Helping Reduce Chemotherapy-Related Skin Issues

In the war against cancer, chemotherapy (including immunotherapy) has made some terrific advances, but some cancer therapies are associated with significant side effects including skin issues such as dry skin, pruritus, rashes, and skin eruptions.  Furthermore, certain chemotherapy can result in edema (swelling) that can lead to other serious skin issues.  Providing optimal skin care during chemotherapy can help reduce some of these issues and help patients continue lifesaving treatments, as well as attain higher qualities of life.

Skin breakdown resulting from chemotherapy can result in infections and major wounds.  Common skin microbes that ordinarily are not dangerous can cause serious infections in cancer patients due to immune system suppression typically caused by various cancers, as well as chemotherapy.  In addition, chemotherapy is well known for its negative effect on the epithelial layers of skin.  This effect is attributed to the death of epithelial progenitor cells resulting from the non-specific effects of certain types of chemotherapy on rapidly dividing cells. 

Skin barrier disorder caused by chemotherapy that results from the dysfunction of proliferation and differentiation of keratinocytes and epidermal stem cells can cause dryness and scaling of the skin that can lead to inflammation and pruritus (itching).  Viniferamine^® skin and wound care products include many potent anti-inflammatory ingredients that can reduce pruritus including the polyphenols oleuropein, resveratrol, and epigallocatechin-3-gallate (EGCG) from olives, grapes, and green tea, respectively, as well as the important small molecules, melatonin, and L-glutathione.  In addition, dipotassium glycyrrhizate from licorice, avenanthramides in oats, aloe vera and shea butter possess anti-inflammatory activities. 

Epidermal growth factor receptors (EGFR) are expressed on certain keratinocytes and have a critical role in regulating keratinocyte proliferation, differentiation and survival.  Inhibition of EGFR results in decreased keratinocyte growth, decreased cell migration and enhanced cellular differentiation.  Chemotherapy drugs that are EGFR inhibitors and EGFR tyrosine kinase inhibitors (including cetuximab, panitumumab, matuzumab, gefitinib, erlotinib, lapatinib, afatinib) can cause skin rashes, erythema (redness), scaling and dry skin.  These drugs can also cause depletion of the antioxidative capacity of skin. 

Many of the ingredients in the Viniferamine^® skin and wound care products soothe rashes including aloe vera, oat extract and shea butter.  Moreover, Viniferamine^® skin and wound care products including Renewal Moisturizer contain various potent antioxidants that help protect skin such as oleuropein, resveratrol, and EGCG, as well as melatonin, and L-glutathione.  In addition some ingredients activate important oxidative defense enzymes including manganese superoxide dismutase.  In fact, in a model where MnSOD was deactivated, oleuropein induced MnSOD activity, EGCG has been found to induce MnSOD expression and resveratrol has been shown to upregulate MnSOD activity.

Renewal Moisturizer contains the most potent dose of Viniferamine^® that includes skin hydrating ingredients like dipotassium glycyrrhizate, which protects hyaluronic acid found in the extracellular matrix of skin.  Hyaluronic acid has a great capacity to bind water and keep skin hydrated.  Renewal Moisturizer also includes an advanced silicone complex that provides a breathable barrier to help protect skin and keep in moisture.  Dry skin is often itchy (pruritic). The anti-inflammatory ingredients in Viniferamine^® skin and wound care products including Renewal Moisturizer help decrease pruritus, which helps prevent scratching, wounding and infections. 

Programmed cell death (PD)-1 is an immune checkpoint receptor expressed by activated T cells, which normally down regulates T cells to avoid autoimmunity.  Inhibiting this receptor allows T cells to carry out T cell killing of cancer cells more effectively. However, chemotherapy that works by inhibiting PD-1 (including pembrolizumab and nivolumab) can result in rashes, pruritus and eczema. As discussed, many of the ingredients included in Renewal Moisturizer help decrease inflammation. Emollients are the first line of defense against mild eczema. Renewal Moisturizer also includes beneficial emollients from shea butter, oats and aloe vera.

Certain chemotherapy can also result in edema in the feet and legs including chemotherapy involving cisplatin and docetaxel.  Accumulated fluids that cause edema can create a physiological barrier that prevents the delivery of nutrients from the blood to the skin.  Without the nutritional support from circulating blood, skin cells eventually die resulting in inflammation and skin breakdown.  Another reason skin problems develop with edema is that the accumulation of lymph fluid and subsequent swelling creates pressure and tension in the skin as it stretches to accommodate the extra fluid, increasing the chances that the skin will break or tear and develop open sores that are slow to heal and prone to infection.  Viniferamine^® skin and wound care products deliver small molecule nutrients (< 500 Daltons) to the epidermal layers to help protect and strengthen the skin.

Skin that is stressed from chemotherapy should be kept free of irritants and treated with extra care.  Sun exposure should be avoided, as well as hot showers and baths. Harsh soaps and detergents should also be avoided.  In addition, perfumes and fragrances can irritate sensitive skin.  Viniferamine^® skin and wound products are non-sensitizing and non-irritating.  Viniferamine^® antiseptic cleanser is a gentle cleanser that can be used instead of soap.  The no-rinse formula can be used for routine cleansing to help control odor and reduce the risk of infections.  Antiseptic cleanser also includes anti-inflammatory ingredients and all the other small molecule nutrients found in other Viniferamine^® skin and wound care products.

It’s good to know that Viniferamine^® skin and wound care products can soothe and protect skin that is extra sensitive or compromised from cancer chemotherapy.  Viniferamine^® products include potent anti-inflammatory ingredients that help decrease pruritus, as well as skin hydrating ingredients that help maintain skin moisture.  Viniferamine^® skin and wound care products including Renewal Moisturizer and Antiseptic Cleanser contain vital skin nutrients to strengthen skin and help prevent skin breakdown.  Moreover, Antiseptic Cleanser includes a gentle antimicrobial to help protect skin against the risk of infection.

About the author: Nancy Ray, PhD is the Science Officer at McCord Research. Dr. Ray received her PhD in Biochemistry and Biophysics and was a postdoctoral fellow at NIH, Harvard University and Dana-Farber Cancer Institute, and the University of Iowa. She also earned bachelor of science degrees in Chemistry and Microbiology.

 References

1. Breast Cancer: Targets and Therapy 2014; 6: 115-122.
2. Pathogens 2016; doi: 10.33901/pathogens5010006, 1-16.
3. Int J Mol Sci 2014; 15: 18508-18524.
4. Diab Vasc Dis Res 2014; 11: 92-102.
5. Oxid Med Cell Longev 2012; ID 560682:1-8.
6. J Pineal Res 2013; 55: 325-356.
7. Int J Gen Med 2011; 4: 105-113.
8. Evid Based Complement Altern Med 2012; ID 650514:1-9.
9. Cell J 2014; 16: 25-30.
10. ISRN Endicronol 2014; ID 816307: 1-8.
11. J Am Acad Dermatol 2005; 52: 1049-1059.
12. J Med Life 2015; 8: 57-61.
13. J Am Acad Dermatol 2014; 71: 754-759.
14. Drugs 2015; 75: 1335-1348.
15. Support Care Cancer 2016; doi: 10.1007/s00520-016-3231-1, 1-8.
16. Am J Clin Oncol 2016; doi: 1097/COC.0000000000000291, 1-9.
17. Mol Cell Oncol 2015; 2:4, e1004969, 1-10.
18. Ann Plast Surg 2007; 58: 449-455.
19. PLOS One 2015; 10: e0115341: 1-18.
20. Exp Dermatol 2008; 17: 713-730.
21. J Biol Regul Homeost Agents 2014; 28: 105-116.
22. Arch Biochem Biophys 2008; 171-177.
23. Phytochem 2014; 98: 164-173.
24. Clin Cancer Res 2016; doi: 10.1158/1078-0432.CCR-15-2872, 1-7.
25. J Am Acad Dermatol 2016; 74: 455-461. 

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