When people are told they have cancer, they naturally fear for their health and worry about how the diagnosis might affect other aspects of their lives like family and work. Often in the back of their minds is a concern that they might feel is trivial or shallow: How will this affect my appearance? “People often feel in their conversations with medical teams that they’re embarrassed to bring up issues like hair loss because they perceive it as vain,” says Sue Larkin, VP of programs and marketing for Look Good Feel Better, which organizes beauty workshops for women undergoing cancer treatment. “But how we look can have a huge impact on how we feel. People with cancer lose so much control of what’s happening in their lives. Changes in appearance are a very visible reminder of this loss of control.”

As well as changes to appearance, treatments can also make skin sore and uncomfortable. “Around 80 per cent of patients experience skin side effects as a result of cancer treatment,” says Dr. Tarek Hijal, a radiation oncologist at McGill University Health Centre. “It can vary based on the type of treatment: Skin can become darker or lighter. Immunotherapy for breast cancer can cause skin dryness, rashes, itchiness, and, in some cases, discolouration of the skin. Some treatments like radiation burn the skin and you get radiation dermatitis, where skin becomes red and inflamed, sloughs off and blisters. As well as the well-known effect on hair, the nails can become weaker or stop growing temporarily.” Dr. Hijal says that these days, treatment is less aggressive than it once was. Radiotherapy for breast cancer is targeted at a smaller area over fewer sessions (five instead of 25). Nevertheless, there are still effects on the skin that can last for weeks, months or even years afterwards, and patients may also need to have medication long after the cancer is “cured” in order to prevent recurrence.  

Dr. Hijal is part of a group of physicians called the Canadian Skin Management in Oncology Group (CaSMO), which is researching this exact subject with the support of La Roche-Posay. “Part of the work of La Roche-Posay is to collaborate with different physicians, dermatologists, pharmacists and nurses to find recommendations for patients,” says Dr. Nour Dayeh, the brand’s medical communication manager. “When a patient is suffering from skin side effects, a lot of products don’t work for them anymore. We have worked with CaSMO on developing a basic approach — a set of recommendations that are adapted to the needs of people undergoing cancer treatments.” The idea is that all healthcare professionals who work with those who have cancer can help educate them on what will work best for their skin.

La Roche-Posay, along with many other brands, also works with Look Good Feel Better to provide workshops for people on skincare, makeup, wigs and hair alternatives. “Typically in non-COVID times we see 10,000 women a year,” says Larkin. “The workshop in person lasts two hours, and online it’s three separate sessions. We talk about the full experience—skincare and sunscreen, colour cosmetics including concealer if you have dark circles, hair loss that impacts lashes and brows.”

Larkin says that the workshops are about giving women practical skills, but it goes way beyond that. “It’s empowering women. Beyond the feeling of control about how they look, it’s also about who knows they’re sick. When you’re at the grocery store or school pickup or brunch, you might not want to say to the whole world that you’re undergoing cancer treatment.”

While Larkin says it was initially challenging to pivot to online programs during the pandemic, there were some advantages and even when the organization reintroduces IRL meetups, it will maintain online options. “They have been very important for teenage girls in small communities, for example, who might not know anyone else who has gone through the same thing,” she explains. “For our teens it’s an ongoing series: We give the core info but in each session we also do something applicable to the time, like Halloween makeup, holiday sparkle or spring looks. A lovely community can develop.”

Sometimes the side-effects of cancer treatment can be enough to make people ditch it completely. In a study published in The Oncologist in 2013, 8 per cent of women said they’d reject treatment based on hair-loss. And interventions like workshops are helpful—2018 research showed they can help reduce depressive symptoms and increase quality of life, self-esteem and wellbeing. Dr. Hijal wants to convey the message that people shouldn’t be embarrassed to raise their concerns about their appearance with their medical teams. “This is important—cancer affects every Canadian in some way,” he says. “A lot of patients will stop treatment or ask for a change because the skin side effects are so severe,” says Dr. Dayeh. “This is where the brand initiative comes in because we can raise awareness of managing those side effects and offer a way to decrease their severity.” If you head to the La Roche-Posay website you’ll see a whole section devoted to caring for skin through cancer—gentle cleansers, moisturizers and sun protection, all fragrance free.  

Larkin encourages people whose loved ones have cancer to recommend Look Good Feel Better. “When someone we love is going through a challenge, we do things for them: We drop off food, we run errands or shovel snow or mow the lawn or help with the kids,” she says. “I always say, add recommending Look Good Feel Better as something you can do for a person you love. They deserve to take time for themselves. They deserve the tips, techniques and information they’ll receive. And the magic is what happens when a group gets together that is going through a shared experience. They laugh, they cry, and they connect. You can’t bottle that.”

Products That Are Kind To Skin

La Roche-Posay recommends a whole skincare regimen for people undergoing cancer treatment. Start with a cleanser such as Lipikar Huile AP+, which can be used on face and body, and pat skin dry instead of rubbing. Follow up with a moisturizer like Toleriane Ultra Crème or Lipikar Baume AP+. If you have particularly sore and dry spots—including your lips—treat them with Cicaplast Baume B5. Finally, protect skin with an SPF of over 50, such as Anthelios Ultra-Fluid SPF 50+, and don’t neglect sensitive spots like the nose, lips ears and scalp, if you’ve lost your hair. If you’d had radiation therapy the areas that have been treated will be particularly susceptible to sunburn and this will continue to be the case for the rest of your life. Scars should also be protected and kept out of the sun as they can be prone to hyperpigmentation.

Chelsea Bice, Dermablend’s education expert, says that you may want to change up your makeup while you’re undergoing treatment—skin can get bumpy or inflamed, and of course you may have scarring. “Shade selection can be something to consider because during treatment people may not be experiencing as much exposure outside and treatments may cause the skin tone to become more fair and sallow,” she says. “On the contrary, some may opt for a shade slightly deeper to bring colour and vitality back to the complexion.” Her pick is the brand’s Flawless Creator Liquid Foundation Drops, which has minimal ingredients and can be used alone or added into moisturizer to give you a bit of coverage with your skincare. It’s also oil-free, which can be helpful for people who wear a wig because it won’t disrupt adhesive. Some cancer treatments lead to menopausal-like symptoms such as hot flashes, so she suggests Cover Care Concealer, which is waterproof. And if you have texture changes due to hair loss or scarring that could make it harder for makeup to stick on, she suggests Insta-Grip Jelly Primer. “It has a unique gripping texture that can be really helpful for face and body—for example, to help adhere products to create eyebrows after hair loss.”

If you have completely lost your brows, Benefit’s Breigh Bellavanace suggests a trip to the brand’s Brow Bar for an eye mask treatment and in-depth brow consultation, where you can learn how to create a brow from scratch. If there is some hair remaining, it might not be ideal to have brow-waxing as treatment can make skin sensitive. “In this circumstance, a brow-tweeze and trim will get everything in tip-top shape until the skin is in a ready-to-wax state. To create brows at home, she suggests POWMade, a full-pigment pomade. “Simply sweep a steep-angled brush into the formula  and wipe the brush tip across its custom-built wiper. Result? A precise, naturally and easy-to-control brow fill that lasts a full 36 hours,” she says.

For hair replacement, Locks & Mane founder Jennifer Parrott says that wigs are the only choice. “This is the safest and most natural-looking option available,” she says. “Extensions would not be recommended until the hair has fully grown back and only if the hair is strong and healthy.  Her brand donates human hair wigs to young women undergoing cancer treatment through her non-profit, Strong Like Me. “When my son was three, he was diagnosed with leukemia and through my time spent at the children’s hospital, I met a number of teens who I was able to provide wigs for through my business,” she explains. “We now have a formal process in place with the social work team at the hospital and hope to expand the program across North America and to include women of all ages in 2022.” —Aileen Lalor