Breast Cancer Basics: Going To A Spa (What Cancer Patients & Survivors Need to Know)
Your skin is your body’s largest organ and what you put on it and how you treat it really does matter. It is also your first-line of defense against the numerous toxins and infectious organisms you come into contact with every day. If you have cancer or have been treated for cancer in the past, these recommendations are important.
General Recommendations:
We highly recommend that before you head out to the spa/salon, seek out aestheticians or massage therapists who are trained in Oncology Esthetics® or Oncology Massage Therapy.
Additionally, ask your oncology providers for their recommendations on reputable spas/salons and on whether they have any specific concerns or risks pertaining to your situation.
You can find oncology-trained aestheticians and massage professionals on these websites:
Just because a product claims to be organic or natural (i.e. ‘natural ingredients,’ ‘not tested on animals,’ etc.) does not mean it is necessarily safe to use for your particular circumstances.
Always discuss skin care products with a salon/spa professional who is experienced in working with cancer patients.
Massage techniques, body positioning and areas to avoid should be modified based on the specific treatments and side effects unique to each patient.
According to the Society for Oncology Massage, “When you are receiving an oncology massage, you are receiving traditional, established massage therapy techniques that have been adapted to account for your unique health situation. The changes that might be made to a massage that make it an oncology massage can fall under any number of categories, but typically they will be related to session length, pressure, positioning and areas of specific compromise or concern like mediports, bone metastases or skin reactions to treatment.”
It is important for your massage therapist to know where any tumors are located in your body. This can help them make modifications in their technique, pressure and joint movements. Massage over superficial tumor sites is typically contraindicated. If the tumor is in a deep location (i.e. lung, pelvis), modifications to technique may still be indicated but massage over these sites is permissible. Bone metastases can predispose to fracture or pain, especially with heavy pressure, torque or forceful movements.
Cancer patients and survivors may have side effects, complications or other concerns relating to their cancer or treatment. As such, additional massage or positional modifications may be needed (examples):
Reduced massage pressure for individuals with a history of blood clotting, bleeding, neuropathy or pain.
Predictable rhythms and slower speed massage for individuals who are experiencing nausea.
Shorter massage sessions for individuals with a fever or are fatigued.
Limb avoidance or technique adjustments may be needed in any patient who has had lymph node surgery or radiation to reduce the risk of exacerbating lymphedema.
At the beginning of your cancer journey or anytime before, during or after treatments, there are many things you can do to help ensure your appearance remains as normal (under the circumstances) as possible.
Let you medical team know that you would like to be able to go to a salon or spa for hair, skin and/or nail services. Ask them to provide you with a list of possible treatment-related side effects that might impact your skin, hair and nails. You may be able to circumvent some of these through a variety of strategies before treatment. Oncology-trained salon/spa professionals will likely ask you to obtain a medical release note from your medical providers to indicate limitations, if any.
Cancer treatments can cause short-term or permanent side effects on the skin, hair and nails may include:
Radiation therapy – hair loss (alopecia), skin inflammation, discoloration and scarring
Chemotherapy and some other drugs – hair loss, skin sensitivity, skin rashes and dryness, nail changes (texture, coloration, nail loss)
Surgical procedures – inflammation, scars and bruising
All treatment-related skin side effects must be addressed before the application of camouflage makeup. Provided the skin is not compromised (i.e. burns, blistering, pealing, open wounds, infections) you should be able to use airbrush makeup (it is sprayed on, so there is no rubbing or tugging at the skin). Brows can be recreated using airbrush and stencils.
Recommendations After Cancer Treatment:
Even after your cancer treatment is over, your skin has a memory and does not forget the damage or inflammation from the past. So, you still need to be careful in how you treat it.
Radiation therapy can cause either thinning of the skin in the area radiated or scarring/fibrosis (thickening of the skin), impaired circulation of blood or lymph fluid (lymphedema) and increased sensitivity to chemicals, ultraviolet light and heat.
Cancer drugs can cause scarring of the skin or make the skin more sensitive to chemicals and ultraviolet light.
Surgery can lead to impaired blood and lymph circulation, thinning or scarring of the skin, decreased skin pliability and limitations in limb range of motion.
Cosmetic Procedures (Do’s and Dont’s)
All of these procedures should be done with a qualified dermatology expert who has extensive experience working with cancer patients and survivors. Superficial (“light”) chemical peels– a gentle acidic solution is applied topically, to speed up cell turnover and consequently address acne scars, hyperpigmentation, rough texture and fine lines. This is an option most cancer patients, unless the tissues to be treated are affected by chemotherapy, radiation therapy or are at a high risk of developing lymphedema. Learn more here.HydraFacials– a medical-grade resurfacing treatment that gently sucks dead skin cells and debris off your face while also hydrating the skin with serums. This is an option most cancer patients, unless the tissues to be treated are affected by chemotherapy, radiation therapy or are at a high risk of developing lymphedema. Learn more here.Hyaluronic acid fillers (such as Juvederm and Restylane)- Small amounts of filler are low-risk during chemo or radiation, unless the patient has a low white blood cell count or low platelets (which may increase the risk of bruising and infection). This is an option most cancer patients, unless the tissues to be treated are affected by chemotherapy, radiation therapy or are at a high risk of developing lymphedema.
Neurotoxins (such as Botox, Xeomin, Dysport and Jeuveau)- Likely safe in most circumstances, but should not be injected into areas of skin that are affected by chemotherapy, radiation therapy or are at a high risk of developing lymphedema. Learn more about these medications here.Kybella– is used to reduce fat in small areas like under the chin. It works through chemically induced inflammatory destruction of fat cells. Kybella carries a risk of chemical ulcer formation and tissue necrosis, which can increase the risk of systemic infection and death in cancer patients who are immunocompromised. Not to be used in skin areas affected by chemotherapy, radiation therapy or are at a high risk of developing lymphedema.
Laser resurfacing– Lasers (such as Fraxel) make tiny zones of injury in the skin, which can be increase the risk of viral and bacterial skin infections (especially in patients with a weakened immune system). Cancer patients should avoid this procedure if they are immunocompromised, as these infections are harder to fight off in this condition. Additionally, laser resurfacing is contraindicated on any tissues affected by chemotherapy, radiation therapy or are at a high risk of developing lymphedema. Learn more here.Laser hair removal- several chemotherapeutic drugs make the skin more sensitive to light, which can increase the risk for a skin burn. Ask your medical oncologist if the drugs they are using can cause photosensitivity reactions. Laser hair removal is contraindicated on any tissues affected by chemotherapy, radiation therapy or are at a high risk of developing lymphedema. Learn more here.
Bottom Line:
Going to a salon/spa is truly a holistic mind-body-spirit experience, and one that we highly encourage patients to explore and enjoy. We hope that the recommendations and information in this article will make your trips to the spa as safe as possible.
Choose your salon/spa professionals based not only on their reputation, but also on their experience in working with cancer patients and survivors.
Make sure to ask about the products that use, as many are loaded with potentially toxic or irritating chemicals. Oncology-trained professionals will know which products are the safest for you.
Most importantly, pamper yourself, have fun and relax…you deserve it.
Contributing co-author: Morag Currin, Author of Oncology Esthetics: A Practitioner’s Guide and and founder of Oncology Esthetics® training.
