Breast Cancer

Tips to Help You Look and Feel Your Best

*Although breast cancer can be diagnosed in women and men, it occurs significantly more often in women. As a result, this article focuses mainly on female patients. However, many of these suggestions apply to anyone diagnosed with breast cancer.

Treatment for breast cancer may cause significant changes in your appearance that can take a toll on your self-confidence and self-image. It’s hard not to feel defined by cancer when the effects are visible to others – and to yourself.

You may have one or both breasts removed, scarring, hair loss, discolored facial skin or fingernails, or lymphedema. Managing even one of these treatment-related side effects takes energy and effort, and you may feel that worrying about how you look is the least of your concerns. Although your physical health must be the priority right now, your mood and self-esteem can be affected when you don’t feel good about your appearance. Caring for your overall appearance while you’re undergoing treatment can help improve your self-image, which can actually help you feel better. And the better you feel physically and emotionally, the more likely you’ll be able to complete your treatment and get the maximum effectiveness from your therapies.

As much as possible, maintain your regular grooming habits. Try these practical suggestions to help boost your mood and put your best self forward during treatment and beyond.

Hair Care

For many women with cancer, losing their hair during treatment is one of the most difficult aspects of cancer treatment. It may be helpful to remind yourself that your temporary hair loss is the result of powerful drugs at work inside your body killing cancer cells.

As soon as you and your doctor determine your treatment, ask whether you are likely to experience hair loss. If your treatment plan includes a chemotherapy drug that will cause hair loss, you may consider asking your doctor about scalp cooling, also called cold cap therapy. It involves wearing a tight-fitting helmet-shaped cap filled with soft gel packs cooled to between -15 and -40 degrees Fahrenheit. The cap must be worn before, during and after chemotherapy. The cold reduces blood flow to the head, which makes the drugs less likely to reach and destroy the hair follicles. Scalp cooling may help some women retain some or much of their hair during treatment; it also has side effects and may not be covered by your health insurance.

If you expect to lose your hair

Many options for head coverings are available to help you manage hair loss in style, or you can choose to “go natural.”

  • Colorful, stylish head coverings range from ball caps and form-fitting caps to scarves and elegant turbans. Cotton and bamboo are natural fibers that “breathe” and may be more comfortable in hot weather. Also consider getting a soft cotton “sleep cap,” as your head will likely get cold at night. Ask your patient navigator about cancer-related boutiques in your area, or search online for head coverings for cancer patients. You can also find patterns online for caps to knit or crochet.
  • If you want to wear a wig, contact your oncologist’s office for a prescription for a “cranial prosthesis due to alopecia caused by cancer treatment.” Such phrasing may qualify the wig to be covered partially or in full as a medical expense, but contact your health insurance provider first to find out. Synthetic wigs today are natural looking, lightweight, pre-styled to hold their shape and easy to maintain. If you’d prefer the feel of a human hair wig, it’s important to know they’re substantially more expensive and require a lot of maintenance. Ask your nurse navigator for a list of wig shops in your area. Many women choose a wig that closely matches their current hair color and style, while others take the opportunity to choose a different look. Take a friend or family member with you for a second opinion, and try on a number of wigs before making a decision. Consider a wig a few shades lighter than your current hair color to help mask any treatment-related changes in your complexion. These accessories will come in handy: a wig cap, wig stand, wire wig brush, and shampoo, conditioner and hairspray made for wigs.
  • If expense is an obstacle to getting a wig, ask your nurse navigator about cancer advocacy groups or resources in your area that may provide refurbished wigs free to cancer patients. Some online sources offer free wigs to cancer patients through a wig exchange program; be sure to find out the estimated delivery time before you order, as it may take several weeks for your wig to arrive.
  • Scarves can provide a multitude of looks depending on how you tie them. Begin with a large, square scarf folded once diagonally into a triangle. Place the center of the folded edge across your forehead. Then tie the ends in one of several ways: over the point in a loose bow at the nape of your neck; once in back or on the side of your head, then coil the ends together tightly in a circle to form a rosette; or once in back, then coil the ends separately and wrap them around your head (like a headband) before tucking them up under the scarf. You can also find step-by-step scarf-tying instructions online.
  • If you “go natural,” it is very important to protect your scalp from sun exposure with an ample application of sunscreen containing an SPF of 30 or higher. Limit time out in the sun because some cancer treatments can increase sun sensitivity. In cooler weather, be sure to wear a knit cap to keep your head warm, because you lose much of your body heat through the top of your head.

If you have hair, protect it.

  • Choose haircare products free of alcohol and other harsh ingredients. Gently use a soft-bristled hairbrush and a wide-tooth comb.
  • Avoid blow dryers, curling/straightening irons, hair dye, hair clips and elastics that can harm fragile hair.
  • After washing your hair, blot gently with a plush towel to remove excess water, comb gently and allow it to air dry.
  • Sleep on a silk or satin pillowcase to reduce friction.
  • When “peach fuzz” begins to grow back, attempting to color it could cause it to fall out. Allow plenty of time for your hair to grow several inches long before you consider coloring it. Ask your stylist or your oncology nurse for tips on caring for your new hair.

Skin and Makeup

  • Use gentle soaps and lotions that are free of dyes and perfumes. Many treatments can cause skin to become very dry, so use a thick cream moisturizer twice a day, particularly after you shower/bathe.
  • Massages and facials can provide a welcome escape from your illness and can relieve stress. Tell the massage therapist about your cancer diagnosis so that gentle products will be used, and mention any areas that are sensitive. Check with your health insurance provider to see if any of the cost may be covered.
  • Treatment can cause patchiness and discolored areas anywhere on your body, and this is usually temporary. Choose foundation with built-in sunscreen in a shade that helps even out your skin tone.
  • Using a concealer a shade lighter than your foundation can mask dark under-eye circles and brighten your eyes.
  • If you lose your eyebrow hair, use eye shadow or an eyebrow pencil a shade darker than your natural brow color to give your brows definition. Gradually fill them in and smudge until you get the look you like. Ask your doctor about over-the-counter topicals or serums.
  • If you lose your eyelashes, try a fine eyeliner brush and a dark gel liner to coat the upper inner rim of your lash line. Mastering eyeliner takes practice, so stick with it.
  • Tinted lip balm can brighten your smile and add color to your face.
  • Ask your patient navigator about programs at your cancer center or in your area that demonstrate techniques for using makeup and accessories during cancer treatment. You can also watch demonstrations and tutorials online.

Nail Maintenance

Certain cancer drugs may cause your nails and nail beds to change color or become grooved, sensitive or brittle. These changes are usually temporary.

  • Always keep your nails trimmed short and filed smooth during treatment. However, do not file streaks, stains or brown spots on your nails.
  • Wear gloves when gardening, cleaning and during any prolonged exposure to water to protect your nails from fungal infections.
  • Avoid acrylic nails, silicone fillers and nail gels during treatment, as these carry a higher risk of fungal infection.
  • Ask your doctor before applying dark polish. Change polish as infrequently as possible to avoid the harsh chemicals in nail polish removers.
  • Tell your doctor immediately if you notice dark or lifted nail beds, which may be signs of infection.

Clothes

Feeling comfortable in your clothes can really affect your mood.

  • Manage drains after breast surgery and areas swollen because of lymphedema by wearing clothes that are loose-fitting and comfortable.
  • Today’s mastectomy bras come in beautiful colors and styles and are indistinguishable from regular bras, except for the discreet inner pockets to hold breast prostheses. Ask your nurse navigator for information about shops in your area that specialize in post-surgery garments for breast cancer survivors. Also contact your health insurance provider before making a purchase because many policies cover the cost of multiple mastectomy bras per year.
  • Your clothes may fit you differently now, which may make you self-conscious if you’re returning to work, school or another activity. Consider having some of your favorite pieces altered, shopping for a few new tops or dresses or checking out thrift shops that carry gently used clothing.

Nurturing Your Well-being

Coping with your breast cancer diagnosis includes caring for your emotional health. Your feelings may range from being angry and anxious to feeling fearful, overwhelmed, isolated or depressed. These emotions are common, especially if you aren’t able to express yourself to someone who “gets it.”

Family and friends are wonderful, but they can only understand so much if they haven’t been in your shoes. Find a support group for breast cancer survivors in your area or online. People there will understand what you’re going through because they’ve had similar experiences. Opening up to them or to a licensed counselor may help you work through unfamiliar emotions.

Research studies have shown that various holistic approaches may reduce depression and increase the overall sense of well-being. These include therapeutic writing exercises, journaling, meditation and group therapy using guided imagery (visualization). Ask your nurse navigator about resources in your area.

Your Social Self

Dating and intimacy after breast cancer treatment can be challenging, particularly at first. Physical changes in your appearance may make you feel less desirable or insecure about being intimate with a romantic partner. Cancer-related fatigue and/or depression can significantly reduce your sex drive as well.

In addition, certain cancer treatments can cause premature menopause. Going through it at the expected age is difficult enough, but entering menopause early and suddenly can disrupt your hormones, causing additional side effects that could make you anxious about being intimate. You may also be hesitant or embarrassed to discuss these issues with a potential intimate partner.

Talking with a counselor or therapist who has experience with cancer patients may help you sort out your feelings. If you’ve found a cancer support group that you feel comfortable with, find out how others have addressed intimacy issues. When you’re ready, an honest conversation with your partner can open lines of communication and ultimately deepen your relationship.

 

Take a Break From Treatment

While everything from fishing, yoga and spa retreats can help you heal your mind body and soul, the price of these getaways can deter many from participating. Fortunately, there are organizations nationwide that offer free or discounted rates to cancer patients and their families. Search for opportunities in your area; here are a few examples:

 

Hair Care and Head Coverings

Hair loss does not affect every person treated for cancer, but it is a possibility with certain treatments. If you lose your hair, a head covering can help protect your scalp against sunlight and the cold. Several fashionable options are available, and the best head-covering choice is the one that makes you feel most comfortable.

What are my head-covering options?

Many options are available, including hats, wigs, turbans and scarves.

  • Hats:
    • Countless options are available, including fedoras, knit hats, baseball caps and more.
    • Try on several different styles, and if possible, buy a variety for different days and occasions.
    • Some hats even come with sewn-in bangs or hairpieces.
  • Wigs:
    • You can better match your natural hair color and texture if you buy a wig before you start treatment. However, choosing a wig that’s a few shades lighter may help mask treatment-related changes in your complexion.
    • Both synthetic and human-hair wigs are available.
      • Synthetic wigs often cost less than human-hair wigs, and they keep their style after washing. Synthetic wigs range from mass-produced, machine-made wigs to high-quality, handmade wigs to high-end, custom-made wigs.
      • Human-hair wigs feel more natural to some women, but they are expensive and require a lot of care.
    • Try on several different wigs to find one you really like, and shop with a friend or family member so you can get a second opinion before purchasing.
    • Your wig size can shrink as you lose hair, so ask if the wig can be adjusted.
    • If you can’t afford a custom wig, buy a standard, less expensive wig and have it professionally styled, or contact your local branch of the American Cancer Society to learn about free wigs that have been donated by former patients. You can also ask your doctor for a wig prescription because your health insurance may cover it. (The prescription must state “skull (or cranial) prosthesis for hair loss caused by cancer treatment.”)
    • For variety, purchase a couple of wigs in different hairstyles if you can afford it. (Keep in mind that shorter styles are easier to manage.) The extra wig will also be helpful when you’re washing the other.
    • The following accessories may come in handy: a wig cap (cotton and nylon are good choices), a wig stand, a wire wig brush, shampoo, conditioner, light wig spray or low-alcohol hairspray, a hair net, hair pins and hair rollers.
    • Ask the stylist at the wig shop to teach you how to put on your wig and to trim any excess hair to create the most flattering style for your face. Also, always remember to keep your ears on the outside of the wig.
  • Turbans:
    • Turbans are quick, inexpensive and easy to style.
    • You can buy them ready-made or create them out of scarves and bandanas. Some of the ready-made options come with sewn-in bangs or hairpieces.
    • Turbans come in endless colors and patterns, and you can further customize them with pins, barrettes and other accessories.
    • For a little extra height, consider pinning an unused shoulder pad inside the turban at the crown of your head.
  • Scarves:
    • Scarves are typically 32-to-36-inch squares that come in a multitude of colors, patterns and fabrics: Cotton is cool and casual; wool can be itchy but styles well; and silk is fancy but slippery.
    • To wear the scarf:
      • Begin by folding the scarf diagonally into a triangle and placing the center of the folded edge across your forehead (just above your eyes).
      • You can then choose to tie the loose ends in a bow in the back or on the side; knot the ends in the back and fold the point up and around them; or braid or coil the ends and wrap them around your head (like a headband) or around each other (like a rosette).
      • Visit http://lookgoodfeelbetter.org/beauty-guide/new-hair-looks for detailed instructions and diagrams on how to tie scarves in various ways. There you will also find step-by-step instructions on how to create a head wrap out of a T-shirt.

Of course, leaving your head uncovered is an option, too. However, if you decide against a head covering, be sure to use sunscreen on your scalp when you’re outside. When your hair begins to return, it may be very curly and possibly a different color than it was before. While it’s tempting to color it as soon as it starts to grow, delay until it’s at least 3 to 4 inches in length. Ask your stylist for tips about how to care for your new hair.

 

Additional Resources

 

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