Many patients report a deterioration in their skin tone and general condition after chemotherapy. This varies from person to person and can range from blotching, thinning, reddening, reduced flexibility and increased freckles. Certainly radiotherapy can cause some long term problems with the skin, in the treated area, although with modern skin sparing techniques this is much better than it used to be. Long after radiotherapy there is an increased sensitivity to the sun and increased risk of skin cancers. Most chemotherapy drugs will make the entire skin more sensitive to the sun during their administration but some drugs such a bleomycin, capecitabine and fuorouracil can increase the risk of sun burn for several months afterwards.

How can you help:

There are three basic principles you should follow:

• stop smoking - smoking reduces the oxygen to the skin and increases traces of aging (thinning, reduce turbidity, and age spots). The amount of haemoglobin which carries carbon monoxide instead of oxygen is increased and this produces a grey/brown pallor particularly on the face and around the eyes.

• eat well

• exercise

• Avoid sun burn

• Use olive oil

Simply people who are healthy and lead healthy lifestyle tend to look healthy.

There has to be a degree of common sense when it comes to sunlight. Light sun exposure is encouraged as it increases vitamin D levels helping bone health, furthermore the diet section also discusses how vitamin D may also have an anti-tumour effect. All the same, excessive exposure to the sun very is damaging to the skin especially if there is burning.

Olive oil

Olive oil is predominantly oleic acid and has strong antioxidant properties; it exhibits a number of biological benefits:

• reduction in polyunsaturated fatty acids

• improves diabetes

• improves skin wrinkling and skin aging

For centuries, Greeks and Egyptians have also used olive oil topically for the treatment of skin redness and it is still commonly recommended by complementary medicine specialists for this complaint. Olive oil is reported to have a potent antioxidant effects and has shown to reduce DNA damage, and delay the onset of UV induced skin damage. An experiment in mice, although a little unsavoury, highlighted the major benefits of olive oil on the skin. Two equally sized groups of nude mice (a breed without fur) were kept in a comfortable, warm stimulating environment. They both were exposed to ultraviolet light during the day. One group had olive oil gently massaged into their skins every evening. At the 6 months, the olive oil group had fairly normal skin for the age of the mouse, the other group were covered in skin cancers, dry thin cracked skin. Further investigations have discovered that the mechanism for this skin protection is thought to lie in the finding that mice had reduced formation of the DNA breakdown product 8-hydroxy-deoxyguanosine (8OhdG) in their skin following the application of olive oil immediately after UV radiation. The oil therefore has a DNA stabilising effect in addition to its moisturising properties which reduce cracking and a risk of secondary infection. Of course the same experiment has not been repeated in humans but observational studies have correlated lower skin sun damage with higher olive oil consumption. We do repeatedly expose ourselves to high concentrations of UV light and as a result have considerable risk of skin damage and skin cancers as we get older. As, these risks are older after chemotherapy and radiotherapy and it makes sense to treat our skin with more care. Apart from the dietary benefits a good tip I have learnt from some patients is to massage oil all over particularly in the exposed areas, for 5 minutes before your shower, especially if you have been in the sun. This is likely to reduce the risk of second cancers and improve the general condition of the skin. The Romans had a great idea – they (well no doubt the rich ones) used to go into their steam baths and smother themselves with olive oil. Between the heat, steam and sweat it tip off leaving the skin soft, healthy and feeling great. Most good gyms have a steam room these days so you don’t have to travel to Bath or Lemmington spa! Although probably not a good idea to lash on the oil in the room dripping it over the floor in front of everyone, there’ll be some questions to answer if someone slips and cracks there head! Maybe, make  habit of taking some into the shower after exercising apply the oil and then go to the steam.

Skin care during chemotherapy. Chemotherapy can make the skin dry and blotchy. Not uncommonly a red rash may also appear. Some chemotherapy and biological agents (eg capecitabine, caelyx, sunitinib Sorafeneib) can particularly affect the palms of your hands or the soles of your feet , which may become red, swollen and sore. If severe, the skin will become flaky and your nails may become brittle and damaged.  This is called Palmer-Planter Syndrome or Hand Foot Syndrome. You may be given additional medication by the doctor and/or rested from the responsible drug for a while to allow your skin to recover.  Before a slower massage olive oil into the skin, if the hands are affected try this more often in the day for 2 minutes then rinsing with warm water. Stop smoking, eat a health balanced diet take regular light exercise and avoid the sun (see left frame for detailed information on these topics).

Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.