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: Stem Cell Transplant and GvHD. Morag is joined by special guest Jeanna Doyle.
Transplantation requires matching the tissue or organ (graft) from a donor to the patient (host). Since the graft comes from a donor other than the patient it may involve many factors to ensure that it is not rejected by the host.
A skin side effect that can result when the body’s immune cells attack the unknown donor cells is a skin rash called “Graft vs Host Disease” (GvHD). This can manifest in two forms – acute and chronic. Ideally, preventing the onset of this skin rash has the best outcome.
Management of Cutaneous Side Effects:
Working with a transplant client is challenging in a medical and spa setting. The skin can react to skin care products, so any spa service needs to be kept ‘simple’ and number of products used kept to a minimum. The skin needs to be moisturised to help with dryness and itching, yet soothed. Any rash with raised spots or blisters to be avoided.
Skin care treatments during both the acute (first three months usually) and chronic phase of GvHD require extreme care due to the following manifestations. It is strongly recommended that the patients physician provides permission to do so and at what phase.
- Tender, red spots which can occur within 10-30 days post transplant
- Face, hands and feet get affected first, then can spread to whole body (erythroderma)
- Spots can form widespread red rash
- Spots can form widespread red rash
- Dry, itchy, raised rash that develops over the whole body
- Dry mouth and sensitivity to spicy/acid foods can lead to mouth lesions
- Dry eyes can cause irritation and redness
- Skin can thicken up, become scaly, and become discolored (hyper- or hypopigmentation – this resembles lichen planus)
- Skin can harden (scleroderma) therefore joints can be affected
- Hair loss can occur, or premature greying of hair
The psychological side effects can have a negative reaction, particularly if person has the rash in visible areas such as the face, neck, arms, etc. Spa therapists are to be professional in their approach with line of questioning to obtain clarity on how to modify spa treatment to avoid any reaction on the skin. We have to remember, this client may want help with these skin manifestations in order to look healthy. Peppermint hydrosol is a very valuable product to have on hand for immediate, temporary relief, provided the person can handle the smell of peppermint.
Utilizing Corrective Makeup
Whether acute or chronic, GvHD patients need to be cleared for cosmetics by their treating oncologist or dermatologist.
Suggestions for Acute GvHD
If it is advised to avoid all cosmetics during the acute phase (first three months), creating a well-defined eyebrow and applying a neutral lip color may help balance the face.
Suggestions for Chronic GvHD
At the chronic phase with no active lesions, the airbrush makeup technique can be ideal. Ensuring minimal contact to the skin, combined with the sheer nature, allows the skin to heal more effectively. The sheer quality of the application will also aid in neutralizing any redness associated with the skin rash, and can be applied over the moisturizer advised above.
Eye dryness can be associated with Chronic GvHD, requiring saline drops. When excessive dryness is present, avoid applying eye makeup powders and liners. Opt instead for well-defined eyebrows and a brighter lip color to balance the minimal use of makeup on the eyes.
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).
JEANNA DOYLE, LC MAP OE CM Jeanna has an impressive dual career in medical settings and in fashion and advertising. She has worked extensively with plastic and reconstructive surgeons as well as with dermatologists and oncologists. She also possesses a strong background in print, television and film. Jeanna is the founder of Suite HOPE (Helping Oncology Patients Esthetically), a nonprofit organization which provides education and support to female cancer patients who have esthetic concerns resulting from cancer treatment. Jeanna developed The HOPE Method, a training curriculum for oncology estheticians across the globe to become certified in corrective makeup for cancer patients. The HOPE method is the first corrective makeup course approved by the International Society of Oncology Estheticians. For more information about Suite HOPE and The HOPE Method, visit suitehope.org and thehopemethodtraining.com. For more information about Jeanna, please visit her website at jeannadoyle.com.