extremely sharp pencil applied in feathery strokes gives definition.
“There are stencils on the market that you can simply hold over the skin and colour in the shape,” she says.
Lashes can also thin and fall out.
“There are newer false lash strips available with an invisible line to adhere to the skin, so you don’t need lash hairs. They are lightweight and can be reapplied by peeling off the old glue,” she says.
“I’ve seen some incredible results with lash growth serums and many post chemo clients regrow their brows between 50-75 per cent of their natural capacity. For sparse brows, we can etch micro hair strokes into the skin using our feather touch tattoo technique and results last up to two years.”
Losing my lashes and brows has been one of the hardest parts of chemo because my face used to be 90 per cent brow. That’s what you get from being Italian.
Now, I look into the mirror and don’t recognise myself.
They stuck around during FEC but docetaxel is taking them away. Yet my hair is growing back. Go figure.
At the moment, there’s not much I can do apart from drawing them in. I’m avoiding mascara, I find I lose too many lashes when I remove it, but smudgy eyeliner helps disguise the lack of hairs.
You’ll also need to keep tissues handy, a lack of lashes means watery eyes. Who knew they actually had an evolutionary purpose?
Tissues are also good for runny noses. A lovely side effect of losing nose hairs.
I’ve had two personal recommendations for lash serums, Revitalash and Priori Lash Recovery serum. I’ll give one a go, and cross my fingers, three weeks after my last chemo session.
- I started chemo in July and didn’t realise how much warmth your hair holds until I didn’t have any. My head was cold and the cashmere beanies from www.essentialluxuriesforcancer.com were a godsend. Super soft, they had no seams so didn’t irritate my scalp and kept my head warm. I bought two, a double layer for daytime and a single layered beanie to sleep in.
- The selection of wireless bras here was also great. I had my lymph nodes removed, which ups my risk of lymphoedema and meant that post-surgery I had to throw out all my underwire bras. Finding pretty, supportive lingerie without underwire in anything bigger than a C cup isn’t easy but these fit the bill.
- This was part of my post-surgery kit. It’s not the most attractive bra, but it ticked all the boxes for post surgery; no underwire, cotton, strong compression so that your breasts don’t move and irritate scars, thick straps, supportive plus front and back clasps so it was easy to get on and off. The compression is so good, we’re talking no bounce, that I still use it as a sports bra. http://www.berlei.com.au/post-surgery-bra-y130w-l59.html?gclid=CJLUsoGj0sgCFQGZvAodPpgDRA&gclsrc=aw.ds
- These stretch lace, soft cup bras aren’t the most supportive but they made me feel pretty and feminine after having my chest hacked. http://www.palindromestudio.com.au/bras/soft-cup