Chemotherapy Skin Problems – Preventing Skin Infections

chemotherapy skin problems tips from Dr. BaileyStaying healthy is really important when you are on chemotherapy. One of the biggest – and most preventable – health problems for us chemo patients are skin infections. The skin is our biggest organ and it’s exposed to the outside world that is full of germs.

As a dermatologist, I know that skin infections can become very serious, especially in people who are immune suppressed such as those on chemotherapy. During this last year I received four months of very strong chemotherapy for the treatment of hereditary breast cancer. I used my training for my own benefit and I took special steps to protect my skin from infection. My strategy worked, which is why I want to share it with other chemotherapy patients. This information is NOT a substitute for advice and care from your treating physician – it is informational and educational only and can be brought to your physician’s attention to help you discuss your own personal care. As a chemo patient you are fragile and all of your personal care choices need to be discussed with your oncology team.

We know that everyone’s skin is constantly exposed to a myriad of potentially dangerous germs, both at home, out in public, and sometimes from our own bodies. On chemo, I wanted to avoid any infection that would need treatment with oral antibiotics. As a doctor, I know that if I was given oral antibiotics I could suffer from yeast infections, more drug side effects, more overall suffering, and ultimately I could even need prescriptions for anti-fungals medicines.

As cancer patients, we face additional skin infection threats because our well-meaning medical team is constantly poking, prodding, and cutting open our skin for tests, treatments, and surgical procedures – all while our immune system is compromised. We also get breaks in our skin due to the itchy rashes we get from medicines and surgical tape adhesive. All breaks in our skin are at risk for infection. I’m sure the steps I took saved me at least two different courses of antibiotics for minor skin problems that I “fixed” with good skin care and wound care, and I’m grateful.

Here are the steps I took to protect my skin during my chemotherapy. They are steps that apply to anyone prone to skin infections, not just cancer patients.

Step #1: I kept Mupirocin ointment on hand and used it promptly for all minor skin wounds.

Mupirocin is a topical antibiotic ointment that treats the most common skin infection germs called Staphylococcus aureus and Streptococcus. It is a prescription. I asked the chemotherapy nurse navigator for a prescription on my very first chemotherapy education appointment. She was unfamiliar with the medicine, telling me that my request was one she had never heard before. Comically I was given prescriptions for all sorts of strong oral medicines to counter other chemo side effects including heart burn, constipation, anxiety, nausea, etc., but not a simple ointment and advice known to effectively fight early skin infections. (Of course you would need to clear this prescription treatment with your personal treating doctors and all skin wounds during chemo need to be medically evaluated by your treating team!)

In my dermatology practice, I commonly make and treat skin wounds. It’s part of my job and my training so I’m familiar with them. My favorite wound management trick is to have my patients apply a Vaseline-type ointment and cover the wound with a Band-Aid. I have them change this dressing and ointment daily until the wound is healed. If a patient has an early sign that might suggest an impending wound infection, I use Mupirocin ointment instead of Vaseline and have them apply it three times a day under the Band-Aid. On chemotherapy, I decided that all my skin wounds would benefit from this extra precaution and that’s how I treated them. It worked beautifully and I know for a fact that two wounds I developed would have required oral antibiotics were it not for this simple and preventative wound care routine that turned them around and allowed them to heal.

 When I visited (my daughter) she tried your hand cream and said ‘mom this is better than anything I’ve ever tried including prescriptions like Halog. Georgia H, Santa Rosa, CA

Step #2: I constantly washed or sanitized my hands AND applied moisturizer often.

Skin-infecting germs are everywhere. Healthy skin in people with a normal immune system can usually fend them off. Not so when you are immuno-suppressed from chemotherapy. The best protection is simply obsessive hand washing and hand sanitizing so that you remove the germs you inevitably touch before they can cause problems. By “obsessive hand washing and sanitizing,” I mean after touching anyone else’s hands, public items like the ink pen at the doctor’s office, elevator buttons, hand rails, shopping carts, etc., clean your hands. If my hands touched any of these things I washed or sanitized them, which is the perfect storm for dry and chapped skin that breaks down and gets infected. For this reason I also moisturized my hands immediately after washing, which meant numerous times a day. I use either my Dry Skin Hand Cream or my All Natural Dry Skin Lotion immediately after washing. These products are part of my skin care survival kit for chemotherapy. To see my tips for chemo skin care read my post on The Best Skin Care for Chemotherapy by clicking here.

best dry skin hand cream for chemotherapyAll Natural Face, Hand and Body Lotion for chemotherapy ski problems

Step #3: During chemo I avoided some of my favorite high-risk environments for skin infection.

For me this means that during chemo I did not do my weekly lap swim at our local public pool, I did not get a pedicure, I did not cut any of the beautiful fall roses in my garden, and I really limited my exposure to public places. And, I am grateful that I made it through the four months of treatment without a skin infection that required oral antibiotic treatment.

Of course, if you are a chemo patient or are immuno-suppressed for other reasons, you need to bring all possible skin infections to the attention of your treating doctors promptly. You can also bring this post to their attention and ask them if these steps might be appropriate to help keep your skin healthy and to help you avoid needing oral antibiotics for skin problems that might be treated topically.

chemotherapy skin problems care kitTo see the turn-key skin care kit I developed during my chemotherapy to keep my own skin healthy all over click here for my Chemotherapy Skin Care Kits.

To see the other products that I personally used and have recommended to my dermatology patients undergoing chemo click here for the full Chemotherapy Skin Care section on DrBaileySkinCare.com.  

If you have found these chemotherapy skin problems/preventing skin infections tips useful, thanks for  your likes, share, tweets, pins, and comments on Facebook, Pinterest, Twitter, and Google+.

Photo attribution: Thanks and gratitude to © Push Pictures/Corbis

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4 Responses to “Chemotherapy Skin Problems – Preventing Skin Infections”

  1. lusi degol August 5, 2014 at 5:30 pm #

    Hello your blog is very interesting..you got great helpful topics. I agree with you that while having chemotherapy we should also take care of our skin. Our skin is our first line of defense from any harmful microorganisms outside, however during chemotherapy our healthy skin cells will be weaken and some of them die, because of this our body will be prone to a lot of skin infections. Your topic is very rare yet very informative and helpful. I will surely share this to all my friends at least we can share this to those who really are in need to know.Thanks

  2. Cura Pelle August 6, 2014 at 9:11 pm #

    You’re a brave one, to be sure. I would swim in your get-up in my own pool, but out at a public pool, I would pass.

    Your tips, per usual, are great. When you say ‘Vaseline type ointment’, are you thinking of things like Polysporin, neosporin, bacitracin? I try to never use these for fear of provoking a contact dermatitis situation. And I don’t know why, really. I’m not especially sensitive.

    How about tretinoin therapy? How long after chemo can a patient get back on it?

    Meglio in inglese a non escludere gli altri interlocutori :)

  3. Cynthia Bailey, M.D. August 7, 2014 at 7:54 am #

    Sì e la mia capacità di parlare italiano sta svanendo. Ma comincio una nuova classe in 3 settimane. This complements of Google Translate unfortunately. Ohh, is it time for another trip over the pond yet…….

    By Vaseline type ointment I mean petrolatum just by itself. You are right to fear the contact derm of antibiotic ointments.

    I used tretinoin on chemo but only sporadically as my energy allowed. If a person’s skin is not too terribly dry or irritated, and if there are no other facial rashes, then it would not be contraindicated in my opinion. If the skin is dry or there are rashes, then it would irritate the skin and create a portal of entry for infection. Thus the prudence of its use is a judgment that would need to be made by the treating physicians. Also because it is a prescription.

    Lastly, I swim in that crazy get-up anywhere, Italy included. Yes, I did draw attention, but then, well, my fair skin looks pretty good for the sunny mileage I’ve put on it. Like I’ve admitted here in public before, I’ll swim for hours at high noon, even in the summer and even on the equator, but in that hazmat getup. I love to be outside and play in water – and yet I am a tan-line free zone! I love that suit. Got a new one this year from Coolibar (love those guys too). It’s gray on gray with little sea blue piping. Stunning in a porpoise sort of way ;-)

  4. Cura Pelle August 7, 2014 at 7:27 pm #

    Yeah, stunning. You keep telling yourself that. :D