How to minimise chemotherapy side effects on skin hair and nails

How chemo and other cancer treatments affect your hair, skin and nails – and how to minimise the side-effects

2nd November 2023 | Author: Shyma Millman

Cancer treatments, while life-saving, often come with challenging side effects for our skin, hair, and nails. Here’s what you need to know and how to minimise the impact

It’s an unfortunate and devastating reality that many of us will know someone affected by cancer.

Stats show that one in two people face a cancer diagnosis in their lifetime and a quarter of these patients will go through chemotherapy, among other treatments.

In fact, more than 320,000 people received treatment for cancer in the UK last year which was the highest year on record – up by more than 8,000 on the same period pre-pandemic.

What’s more, not only did the NHS see and treat more people than ever before for cancer, but recent data also shows 100,000 patients were diagnosed with cancer at stages one or two when it is easier to treat.

Again, this is the highest proportion on record.

Yet while these treatments are designed to target and kill cancer cells, they also impact other rapidly dividing cells in our body, including those in our skin and hair.

The physical and mental toll of which, on people already going through a scary and uncertain time, cannot be underestimated.

If you’re just starting out on your cancer journey, or you want to support a loved one who is, we explain some of the key symptoms to look out for and expect below.

We also offer ways in which you can minimise these side effects so you have one less thing to worry about.

Chemotherapy vs radiotherapy vs immunotherapy

Chemotherapy vs radiotherapy vs immunotherapyShutterstock

While there is a growing number of cancer treatments, some of which are still undergoing clinical trials, if you’ve received a diagnosis you’ll likely be offered one of three main treatments – chemotherapy, radiotherapy, and immunotherapy.

Below we summarise each treatment before explaining their individual side effects, if you want to jump straight to the side-effects of your treatment, click the “Jump to section” links next to each treatment.

  • Chemotherapy: According to Cancer Research, chemotherapy prevents cells from growing and dividing across your entire body. This is because cancer is caused by rogue cells growing and dividing uncontrollably and unpredictably. Chemotherapy drugs can’t always distinguish between these healthy cells and cancer cells, which leads to side effects – Jump to chemotherapy side effects section. 
  • Radiotherapy: Radiotherapy uses radiation to kill or slow growth of cancer cells. Jump to radiotherapy side effects section. 
  • Immunotherapy: Immunotherapy stimulates the immune system causing it to be more active, which in turn makes it better at attacking cancerous cells. Jump to immunotherapy side effects section. 

FURTHER READING: Support cancer research charities with these beauty brandsDo you know what skin cancer looks like?Boots and Macmillan launch No7 virtual beauty consultations for women going through cancer | The best moisturisers for dry skin | Expert tips on how to stop or regrow thinning hair

What is chemotherapy?

There are a number of different chemotherapy drugs, each with their own strengths. Some damage the DNA of the cancer cells, preventing them from replicating. Others target the structures or functions within the cell, such as the cell’s skeleton or the enzymes required for cell division.

Depending on the treatment, and dose, chemotherapy can be administered via chemo pills, intravenously, topically on the skin, or by injection into specific sites.

Chemo side effects on skin and hair

Below are chemo side effects you can expect on your skin and hair. You may not get all of these side effects, or they may not be as severe as others.

Hair side effects

Hair loss menopause symptomsGetty Images/iStockphoto

Hair follicles, responsible for hair growth, are among the fastest-growing cells in the body. Chemo drugs, targeting rapidly dividing cells, often affect these follicles which causes them to stop working as effectively.

If you’re going through chemo, you might notice hair thinning or bald patches a few weeks into treatment. This hair loss can occur anywhere on the body, including the scalp, eyebrows, eyelashes, and pubic area. The extent of hair loss varies depending on the drug, dose, and individual.

After the chemotherapy course is complete, the drugs can stay in your body for some time, yet as they slowly leave and your hair follicles start working again, you may find you experience what’s known as chemo curls.

This is when the hair follicles may produce different types of hair, which might make it curly. Even if it’s always been straight. You can read more about how the shape of your hair follicle determines your hair type in our What type of hair do I have? guide, and our curly hair products 101 guide. 

Skin side effects

What causes dry skin and how to get rid of dry skin for goodShutterstock

These side effects can be seen across your body, so aren’t just seen on your face. This includes your scalp, which can play a further role in hair loss or thinning.

  • Dry skin and itching: Chemotherapy can reduce the amount of oil your glands produce, leading to dry and itchy skin. You might get flaky skin, especially on the arms, legs, and back. Read more about this in our guide to getting rid of dry skin.
  • Hyperpigmentation: Some chemo drugs can cause darkening of the skin, especially in areas exposed to the sun. This might cause your skin to look tanned or you might see dark spots on your hands and face. Read more in our guide to hyperpigmentation.
  • Photosensitivity: Chemotherapy can make the skin more sensitive to sunlight, increasing the risk of sunburn. If you’re used to tanning easily, you might now get sunburn after just a short time in the sun post-chemo.
  • Chemo rashes and redness: Some patients develop rashes or red, flushed skin. This could look like red blotches on their skin, similar to an allergic reaction.

Nail side effects

How to strengthen nails and brittle nails causesiStock

Just like hair and skin cells, nail cells also divide rapidly and can be affected by chemo. You might find that you get brittle nails, or they become, ridged, or develop dark bands. There’s also a possibility of the nail lifting off the nail bed or becoming discoloured. Read more in our guide on how to strengthen brittle nails

What is radiotherapy?

Radiotherapy, also known as radiation therapy, uses high doses of radiation to kill cancer cells and shrink tumors. In particular, radiotherapy damages the DNA within cancer cells, either destroying them or significantly slowing their growth.

The radiation can be delivered externally, using a machine that directs high-energy beams towards the cancer – known as external beam radiation – or internally, where radioactive sources are placed inside the body near the cancer cells. This is known as brachytherapy.

Modern radiotherapy methods, such as intensity-modulated radiotherapy (IMRT) and stereotactic radiosurgery, are designed to maximise the dose to the tumor while minimising exposure to the healthy tissue around it.

It’s usually given in small doses over a period of time, known as fractions. This gives normal cells the chance to repair themselves between treatments while cancer cells are less capable of repair.

Radiotherapy side effects on skin and hair


Due to the localised nature of radiotherapy vs chemotherapy, the side effects are more localised too.

Hair side effects

When radiotherapy is directed at a part of the body that grows hair, the radiation can damage the hair follicles in that specific area, leading to hair loss.

If you receive radiotherapy to the brain, for example, you’ll likely only lose hair on your scalp.

If the treatment is targeted at the lower body, you might lose hair in the pubic region.

Skin side effects

  • Radiation Dermatitis: This is a common radiotherapy side effect where the skin becomes red, dry, and tender in the area that’s being treated. You might notice changes in the skin over the breast, if you’re being treated for breast cancer for example, ranging from mild redness to more severe reactions like peeling or blistering, similar to sunburn.
  • Hyperpigmentation: Like with chemo, the treated skin may become darker, a condition known as radiation-induced hyperpigmentation. After several weeks of treatment, you might notice that the skin in the treated area looks tanned or is darker than the skin around it.
  • Fibrosis: Over time, the skin and underlying tissue where the radiotherapy is being administered may become less flexible. This is because of the development of fibrous tissue, a process known as fibrosis. This can occur months or years after treatment, and you might find that the skin and tissues in the treated area feel firmer or thicker than before.
  • Ulceration: In severe cases, the skin around the treatment area may break down and form ulcers. This is a less common side effect, but you may develop an open sore in the area that received the highest dose of radiation.

Nail side effects

Similar to chemotherapy, radiotherapy can also affect the nails if the hands or feet are in the treatment area. This can cause nail discoloration, ridges on the nails, or even separation of the nail from the nail bed, known as onycholysis. Read more in our guide on how to strengthen brittle nails

What is immunotherapy?

What is immunotherapy and its side effectsShutterstock

Unlike chemotherapy and radiotherapy, which directly target cancer cells, immunotherapy works by stimulating or restoring the immune system’s ability to detect and destroy cancer cells.

Some forms of immunotherapy, such as checkpoint inhibitors, work by taking the ‘brakes’ off the immune system, allowing it to recognise and attack cancer cells more effectively. Other types, like CAR T-cell therapy, involve modifying some of the patient’s immune cells to attack specific cancer cells.

While treatments such as cytokines boost the overall activity of the immune cells and their ability to respond to cancer.

Immunotherapy side effects on skin and hair

Like with chemo, immunotherapy side effects can appear all over your body and you see all, or none of these effects depending on your cancer, dosage and immune system.

Hair side effects

Hair side effects are less common with immunotherapy but may be experienced.

Some immunotherapy drugs can lead to hair thinning or loss and you may notice your hair becoming thinner, more brittle, or falling out more easily than before starting treatment.

There have also been reports of changes in hair texture or color in patients undergoing immunotherapy. For example, your hair could grow back with a different texture (curlier or straighter) or colour after treatment, similar to the chemo curls mentioned above.

Skin side effects

What is psoriasis, what causes it and can you cure it permanentlyShutterstock

A number of skin conditions like psoriasis have been linked with changes to the immune system, it’s why they’re called auto-immune diseases. A similar reaction is seen in response to immunotherapy.

  • Rashes and itchiness: Immunotherapy can cause rashes and itchiness, as the immune system becomes more active. You might develop a rash that looks like acne or measles, often starting within the first few weeks of treatment. This can occur anywhere on the body but is most commonly seen on the torso, arms, and legs.
  • Dry skin: Your skin may become dry and flaky due to the immune system’s heightened activity. Similar to the chemo side effects, you might notice increased skin dryness and you might need to moisture more than usual.
  • Vitiligo: In some cases, particularly with treatments targeting melanoma and skin cancer, the immune system can attack normal melanocytes (pigment cells). This can lead to patches of skin losing pigment, known as vitiligo. Read more in our guide on vitiligo.

Nail side effects

Immunotherapy can also affect the nails, though this is less common. You might experience nail discoloration, brittleness, or ridges.

How to minimise chemotherapy side effects

As chemo tends to be the most invasive and impactful, we’ve explained how to minimise chemotherapy side effects below. However, the suggestions and treatments can also be used to minimise immunotherapy and radiotherapy side effects, too as there are many overlaps.

Dealing with hair loss

How-to-stop-hair-thinning-and-regrow-thinning-hair-women-femalemamabella | mamabella

A National Library of Medicine’s study found that 82.6% of patients have hair loss as a severe side effect of cancer treatment so chances are this will be the biggest side effect you experience. Here are some ways to deal with hair loss from chemo and other treatments.

Shave it off: This may seem drastic and may not be what you want to hear, but Macmillan has found that some patients prefer to cut their hair short beforehand so that it does not come as a shock when they start to lose hair due to treatment. Some people even shave their heads before they start treatment while they feel more emotionally and physically stronger to make that decision and to feel more in control.

Invest in a scalp cooling cap: Scalp cooling caps lower the temperature of the scalp blood vessels. This causes these vessels to contract/shrink which reduces how much blood flows to the area. This, in turn, reduces how much of the cancer drug chemicals reach and kill those cells. Although hair may still be lost this reduces the amount of drugs that will reach the hair.

Buy wigs: There are various wig options available for patients. The NHS may give wigs to some patients and there are also charities that provide wigs. These include the the Little Princess Trust, which gives wigs to children going through hair loss, and Wigs for Heroes. You can also donate hair to these charities for use in its wigs. Cancer Research has a great article about how to choose a wig here.

What is microblading?iStock

Microblading for eyebrows: Microblading is an option prior to treatment that adds semi-permanent pigments to your eyebrows. You can read more about microblading here. There are also eyebrow stencils that can be used to fill with powder and create an arched brow shape.

This is great if you want a quick, temporary option. We have more options and advice in the following guides: What causes eyebrow hair loss?How to get thicker eyebrowsHow to do eyebrows.

False lashes: Eyelure’s C-Lash is owned by Codilia Gapare, a cancer survivor who found that there was no false lash option for someone who had lost all of their natural lashes. C-Lash has different lash lengths and volume to make your lashes look natural. The false lash replacement strips have a flexible band that stays in place all day.

You can also buy any of the best false eyelashes to suit your style. You can get more help on how to put on false eyelashes here. 

This Is Silk hair wrapThis is Silk

Silk pillowcases and covers: Using silk or satin pillow covers and hair turbans are good for hair loss because it minimises friction, which can pull at the hair and its follicles.

It can also offer comfort for irritated scalp skin. We recommend the M&S silk range, as well as Beauty Sleep’s collection.

Minimise brushing: Try to reduce how much you brush your hair as it can similarly pull on the follicles, making hair loss worse. Use your fingers to ‘comb’ through your hair, or gently use soft-bristle brushes.

During the treatment process, patients are told to be gentle with their hair and avoid using curling tongs/straighteners, hair dryers, and dyes too.

The Manta hair brush has been designed for cancer patients. It uses a soft-touch material which means no rough edges to catch or tear the hair shaft.

Swap for gentle shampoos and conditioners: Avoid strong fragrances or harsh chemicals in your hair products when going through treatment, and look for fragrance-free shampoos and conditioners to minimise the chance of reaction.

The Philip Kingsley No Scent No Colour Shampoo, and No Scent No Colour Conditioner was created for women who are undergoing treatment for cancer because it’s gentle enough to use on the scalp every day. It was developed for Philip Kingsley’s wife Joan when she was going through treatment for breast cancer and a percentage of each bottle sold is donated to the Look Good Feel Better charity.

Try hair oiling: This is more of a solution for when your treatment is over and your hair starts growing back. The process of massaging the hair oil into the scalp can help stimulate the follicles and encourage growth while nourishing the scalp.

Dealing with skin side effects

Best moisturiser for dry skin and dehydrated skin UKmamabella | mamabella

The exact skin products to help when going through treatment will depend on your existing skin type and the severity of your side effects. However, as a general rule:

  • Choose gentle, alcohol-free, and ideally fragrance-free products to minimise further irritation. We have a number of options in our best skincare for sensitive skin guide.
  • Opt for thicker creams that help not only lock in moisture but which create a barrier on the skin to protect it from pollution. We’ve rounded up our favourites in our best moisturiser for dry skin guide.
  • Look for products with ceramides and peptides and avoid harsh exfoliants.
  • Products for eczema and rosacea are good options for post-treatment skin.
  • Make sure you’re wearing sunscreen every day. Cancer treatments can make your skin more sensitive to sunlight, even when it’s cloudy.
What to look for when buying the best sunscreen for face UKmamabella | mamabella
  • To handle the sunburn-style effects of cancer treatment, use an aloe vera gel – ideally, that has been stored in the fridge – to soothe and cool areas of irritation and dryness.
  • Avoid hot showers and baths and gently pat the skin dry.
  • You may also have to change your concealer and foundation shades to counteract the changes in skin tone and colour. Check out our foundation match guide if you need help. That article links to the foundation matching services of many brands.

Where to find further support

LookGoodFeelBetter BrushesLook Good Feel Better

There is a wealth of resources out there if you need more support.

Look Good Feel Better is a cancer support charity that provides workshops led by volunteers in the beauty industry to give advice on changes they may be facing. They also offer workshops on wellbeing. The charity brings together people going through the same thing so that they feel less isolated and can get help and advice in uncertain times.

Boots offers one-to-one consultations in-store and online, run by pharmacists and beauty consultants, that can help when you have questions about medication or side effects.

Elsewhere, a hotel group in the UK has launched a range of treatments designed to help people who are going through cancer treatments, in remission, or nearing the end of life.

The group, called Exclusive Collection, has partnered with Italian skincare brand, Comfort Zone to launch its Beauty Reloaded program. Each of the treatments focuses on skin renewal, as well as addressing the physical and mental side effects of living with cancer.

Cancer Research UK also has a whole page dedicated to dealing with the side effects of cancer treatments. This includes more detailed information on how chemo side effects impact your skin, hair and nails, as well as hair thinning.

♥︎ Don’t miss out! Sign up for the mamabella newsletter today ♥︎




This site contains affiliate links to recommended products. We may receive a commission for purchases made through these links. We will not recommend anything we don't believe in and we are not paid by brands to include specific products unless explicitly stated.
Next Article Previous Article