If you are being treated for metastatic breast cancer, you may have noticed some changes in your skin and nails. These changes are not actually caused by the cancer itself. They are often a side effect of cancer treatments. Don't worry, in this article we will talk about this in a simple way.
Anyone undergoing treatment for breast cancer can experience these skin and nail changes. However, these side effects are more likely to occur when cancer is being treated for a condition that has spread throughout the body. This is because the condition is usually treated for a long time, which gives these changes more time to occur.
Okay, so let's take a look at why these skin and nail changes occur, what symptoms to expect, how to help prevent them, and how to manage them if they occur.
Why are these changes happening to your skin and nails?
Skin and nail changes are often caused by cancer treatments. These include radiation, some types of chemotherapy, and some hormonal and targeted therapies . If you are taking more than one treatment that can cause these side effects, your risk of developing these changes is higher.
But remember, not all breast cancer treatments cause these skin and nail changes. And not everyone will experience the same effects. If you want to know more about the side effects of your treatment, talk to your doctor .
Radiation therapy
The most common type of radiation therapy used for women with breast cancer is external beam radiation therapy (EBRT). One of the main side effects of this is skin changes in the treated area. This can include redness, peeling, and darkening of the skin, similar to sunburn. Sometimes the treated area may feel tender or painful to the touch.
Brachytherapy is a less common treatment for breast cancer. It can cause bruising and redness in the treated area. Radiation therapy mostly affects the skin, but sometimes the nails can also become darker.
Chemotherapy
Chemotherapy not only kills cancer cells, but also the cells that help our nails grow and keep our skin moist and smooth. This can cause dry and sensitive skin .
Long-term chemotherapy can lower your blood cell count. This increases your risk of skin and nail infections . When your immune system is weak, even a minor infection like this can become serious. So, if your skin is red, painful, or your nails feel warm to the touch, these could be signs of an infection. If you notice any of these, talk to your doctor right away.
Hormone and Targeted Therapies
Hormonal treatments like Tamoxifen and some targeted therapies can also cause changes in the skin and nails. These targeted therapies can sometimes have more severe effects than radiation therapy or chemotherapy.
What skin changes can you expect?
The skin changes you experience depend on the type of treatment you receive. You may experience some of these.
| Sign / Change | Description |
|---|---|
| Redness and rash | Redness of the skin or the appearance of a rash that looks like small blisters. |
| Dryness and itching | Dry, scaly skin and excessive itching. |
| Thinning of the skin | The skin becomes very thin, delicate , and easily injured. |
| Blisters or peeling skin | Blistering of the skin or peeling of the top layer of skin. |
| Color changes | Some areas of the skin may become dark or pale. |
| Pain and inflammation | Pain, inflammation, or painful sores on the skin. |
What changes can be seen in the nails?
Nail changes can occur on the hands, feet, or both. It may only affect one or two nails, or it may affect all nails.
| Sign / Change | Description |
|---|---|
| Color change | Nails may appear bruised, discolored, or have unusual spots or streaks. |
| Being weak and fragile | Nails become thin, weak, and break easily. |
| Nail infections | The skin around the nail becomes red, swollen, and painful. |
| Nail peeling | The nail lifts up from the nail bed or comes off completely. |
| Pain | Pain in the fingers, nails, or nail bed. |
What can be done to prevent and manage these changes?
The good news is that for many people, the skin and nail problems that caused them gradually improve after stopping the treatment. This can take a few weeks or months.
In the meantime, here are some things you can do to prevent these changes and manage symptoms.
Do these things to protect your skin.
- Eat a good diet and drink at least 8-10 glasses of water a day.
- The soaps and creams you use should be unscented and mild . Ask your doctor about this.
- Keep your skin moisturized. The best time to apply cream or lotion is right after you take a shower and dry yourself with a towel.
- Avoid bathing in hot water . It dries out the skin even more. Also, reduce the time you shower as much as possible.
- When going out, be sure to apply sunscreen and lip balm . Wear loose clothing that covers your skin, wear a hat, and stay out of the sun as much as possible.
- Don't scratch your skin . While it may be tempting to scratch when you have an itch, doing so can cause painful sores and even infections. To reduce itching, apply a cold cloth or ice pack to the area.
Do these things to protect your nails
- Apply moisturizer, olive oil, or coconut oil to the cuticles. Do not cut or pull the cuticles.
- If you have discomfort due to ingrown toenails, wear shoes that have room for your toes.
- Keep your nails clean and trimmed short.
- Wear gloves when doing housework, washing dishes, or working in the garden.
- Avoid getting manicures and pedicures . Do not use artificial nails.
- If one or more of your nails fall off, tell your doctor. Keep the area clean and covered with a bandage.
When you start a new treatment, it can be very helpful to keep a journal of your skin and nail symptoms. It helps both you and your doctor to keep track of how long your symptoms have been present, what they are like, how severe they are, and how much they affect you.
The most important thing:
If you are having a lot of trouble with these skin or nail symptoms or think they are serious , be sure to talk to your doctor . He or she may be able to give you a medication to treat the side effects, reduce your dose, or change the frequency of your doses.
If you have signs of an allergic reaction, such as swelling, severe rash or itching, or inflammation where you received your IV, seek medical advice immediately.
Take-Home Message
- It is common for skin and nail changes to occur during breast cancer treatment. These are not caused by the cancer itself, but are a side effect of the treatment.
- These changes are often temporary and return to normal over time after treatment is stopped.
- Taking good care of your skin and nails (drinking plenty of water, applying moisturizer, and protecting yourself from the sun) can greatly reduce these discomforts.
- If you experience any changes, even if they are minor, that are causing you discomfort , don't be shy or afraid to talk to your doctor about it.
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