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Look Good Feel Better: From the Outside In

Many women who experience side effects of cancer treatment that have an impact on their appearance can attest to the emotional toll these changes take. Some of the side effects that can be particularly challenging include hair loss, brittle nails, and changes to the skin (including acne, rashes, and dryness). Enduring these symptoms can be a lot to bear on top of the many other physical and emotional challenges cancer patients face.

The Look Good Feel Better program, a collaboration of the Personal Care Products Council Foundation, the American Cancer Society, and the Professional Beauty Association, aims to help patients manage these appearance-related side effects by providing hands-on workshops at cancer centers and hospitals nationwide. During these free two-hour workshops, certified volunteer beauty professionals facilitate the program’s signature steps and provide tips and techniques to help boost program participants’ self-esteem.

Recently, three Look Good Feel Better program graduates—Jessica, Janice, and Cathy—offered their thoughts about the impact of appearance-related side effects and why looking good really does make people feel better.

Q: What appearance-related side effects did you experience during cancer treatment?

Jessica: Chemotherapy changed my skin color and made my skin dry. My nails turned dark, but the most terrible side effect was the hair loss—I even lost my eyebrows and eyelashes.

Janice: I experienced hair loss at the beginning of my second chemotherapy cycle. It started as hair loss on my arms, legs, and pubic area, then the hair on my head. Just when I thought I was safe, my eyebrows and eyelashes fell out. I remember using mascara on my last three eyelashes on each eye, before they finally fell off. I also experienced weight loss further into the chemo treatments.

Cathy: The first side effect I noticed was a change in my skin. It became dry and dull. Then there was the hair loss, which was the most disturbing side effect.

Q: How did these side effects affect you emotionally?

Jessica: I could not look at myself in the mirror. My appearance changed, and this affected my self-esteem; I didn’t want anyone to see me like that. I was isolated, and I became depressed.

Janice: I did a lot of journaling and praying to come to acceptance about my impending hair loss, and I thought I was totally prepared—until I went to my hairdresser to have my head shaved two days before my fifty-sixth birthday. Not only did I black out at the salon due to dehydration (I hadn’t been eating or drinking enough), which resulted in a trip to the emergency room via ambulance, but I had to face the fact that I was *bald—*and not by choice! I had a good, ugly cry, after which I was able to call on my faith and all of my strength to move into the fight for my life. I came out of this experience feeling much stronger—bald and beautiful!

The weight loss actually affected me more. I lost 23 pounds, leaving me at 108. I looked sickly, and that had a more devastating impact on me. I did my best to use my fashion know-how and style to make the best of my new body. It took a little longer for me to embrace the “little” me, but I finally did.

Cathy: My hair loss was gradual, but the day my fiancé shaved my head was a very traumatic day. My self-confidence plummeted. I had always had long hair, and when I looked in the mirror I just didn’t know who was looking back at me. The tears flowed on a regular basis.

Q: What steps did you take to manage your appearance that made a difference?

Jessica: I looked for information through the American Cancer Society website, where I found Look Good Feel Better and decided to give it a try. I learned how to correctly draw on my eyebrows and eyelashes and how to tie scarves. These skills allowed me to continue with my life.

Janice: I sought out ways to help boost my self-esteem, which included attending a Look Good Feel Better workshop. The workshop helped lift my spirits. It was wonderful to be around other women who were dealing with the same fight that I was. We had great volunteers, who made the experience fun. I also worked on creating new personalities with the use of wigs, and I arranged to get my head shaved every two weeks so that I felt good about the new style and to keep some parts of my life intact.

The weight loss took a little more creativity. I began to wear more-flowing outfits and brightened my wardrobe, even though it was during the winter. This helped boost my self-esteem during chemo, especially during the holidays, which came at the end of my treatment cycle.

Cathy: Though I’d thought that wearing a wig would be the answer, it wasn’t. The wig was hot, and, once again, I found myself not recognizing the woman in the mirror. My skin was dull, and nothing I did seemed to brighten it. Late in my treatment, I was able to attend a Look Good Feel Better workshop, which was a real lifesaver—I felt like myself again. I learned tips on the application of makeup, which gave me some of my confidence back. I not only looked more like me but I also felt more like me.

Caring for Sensitive Skin

Developing sensitive skin during cancer treatment is quite common because the treatments disrupt your

skin’s normal process of rejuvenation. You may be literally uncomfortable in your own skin during this time,

as you experience dryness, increased sensitivity, and perhaps changes to your skin’s texture.

Skin Care Routine

To offset these temporary changes, you may need to make a few adjustments to your skin care routine. I recommend adopting a simple, gentle routine:

Cleanse with a creamy cleanser or warm water and mild soap; pat skin dry.

Apply a moisturizer with a sun protection factor (SPF) of 15 or higher to your face, using light massaging movements (and don’t forget to moisturize your neck). Allow the moisturizer to absorb into your skin and apply more if needed.

To revitalize the delicate skin around the eye area, you might find it helpful to use an eye cream at this stage.

If so, apply a pinhead amount to each ring finger and pat very gently onto the bony area beneath your eye. Be gentle, as the skin around the eye area is very fine and sensitive.

Reapply moisturizer throughout the day as needed (you may need to reapply several times).

Because skin may be sensitive during treatment, ask your doctor before using any cream, lotion, makeup, soap, sunscreen, or other product—especially on or near treatment areas if you are receiving radiation. Also, women undergoing chemotherapy should avoid using hormone creams, such as those containing hydrocortisone.

Health and Hygiene

During cancer treatment you are likely to be more vulnerable to infection due to suppression of your immune system. Because of this, hygiene is a top priority. When it comes to your skin care/beauty routine, here are the golden rules:

Always wash your hands before using skin care or cosmetic products.

Always close lids and caps tightly after use.

Clean brushes and sponges regularly with warm soapy water, rinse thoroughly, and allow to dry naturally.

Do not use your hands to dispense product. Use clean cotton balls, swabs, or disposable sponge-tip applicators.

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Never share products or applicators with other people.

Be sure to use a clean washcloth and towel.

When shopping for skin care and cosmetic products, test them on the back of your hand rather than on your face, and always use cotton swabs or other disposable applicators when testing products.

Courage, confidence, control, community, and *caring—*ask any woman who has lived with cancer, and she will likely find meaning in these words. They are also integral to Look Good…Feel Better®(LGFB), a national public service program that helps women cope with appearance-related changes of cancer treatment. The program offers free workshops, practical tips, and guidance that improve a woman’s self-esteem and help her manage cancer treatment and recovery with greater confidence.

Celebrating its twentieth anniversary this year, LGFB is focusing a yearlong “Hope Is Beautiful” campaign on the women the program serves. Through their stories, experiences, and favorite tips, the program hopes to offer support and inspiration to other women navigating the challenges of a cancer diagnosis and treatment. Some of the women who have benefitted from LGFB share their stories here.

Nancy Lumb

“I never cried when I was told I had breast cancer or had to tell my mother and husband,” Nancy says. “I cried only when I started to lose my hair. Cancer has a way of robbing you of your femininity.

“With chemo,” she continues, “I lost my hair, I lost my eyebrows, and I lost my eyelashes. Learning about how to re-create my eyebrows was probably the most helpful information I learned.”

LGFB Tips

Eyebrows help balance the eyes and flatter all other facial features. Because of your treatment, you may need to fill in thinning brows or re-create your brows entirely. Whatever your need, the trick is to find your natural eyebrow arch and use short, feathery strokes for a natural look. A close-up photo of yourself taken before treatment is a big help.

To re-create your natural brow line:

  • Buy brush-on eyebrow color or a pencil in a shade that matches your current hair or wig color or just slightly darker. Because eyebrow color does vary, choose what feels most appropriate for you. For a more natural look, you may want to invest in two colors of eyebrow pencil—a light shade and a darker shade—so that you can use alternating colors as you fill or draw in your eyebrows. Be sure to start with foundation and powder to prevent smudging.
  • Hold the pencil straight up against your nose, parallel to the inside corner of your eye. This is where the eyebrow should begin. Draw a dot just above the brow bone.
  • Looking straight ahead, place the pencil parallel to the outside edge of the colored part of your eye. Place a dot where the highest point of the brow line should be.
  • To define the outside edge of the brow, place the pencil diagonally from the bottom corner of your nose past the outside corner of your eye and draw a dot. Be sure the outer edge of the brow is not lower than the inside edge, as this will create a down-turned expression.
  • Once you have the basic shape right, connect the three dots using short, feathery, upward strokes to simulate the look of hair. Make the brow fuller on the inside corner and taper the brow naturally to the end. Use a small brush to gently blend and soften. Finally, apply the lightest dusting of loose powder to set the pencil, if desired.

With practice, drawing an eyebrow is as simple as applying lipstick!

Michelle Kostas

Michelle was only 30 years old when she was diagnosed with Hodgkin’s lymphoma in May 2008. She attended an LGFB workshop shortly after beginning chemotherapy. The timing was good, as she wasn’t sure how she was going to handle losing her hair and eyebrows. “I didn’t want to have those fake, painted-on eyebrows,” she says, “and Look Good…Feel Better teaches you techniques that make everything look more natural.”

Michelle says she also learned to avoid professional manicures and pedicures during treatment because of the risk of infection, something she had not considered beforehand.

LGFB Tips

  • Don’t cut your cuticles. Use cuticle-remover cream or gel and gently push your cuticles back.
  • Massage cuticle cream into the cuticle area daily to prevent dryness, splitting, and hangnails.
  • Be vigilant to minimize the possibility of infection; protect your hands and feet from dirt and grime.
  • Keep nails trimmed short—any imperfections will be less obvious.
  • Short nails that have been neatly manicured look great and can help you feel confident!
  • If you do visit a professional salon for a manicure or pedicure, bring your own sterilized nail care tools, but remember: no cuticle cutting.
  • Apply a rich cream to hands and feet for added protection to moisturize the skin.

Maria Torralba

Maria knew that she was interested in what LGFB had to offer. What she found, upon participating in a workshop, was the clear connection between her physical appearance and her emotional well-being. “When you look in the mirror and you see someone who looks good (and well) looking back at you, it has a great effect on your spirit—if you look good, you really do feel better.”

Maria learned both practical tips and the power of community. “The most important information I learned was how to care for my skin—to even out my skin tone and cover discoloration, especially dark under-eye circles. But also, maybe as important, I got to meet a lot of really amazing ladies who are brave and strong as they face their illness.”

LGFB Tips

Concealer

Concealer is typically used under foundation to diminish dark circles, visible capillaries that are more prominent, and facial blemishes. It is available as a stick or a cream.

Follow these tips for effective application:

  • For the eye area, apply concealer with a clean ring finger (light touch) or a disposable cosmetic sponge. Starting from the inner corner of the eye, apply dots of concealer out to the iris (colored part), and then gently blend the dots to the outer corner of the eye.
  • For extreme discoloration around the eyes, try a color-correcting concealer. Alabaster covers dark circles on warm skin tones; lavender gives a yellowish complexion a healthy glow and covers sallowness; mint neutralizes redness; pink highlights all skin tones; and orange covers blue tones such as veins and dark circles on dark skin.
  • If you’re using a foundation, choose a concealer no more than one shade lighter than your skin. If you choose to wear concealer without foundation, a shade closest to your natural skin color will look best.
  • Discolored skin can be camouflaged with a color-correcting concealer (see above examples) worn under the foundation.

Foundation

Foundation is used to even out your complexion and give it a soft touch of color and a healthy-looking glow. Because cancer treatment can temporarily change the color of your skin, sometimes giving it a gray or yellow cast, you may need a new shade of foundation.

Follow these tips to choose and apply foundation effectively:

  • For skin tone that has a gray or ash appearance, choose a foundation with more moisturizer in it to give skin radiance.
  • Choose a shade that matches the color of your skin at the jaw line.
  • To apply, dot the foundation on your forehead, nose, chin, and cheeks with clean fingers or a disposable cosmetic sponge. Then blend outward and upward from the center of your face to the edge and blend well at the hairline and the jaw line. Blend, blend, blend—that is the secret of flawless makeup application. Use a dry cosmetic sponge for full coverage or a damp sponge for light coverage.

Powder

Powder is quite necessary. It is used to set the foundation and keep it from melting off, and it yields a more professionally enhanced appearance.

Here are some tips for using powder effectively:

  • After the foundation step, lightly apply translucent loose powder over your face with a clean cotton ball using a pat-and-roll motion.
  • Gently dust downward and outward to remove excess powder and smooth any facial hair. Pressed powder is best for touchups.