Cancer has become a common disease. The National Cancer Institute (INCa) estimates 382,000 new cases diagnosed in 2018(1). Everyone knows someone who has had cancer or is currently fighting cancer. This disease is characterized by a great diversity in the organs affected, the associated symptoms, the profile of the patients, as well as in the proposed treatments. Treatments are often heavy and complex, such as chemotherapy, radiation therapy, targeted therapies and immunotherapy. The side effects are numerous. Among them is itching associated with cancer treatments.
(1) Defossez G, Le Guyader-Peyrou S, Uhry Z, Grosclaude P, Remontet L, Colonna M, et al. National estimates of incidences of cancer mortality in metropolitan France between 1990 and 2018. Study based on the Francim network cancer registries. Preliminary results. Santé publique France, 2019. 20 p.
Summary
Itching caused by cancer treatments is the result of several mechanisms. Many treatments lead to intense skin dryness, a source of pruritus. Other treatments are photosensitizing, resulting in redness and skin irritation, which also causes itching. Chemotherapy-related pruritus can also develop in association with more specific skin side effects of cancer treatments such as hand-foot syndrome or folliculitis.
Scalp dysesthesia is a particular case of pruritus that concerns the scalp. More precisely, it is a pain perceived at the root of the hair, from the beginning of the cancer treatment or much later, at the time of hair loss and/or regrowth. The pain is accompanied by itching, tingling and burning sensations resulting in significant discomfort and inconvenience in daily life. In scalp dysesthesia, the mechanism of action is an increase in scalp sensitivity associated with local micro-inflammation.
Whatever the mechanism involved, cancer treatment-induced pruritus is aggravated by a number of factors: inadequate hygiene and skin care, climatic conditions, stress, etc.
If you experience pruritus during cancer, it is important to talk to your general practitioner or oncologist. Paramedical professionals such as nurse coordinators and socio-aestheticians are present in oncology departments and can help the patients dealing with itching. Pruritus should not be trivialized under the pretext that it is not life-threatening! You should definitely talk to your doctor. They will confirm that it is indeed chemotherapy-related pruritus or evoke another cause if necessary. Doctors listen and give information on best practices.
To relieve pruritus, using a superfatted soap, a syndet or a soothing cleansing oil, without perfumes or harmful substances is recommended. After showering, apply an anti-itching cream. Here again, opt for minimalist formulas and high-tolerance ingredients, so as not to generate additional irritation. Place the anti-itching cream in the refrigerator to optimize its effectiveness, and reapply as many times as necessary during the day and/or night. Opt for soft and circular movements, like for a massage. These little moments of relaxation help to reduce tension and stress while taking care of your skin.
For the scalp, there are hair care products adapted for patients undergoing cancer treatment, primarily mild shampoos and leave-in lotions. These can be used from the beginning of treatment and can accompany the regrowth process.
In addition to dermo-cosmetic care, doctors sometimes prescribe medication such as antihistamines. If the skin symptoms are too severe, treatment can be modified or even stopped. Be careful not to make any changes in treatment yourself, always refer to your oncologist's recommendations.
The management of cancer treatment-induced pruritus is multifaceted: it relies on hygiene and skin care measures, medication in some cases, control of contributing factors such as stress, and finally, adapted clothing and accessories. Don't hesitate to talk with your health care team, they are used to advising patients and supporting them throughout their treatment. From the beginning of treatment, wear loose, comfortable clothing made of soft, natural materials such as cotton, linen or silk. Silk accessories such as a scarf, bonnet or pillowcase help to limit scalp pruritus.
