Problem: I have a dear friend who has just been diagnosed with breast cancer. I want to be a supportive and I know how important feeling beautiful is for her. Any suggestions from you would be truly appreciated.
Solution: I’ve spoken with many women who have lived through the ordeal of radiation and chemotherapy, and they all agreed that paying attention to how they looked helped their emotional well-being a lot during the trauma of diagnosis and treatment. Having gone through this life-threatening event with my older sister, I had a reason to look further into these issues, and now I have the opportunity to share some solutions and possibilities with you and your friend. Given the number of women who have breast cancer or other cancers, surely most of us know someone who can benefit from this information. One thing my sister found immensely helpful was talking openly about her cancer experience without embarrassment or reservation. Perhaps your friend or someone else in your life would appreciate that kind of support and openness.
Body care: Because chemotherapy and radiation make the skin ultra-sensitive and even sunburned, as a general rule it is best not to use any types of adhesives, tints, bleaches, waxes, harsh or irritating chemicals, or to take hot baths or showers. Even deodorants and shaving can be problems. Saunas, Jacuzzis, loofahs, strong soaps, and washcloths can also exacerbate irritation. Anything you can do to reduce the hypersensitivity will go a long way to making the skin feel soothed and less irritated.
Instead of bar soap, which can be extremely drying and harsh on sensitive skin, try a gentle liquid body cleanser (it’s almost hard to find anything other than a gentle body cleanser). The least-expensive ones are formulated the same as the most-expensive ones.
Keep the skin moist with lightweight gels that don’t trap heat, such as pure aloe vera (found at most health food stores). If the skin becomes dry, use a nonfragranced, nonirritating moisturizer (the fewer plants it contains, the better) such as those from CeraVe, Cetaphil, or Eucerin. Take tepid or slightly warm showers and baths, and try to enjoy cool baths whenever possible, adding a little bit of light oil, such as safflower or sunflower oil, to the water. Avoid heavy oils such as vitamin E. Despite the fact that vitamin E has a reputation for healing the skin and can help the skin after the radiation and chemotherapy are over (as can other antioxidants), in the midst of treatment keep in mind that vitamin E is a potential allergen, and that its occlusive attributes can trap heat in the skin when it needs to dissipate heat instead.
Many women worry that even washing the skin may increase irritation. It turns out that gentle washing is better for skin than just leaving it alone. According to an article in
Radiotherapy & Oncology (March 2001, pages 333-339), “Washing the irradiated skin during the course of radiotherapy for breast cancer is not associated with increased skin toxicity [or irritation] and should not be discouraged.”
To keep her skin feeling soft and light, one of the first things my sister and I did before she went in for her radiation was to buy silk underwear, including T-shirts, underpants, teddies, and pajamas. She had to give up wearing a bra because the irritation from the straps and the tightness around the breast was just too uncomfortable. The silk was not only soothing, it also helped her feel more feminine and attractive.
Hair care: Some women feel compelled to shave their head in anticipation of losing their hair. That can be the worst possible solution for dealing with the inevitable. Shaving your head may look exotic, but unless you plan to shave every day, it can itch like crazy when it starts to grow back between treatments. It’s best to cut your hair very short and consider wearing designer baseball caps or wigs. Scarves always make it look like something is wrong, while baseball caps and wigs are quite normal nowadays.
By the way, the American Cancer Society can provide you with a free wig; call (800) 2272345. The wigs have been donated and are clean, but use them as a springboard for finding one that is perfect for you. You can buy a wig at a specialty salon or wig shop, but the trick is to find a good one and go to someone who knows how to style it. Wigs almost always need to be cut and styled to match your face. If you live in or near a large metropolitan area, your absolute best option is to find out who styles wigs for the women in the Orthodox Jewish community. For religious reasons, many Orthodox Jewish women cover their own hair with a wig. The shatel-macher (wig maker) is a mainstay of the Orthodox community and knows better than anyone how to make a wig look natural and attractive. Just call the Orthodox synagogue in your area and ask for the number of the woman who styles wigs for the community. The larger the metropolitan area, the more choices there will be.
One woman told me that after she purchased her first quality wig (around $100 to $500), she was a changed woman. “Not only did it fit great, but it looked so real that no one could believe it was a wig. I still wear it now and then, and get the biggest kick out of telling people it’s a wig.”
When your hair starts growing back, you may find that it grows back in thicker and straighter or curlier than it was. As tempting as it will be to dye your hair or perm it, be patient. Wait for the hair to go through a few normal cycles of growth before using chemicals on it. The skin and hair may still be sensitive or altered by the radiation and chemotherapy, and could react in a way that can cause problems.
Skin care: All of my recommendations for gentle skin care are doubly true during radiation and chemotherapy. And it is even more imperative than usual to avoid the sun, because the skin can become photosensitive. Sunscreen is essential, and the less the body and face are exposed to the sun, the better. That means wearing hats; light, tightly woven cotton pants; and light, long-sleeved blouses whenever possible. Because the skin can become dry, it is important to follow my recommendations for dry-skin care, which include using a gentle cleanser, a skin-softening toner, an emollient moisturizer, and plant oils such as evening primrose, jojoba, olive, or sunflower oil over dry patches.
Eyebrows and eyelashes: Accompanying the loss of hair on your head is the probable loss of eyebrows and eyelashes. Avoid the natural tendency to pencil in new brows, which look fake and dated. Instead, try powder shadows to draw on a soft arch of a brow. If you have any eyebrow hair left, consider using the colored brow gels from Bobbi Brown, Origins, or Paula’s Choice; these can add definition and shape to the eye area. Another option is to use a waterproof mascara or a waterproof eye pencil that matches your brow color. Although waterproof mascara and waterproof eye pencils can look slightly more artificial, they are worth trying because chemotherapy or other drugs can bring on menopause or menopausal symptoms, and the accompanying hot flashes, followed by profuse sweating, will wash the others away. This one takes some experimenting, so be patient until you find what works for you.
If you do lose your eyelashes, it’s best to not use any mascara, even if you have a few lashes left, because gaps in your application will be quite noticeable and mascara can shorten the life of the lashes you still have. Instead, consider lining the eyes with a dark brown shade of powder that you draw on more as shading than as a line. Lining with a pencil or liquid liner and no mascara can look odd, but shading the eye with a dark powder can look smoky and defining without making the lack of lashes more obvious.
Remember that brows and lashes grow back quickly, so that part is the most temporary!
Makeup: When it comes to concealer, foundation, blush, lipstick, and the rest, do whatever you are used to doing. Not only will it make you feel good, it will also normalize much of the process.
One woman wrote me a wonderful e-mail about this issue: “I cannot stress enough the concept that look good and feel better really works. I thought I was doing OK and I was, until I found out what it felt like to go out in public with hair and makeup (eyebrows) that looked real. I never lost my sense of humor or my positive outlook; but when I got a great wig and wore makeup (and eyebrows), I felt fantastic.”
One of the most powerful things you can do for yourself is to pay attention to your physical appearance and experiment to find what works. Don’t try to pretend that feeling and looking beautiful doesn’t matter during this time or that it is a waste of your energy. It may provide some of your most pleasant and uplifting moments until you are on the other side of your treatment.