Dermatologist Dr Kara Heelan recently shared her expert advice with Vogue on how to care for your skin while undergoing treatment for cancer.

Dr Heelan is a specialist in oncodermatology and explained that “approximately half of people treated for cancer will develop a dermatologic issue during treatment affecting hair, skin or nails. Chemotherapy, radiotherapy or targeted treatments work by killing cancer cells, while immunotherapy treatments boost the body’s own immune system,” she says. “These effects can have repercussions, not just on the target organ, but also on other organ systems including the skin.”

Your skin can be affected in different ways, depending on the treatment you receive:

• itchy, dry skin
• extra sensitivity
• increased sun sensitivity
• pigment changes
• skin can be more susceptible to infection

The first step is to look at your current skincare routine and eradicate any products that will irritate the skin. Dr Heelan recommends avoiding “harsh toners, and any facial treatments that contain alcohol, BHAs (beta-hydroxy acids), irritant anti-acne products such as salicylic acid or benzoyl peroxide and scrubs, harsh exfoliants or bead containing products.

“Patients often ask me about continuing their ‘active’ topical skin treatments, like vitamin C or tretinoins. However, this often needs to be dealt with on a case-by-case basis, depending on the individual’s cancer treatment and the specific topical product constitution.”

Dr Heelan also advised which products you should be using. “Exchange soaps for mild, gentle fragrance-free soap substitutes or washes, and take short, warm – not hot – showers and baths,” suggests Dr Heelan. When it comes to the skin on your face, Dr Heelan advised gently patting or dabbing your skin dry after washing and applying moisturisers or other products at this stage. “When the skin is damp, there is increased absorption of topical agents.”

Moisturising is also extremely important for treating dry skin and even before you start your cancer treatment, start building up your skin barrier. “Creams and ointments are usually better at hydrating the skin than lotions or gels, and ceramides can also be quite soothing.”

And, most importantly of all, do not neglect sun protection. “Sun-sensitivity can be particularly severe depending on the drug you are on, and can occur quite quickly. Protect your skin with clothing and SPF and use lip balms with a high SPF, as lips can be particularly sensitive. You don’t have to avoid sunshine holidays, but be very careful and wear protective clothing, and regularly apply sun cream with a high SPF of at least 30. Look for mineral or physical sunscreens, which can be less irritating on very sensitive skin, particularly for acne type skins.”

For more advice on how best to care for your skin while undergoing cancer treatment, Dr Kara Heelan recommends that patients should consider consulting a dermatologist with a special interest in oncodermatolgy. Call us on 020 8661 3372 to arrange a consultation with Dr Heelan.

May is Melanoma Awareness Month and all this lovely weather means it’s time to check your moles! The ABCDEs of melanoma is a guide to help you check your moles. Early detection of melanoma is key.

Mole Check: A is for asymmetry

Check that both halves of your moles are the same and match each other

Mole Check: B is for border

Are the borders or outlines of your moles irregular?

Mole Check: C is for colour

Is the colour pattern regular or are there varying shades of browns, tans, white, red or blue visible?

Mole Check: D is for diameter

Melanomas are usually greater than 6mm in diameter –  bigger than a pencil eraser

Mole Check: E is for evolution

Is your mole or spot changing over time?

If any of your moles are showing any of these signs please consult your GP or Consultant Dermatologist immediately

Photoprotection – or the use of regular sunscreen – is encouraged by doctors and dermatologists because they are aware that our outdoor work and lifestyles mean that complete sun avoidance is not possible.

What is photoprotection?

1. Why do we need photoprotection? Photoprotection is required to reduce ultraviolet (UV) radiation-induced skin damage, photo-ageing and skin cancers. Photoprotection includes sunscreens, clothing, hats and sunglasses.
2. What is UV radiation? UV radiation affects the skin by causing ageing, sunburns, precancerous lesions, cancerous lesions and immunosuppression. There are 3 types of UVA radiation: UVC, UVB and UVA. UVA is associated with ageing and pigmentation, it produces free radical oxygen species, indirectly damaging DNA. UVB causes sunburn and DNA damage associated with non-melanoma skin cancers.
3. What is SPF? SPF stands for sun protection factor and indicates the degree of sunburn protection given by sunscreens. It is a primary measure of UVB and to a lesser extent UVA. For a sun cream to be effective it needs to be applied liberally and 20 minutes before going outdoors.
4. What type of sunscreen should I use? A broad-spectrum sunscreen, which involves UVA and UVB coverage, providing water resistance and a high sun-protection factor (SPF 30 or 50) should be used. Included in many sunscreens are antioxidants such as vitamin C, vitamin E and green tea polyphenols which can give additive protective effects. You may need to change the type of sunscreen you use according to what activity you are planning to do.
5. How should I apply sunscreen? Apply 20 minutes before sun exposure. Reapply after 2 hours, after sweating or swimming. An adult requires 30 ml /body (2 tablespoons), with a teaspoon (5ml) used on the face, head and neck. For children the requirements vary according to size for example; 3 years: 10 ml (2 teaspoons), 7 years: 15 ml (3 teaspoons), 10 years: 20 ml (4teaspoons)
6. Is it ok for babies to wear sunscreen? It is safe and recommended to use sunscreen in babies over 6 months. The best way to ensure babies and children are protected is to provide as much shade as possible, use protective clothing, hats and sunglasses. Physical sunscreens are less likely to irritate sensitive skin and eyes.

It is recommended that parents of babies under 6 months should consult a doctor before sunscreen use. This is due to the lack of development of metabolism and excretion of the chemically absorbed agents within sunscreen. If sunscreen is necessary, it should be limited and infrequently used on sun-exposed regions only.

For more advice on photoprotection, arrange a consultation with Dr Kara Heelan at either the Chelsea Outpatient Centre (020 3494 4024) or Sydney Street Outpatients & Diagnostic Centre (020 3733 9029).

You should examine your own skin regularly approximately once a month, but often people aren’t sure what they are supposed to be checking for or how best to examine their skin. Here are some skin examination tips to follow:

Skin examination tips:

• Remember to check your face, neck, ears, body, arms and legs front and back
• Don’t forget your scalp, in between your toes and the bottoms of your feet
• You can use a handheld mirror to look at your back or ask your partner to help
• Things to be concerned about are new, changing lesions, very itchy or bleeding ones and any lesions or crusty sore ones that don’t heal up
• Also seek medical advice if you find new lesions that change in colour, size, shape or thickness over a period of weeks to months
• Remember, moles are not always brown-coloured, so look out for pink, red, blue-black or skin-coloured lumps and bumps also

Self-skin examinations are important for you to do at home at regular intervals. This increases your chances of noticing something unusual so that you can present to the doctor for investigation at the earliest stage possible. If you’ve noticed a skin change that is concerning, you can arrange a consultation with Dr Kara Heelan at either the Chelsea Outpatient Centre (020 3494 4024) or Sydney Street Outpatients & Diagnostic Centre (020 3733 9029).

With winter sports enthusiasts about to take off down the slopes, here are some tips on how to keep safe in the winter sun! Higher altitudes and UV reflection by the snow can increase the risk of sun damage. The sun’s reflection off the snow is strong even on cloudy days. Ultraviolet radiation exposure increases with increasing altitude.

To protect your skin from the sharp cold, strong winds and winter sun here are some useful tips:

• Look for a high factor (at least factor 30) sun cream which is broad spectrum.
• Broad spectrum refers to the protection of the sun cream against both UVA and UVB radiation. UVA radiation causes skin ageing and UVB causes sunburn.
• Apply 20-30 minutes before outdoors exposure and reapply after excessive sweating, exercise or every two hours.
• Apply sunscreen to all exposed skin.
• Remember these areas as they often forgotten… the lips, ears, around the eyes, the neck, the underside of chin, scalp and hands.
• Always wear a lip balm with an SPF. There are several on the market with at least factor 30.
• Bring along travel size or sample size sunscreens with you to reapply while sitting on the chairlift.
• Remember there is no such thing as all day sun cream.
• Wear protective hats and facemasks in addition to sun cream.
• A teaspoon full of sunscreen is required to completely cover the whole face
• The type of sun cream one uses (gel, spray, cream, mist) is not necessarily important, but finding one that you like using will make it more likely that you use it and reapply it often.
• Sunglasses or goggles that have wraparound or large frames will protect your eyes, eyelids and the thin skin around your eyes.
• Use a moisturizer during winter months. Winter conditions can be particularly harsh on the skin and even more so for people who suffer from eczema and dry skin conditions.
• Remember to continue to protect your skin during your leisurely outdoors slope lunch break!

Enjoy the winter season!