> Cancer therapy, prevention, and care of the effects on the skin

The project “The body found” has the objective of identifying and validating guidelines for a protocol dermocosmetologico studied for the various features of the cancer patient, and therapies provided.

In the current pharmacological management of reactions toxicityà skin there are a number of recommendations quite empirical and non-validated by the evidence in the daily clinical practice. Also does not cover the aspect of più specifically cosmetic and do not offer advice to the therapeutic measure of the individual patient.

from the beginning of each therapeutic cycle, the patient should adopt a series of behavioural measures and hygiene preventive that take into account the side effects in the load of the organ skin, the target is “preferred” by the consequences of surgical therapy, pharmacological, and/or radiant.

The protocol developed by the Scientific Board “The Body Found,” aims to intensify the research to prevent and treat  the various side effects caused by cancer therapies.

Xerosis or dryness of the skin

To avoid dryness of the skin is necessary to pay careful attention to the cleansing and hydration. The detergents must not contain aggressive surfactants and excessively foaming (sodiolauril-sulfate, sodiolauriletere-sulfate), and should be privileged, as a cleansing for the “staff affinitiesà”.

Are fine emulsions of Water/Oil in which the lipid component is composed of vegetable fats  naturally derived (karitè, wheat germ, jojoba oil, avocado oil) or synthetic (caprilyc amide capric triglyceride); while avoid cosmetics that contain a large percentage of derivatives from hydrocarbons (petrolatum, paraffin, vaseline) or silicones (cyclomethicone, dimethicone, cyclopentasiloxane, cyclohexasiloxane) currently recognized dangerous although not yet subject to a regulation on the percentage allowed.

restore hydration and to counteract the effect of oxidative drug treatment, moisturizer for excellence will haveà be formulated with active principles selected and targeted compounds (karitè, jojoba, olive, palm), aloe, niacinamide (vit. B3), tocopherols and tocotrienols, and ceramides, gamma oryzanol. The little or no presence of oils and silicones is important.
Avoid creams based on substances exfoliants and irritants such as glycolic acid, alpha-hydroxy acids and benzoyl peroxide or gel formulations of alcohol because of their drying power and an irritant.

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In case the itching is not particularly tolerated, può resort to the use of antihistamines anti-H1 (cetirizine, loratadine, fexofenadine).

When the xerosis è così difficult to produce cracks and fissures, as well as to ensure the disinfection of lesions, può advise on the use of eosin aqueous 2% for touches of local, associated with creams  or pastes with a base of vit. And and zinc oxide. The choice of a formulation in ointment (made with urea, and not with the oil), including that relating to topical antibiotics, should always be privileged.

Damage of the nails

For the prevention of onicopatie you può make use of special gloves, coolant, worn during the infusion of chemotherapy, and reduce toxicityà the local of the drugs due to vasoconstriction induced by low temperature(up to -250 to -30 0). 

In the case of perionyxis, which causes infection of the edge of the nail, you may need to apply topical antiseptics for the prevention of over-infections: rifampicin topically, and if necessary, silver nitrate  topical, to reduce the granulation tissue.

In cases più serious to be considered as the antibiotics.

Alopecia

The use of topical minoxidil 2% seems to give good results, especially in the case of alopecia caused by taxanes, and anthracyclines, but does not protect from that caused by doxorubicin. They are, however, ongoing additional studies.

The use of the wig to be part of a cancer patient remains a valid solution also in the case of alterations of the trophic hair and pigmentation.

The wig should be free of adhesives, which have the power of irritating and sensitizing, and have a texture appropriate for your skin stressed econ a barrier impaired.  Often, especially with biologic drugs, there is no alopecia in the true sense, but a fall massive that, however, does not cause baldness.

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In these cases, può be useful to use lotions that provide active ingredients to the hair bulb  and stimulate the skin’s microcirculation.

it is useful to associate supplements with anti-oxidants and substances that are dedicated to the restoration of the cycle of physiological keratin, e.g. vitamin E, melatonin, reduced glutathione and other active principles in the course of the studies.

with Regard to the use of hair dye,  against those based on parafenilendiamina, while they are allowed, that those on plant-based (even if they never are 100%) just to reduce the risk of sensitization by contact. Permanent or draught, are to be avoided.

Rash cutaneo e follicolite

The rash and folliculitis are a side effect due to a pathology real rather than a blemish. Often, the effectiveness of the medication for the tumor in the course is positive as più induces folliculitis.

The dermatologist has a crucial role in managing the pathology of the skin to allow the oncologist and the patient to continue the therapy in the best way.

The affected skin should be cleansed gently, and without products astringent (instead of as an acneiform reaction would suggest) and hydrated in depthà for the base xerotic that always accompanies the folliculitis. To which già mentioned, based on karitè, jojoba and olive oil, should be reported other active ingredients such as sesame oil, macadamia and argan, which, in addition to the moisturizing power and antioxidant properties, provide an anti-inflammatory action is important.

The principals of antibiotics  topical (gentamicin, clindamycin in combination with the oxide of zinc, mupirocin, erythromycin) are all chosen in the formulation of the più fat can (ointments or salves), and alternating dosage daily. If the inflammatory component is marked, you canò add a cream to hydrocortisone 1%  for the first few days of therapy. During the reaction of the skin is recommended to wear clothing normally recommended for patients, people with atopic dermatitis or allergic, with fibre to the anti-inflammatory action.

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In case of over infection può be necessary the therapy  the antibiotic with tetracycline.

The chemotherapy must be suspended in the severe forms with massive component exfoliative and bullous, but these extreme cases are avoided with a multi-disciplinary collaboration in advance.

Cicatrici

1-2  times daily apply on the scar post surgical a cream based on hyaluronic acid and rose hip oil or st. john’s wort to improve elasticityà of the tissue and reduce inflammation. Also the use of creams formulated with extract of bulb of allium stocks make the scars more soft and more smooth.

Often, the scar area is practiced in radiation therapy and, paradoxically, improves the aesthetic appearance of the scar, tending to atrofizzarla.

But this requires more protection of the area both in terms of hydration is that of photoprotection.

Where possible, and in due time, plastic surgery can improve the damage of surgery.

Tips for fabrics and washes

it is important to the choice of fabrics to wear and detergents preferred for their washing to protect skin weakened by any additional agent irritating, also outside.

The fabrics to put on the skin are definitely natural ones such as cotton, linen, silk, and possibly colored with vegetable colors.

avoid synthetic fabrics, elastic, wool rough, clothing containing  metals and sequins.

The detergents to wash clothes, to be chosen among those più delicate as possible and used in small doses, in particular fabric softeners. The fabrics should be dried very well.

IN ARGOMENTO:

cancer Therapy, prevention and cure effects on skin

Radiotherapy, and effects on the skin

Chemotherapy, effects on the skin

cancer Therapy and protection of skin, the decalogue for the holidays

“body found”

National Cancer Institute Regina Elena

Dermatological Institute San Gallicano

14 June 2013