Welcome to the Save Your Skin Series, by Morag Currin. Morag expertly walks us through the issues that we may encounter with our skin as a result of cancer treatment. Please feel free to email your questions or comments.
Today’s topic is: Itching (Pruritis)
Post-operative itching of incision sites is absolutely normal. It is caused by the chemical histamine, which is present in healing wounds. Some people find a lot of relief in just knowing it is a sign of healing and that the itching will diminish. The itching is usually noticeable where the incision was made, and new cell growth is being stimulated. Itching can last for months, and possibly up to a year. The itching sensation is carried by the same nerve fibers (so called c-fibers) that cause pain.
Post-operative itching all over the body can be a reaction to medications such as Percocet and Vicodin (for pain). Some antibiotics can also cause itching and may need to be changed.
Many topical options can be tried to soothe the itching, however, if nothing works, one must contact their medical professional.
- Peppermint hydrosol can be sprayed onto the itching area, and can temporarily numb the skin.
- Menthol, an ingredient found in some skin care products provides a cooling sensation to the skin and this can also temporarily relieve an irritating itch.
- Calamine is composed of zinc and/or ferric oxide and this ingredient provides great temporary relief to itching. See Tecniche Plantae powder for relief. www.tecniche.com
- Caladryl, a combination of Camomile and Benadryl Cream is another option.
- OTC antihistamines such as Zyrtec, Afrin or Allegra are good for daytime use. Benedryl can be used at night because it also has some sedation qualities.
Moisturise the skin with emollients on a regular basis. As an alternative, one can use a hydrocortisone and/or lidocaine based cream topically. Any of these options can help relieve the itching.
Applying a moisturizer to the skin while still damp (after showering/bathing) can ‘lock in’ the moisture. Avoid any drying and fragranced soaps or bath gels.
Warm, dry air can cause skin to become dry and itchy. Cool, humid air may prevent itching.
Drinking plenty of liquids is very important in reducing dry skin or itching.
When chemotherapy causes pruritus, it may be a sign that a person is sensitive to the drugs being used. The following chemotherapy drugs can cause itching: Doxorubicin, Daunorubicin, Cytarabine, L asparaginase, Paclitaxel, Cisplatin. Several biologic therapy drugs may cause itching. This is most common with drugs called Interferons. Stress and anxiety can make it harder for a person to cope with pruritus. Some ways to control stress include relaxation therapy, positive imagery, music therapy, and distracting yourself with activities.
Itching can occur anywhere on the body, and the same temporary topical options as above can be applied to the skin that is itching due to chemotherapy, however, if this itching continues, the patient must see their medical team regarding this, and they will possibly be prescribed with the following protocols/products. If a person has been prescribed a corticosteroid cream by their dermatologist, it would need to be applied to the skin first, and then followed with a moisturizing cream after about 15 minutes.
This rash is treated according to a determined grade:
- Mild (Grade 1) Topical HC 2.5%, and topical anti-itch creams
- Moderate (Grade 2) Topical HC 2.5%, and oral anti-histamines
- Severe (Grade 3) Oral anti-histamines and oral corticosteroids, and nerve modulators.
Itching can occur after two to three weeks in the area of external beam radiation therapy (EBRT) and this can last for up to four to six weeks post treatment. Many above mentioned options can help in areas of radiated skin.
Hydrogel dressings or pad are soothing, cooling and hydrating when applied to radiated skin. These dressings or pads are applied over the wounded skin for a cool, soothing effect and are held in place with tape. They do need to be changed every 24-36 hours.
Cornstarch can help prevent itching of dry skin caused by radiation therapy but should not be used where the skin is moist such as under the breasts. When cornstarch becomes moist, fungus may grow.
Areas of the skin that involve friction and sweat such as the underarms and under the breasts may be more prone to itching.
Itchy, dry skin must also be protected from the sun. Physical SPF applied regularly is necessary for at least one year post RT.
DISCLAIMER: It is important that a person be referred to a dermatologist who specializes in dermatological issues resulting from cancer treatment.
She pioneered the Oncology Esthetics® advanced training for spa professionals and has set the standard in Canada, US, Australia and New Zealand. She is also the author of Oncology Esthetics: A Practitioner’s Guide (Allured Books 2009) and Health Challenged Skin: The Estheticians’ Desk Reference (Allured Books 2012).
Her students learn to incorporate adjustments to spa treatments specifically for people undergoing cancer therapies, and other health issues.
She continues to travel the globe with her training and expertise, helping to raise the bar in the spa industry and to open the door to all people regardless of skin type or health issues.
A contributor to many consumer and business magazines, her work has appeared in numerous national and international publications. Currin currently serves on the advisory committee of the Skin Inc Magazine Board, and the International Society of Oncology Estheticians.
Going beyond the world of esthetics, Mórag continues to reach out to those suffering from a variety of health challenges through Equine Facilitated Wellness (EFW).