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Hyperpigmentation: A Key Side Effect of Chemotherapy

By: Jennifer Linder, MD
Posted: May 28, 2013, from the June 2013 issue of Skin Inc. magazine.
Chemotherapy treatment

The patient's skin looks visibly healthier in regular light after two months of a chemotherapy and radiation therapy support treatment. There is also a substantial lightening of underlying hyperpigmentation seen in the UV photography.

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Once a client has completed chemotherapy, her skin will be ready for professional treatments rather quickly. It is best to avoid any exfoliating treatments during chemotherapy, but they are highly recommended after. If clients have followed your suggested skin care regimen during their cancer treatments, hyperpigmentation will likely not be visible on the surface; the use of an ultraviolet imaging camera, however, will typically show a marked increase in hyperpigmentation lying just below the surface. If left untreated, this discoloration will rise as the skin naturally turns over and desquamates. Some pigmentation will fade on its own, while much will deposit on the surface. Professionally applied, gently blended chemical peels every three weeks will help to improve the skin desquamation, rid the skin of its dull, impacted surface and help to speed the removal of underlying hyperpigmentation. Consider using peels formulated with multiple peeling agents at lower levels rather than a single acid peel. Straight acid peels can be aggressive and cause undue inflammation that will often worsen hyperpigmentation. There are also peeling blends available today that include melanogenesis-inhibiting ingredients to speed the clearing of unwanted pigmentation.

It is increasingly important for physicians and skin care professionals to address the common cutaneous side effects of cancer therapies with their clients and guide them to resources that can help. As the body’s largest organ, the skin of those undergoing chemotherapy has an overwhelming task. With the knowledge and tools, the skin care professional can be an important ally to the cancer patient. With proper care, hyperpigmentation can be held at bay during treatment and successfully cleared post-treatment, resulting in glowing, even and healthy skin.

Jennifer+Linder%2C+MDJennifer Linder, MD, is a dermatologist and Mohs micrographic skin surgeon, serving as CSO for PCA Skin. She holds a clinical faculty position in the department of dermatology at the University of California,
San Francisco; is a spokesperson for The Skin Cancer Foundation; and is a member of the American Academy of Dermatology (AAD), the American Society for Dermatologic Surgery (ASDS) and the American College of Mohs Micrographic Surgery and Cutaneous Oncology (ACMMSCO).

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