SUPPLEMENT INDIVIDUAL ARTICLE: Skincare for Cancer Patients in Scandinavia

December 2021 | Volume 20 | Issue 12 | Supplement Individual Articles | ss4 | Copyright © December 2021

Published online November 30, 2021

Ada Girnita MD PhD,a Henrik F. Lorentzen MD,b Sampsa Kauppi MD,c Charles W. Lynde MD FRCPC,d Maxwell B. Sauder MD FRCPC DABD,e Henrik Schmidt MD,f Anneke Andriessen PhD,g Andreas Stensvold MD PhDh

aSkin Cancer Center Karolinska University Hospital Stockholm, Sweden
bDepartment of Dermatology and Venerology Aarhus University Hospital, Denmark
cPrivate practice, Terveystalo and Epilaser Oy, Finland
dDepartment of Medicine University of Toronto, Toronto, ON, Canada; Lynderm Research, Markham, ON, Canada
ePrincess Margaret Cancer Centre; Pigmented Lesion Clinic, Toronto Dermatology Centre, Toronto, ON, Canada
fDepartment of Oncology, Aarhus University Hospital, Denmark
gRadboud UMC, Nijmegen and Andriessen Consultants, Malden, The Netherlands
hOncology Department Oestfold Hospital, Norway

sun exposure and reapply it after water exposure or heavy sweating.10,12,35,44

Statement 4: Effective management of dermatologic toxicities associated with cancer treatment is a multidisciplinary effort involving dermatologists, oncologists, primary care physicians, and other HCPs involved in cancer treatment. Telemedicine may be of benefit in this area.

An interdisciplinary professional oncology team approach from the start of anticancer treatment is the most efficient way of providing cancer patients and survivors with cAEs the required dermatological care.6-10,12,34,36,41,43,45

Chemotherapeutic agents frequently cause cAEs, yet up to 84% of cancer survivors with cAEs are not referred to a dermatologist.45

Medical oncologists are more likely to pause or discontinue anticancer treatment due to cAEs, contrary to dermatologists who may prevent avoidable treatment interruptions.7-9 The interdisciplinary oncology team approach may help identify and assist in managing dangerous or life-threatening cAEs.10,12 Early and effective use of a skincare regimen may improve QoL and may be able to preserve anticancer treatment.10,12

The NECOM panel recommends that education, optimal communication, access to support information, and early reporting of cAEs will enable efficient use of dermatology services. The lack of dermatologists in several European countries and population aging along with increasing numbers of cancer patients and survivors challenges healthcare organizations.35 Teledermatology or virtual consultation seems a suitable way to give patients and healthcare professionals access to dermatological expertise or can be used as an adjunct to face-to-face evaluations.10,12,35 Telemedicine can include online patient portals, patient apps, remote monitoring, patient education, and clinical medical education on cAEs for healthcare providers.10,12 These virtual tools further offer a suitable solution for rural areas where access to specialized multidisciplinary oncology teams may not be available. Finally, teledermatology software also allows for instant auditing of practices with the assessment of diagnoses, turnaround times, and outcomes.35

Statement 5: Camouflage can mitigate some of the stigmas of cancer and contribute to a better quality of life.

Cosmetic camouflage use on cAEs on manly exposed sites may improve QoL. A systematic literature review that included eighteen studies reported reduced QoL impact when using cosmetic camouflage in patients with skin disfigurement.46

A randomized controlled trial of sixty-six female head and neck cancer survivors reported that the 3‐month skin camouflage program effectively improved facial disfigurement, fear of social interaction, the anxiety of social interaction, and body image.47 A further systematic literature review concluded that the effectiveness of non-surgical cosmetic or other camouflage interventions could not be established and that more robust trials were needed.48

A Japanese study used Skindex-16 and visual analogue scale scores for thirty-nine female patients with cAEs comparing scores before and 2–3 months after self-administration of camouflage makeup. The use of camouflage makeup improved the patients'QoL even though the makeup was only applied when required.49

Another review concluded that there is a wide variation in the quality and modes of skin camouflaging. A simulated second skin technology appears to be effective; however, training on the technique is required for patients to benefit physically, psychologically, and socially from this treatment.50


Statements used in the current review were based on a mix of data and expert opinion. While it is possible that alternatives for the management of cAEs could exist, the statements are suggestions for best practices developed from a panel of expert clinicians that are supported by peer-reviewed literature.


Cancer treatment-related cAEs are common and can severely impact patients' QoL and interfere with anticancer treatment outcomes. The NECOM project explored clinical insights in cAEs and focused on skincare regimens involving hygiene, moisturization, sun protection, and camouflage products. The evidence and opinion-based best practice recommendations for oncology skincare programs aim to support all Nordic European healthcare setting stakeholders working with oncology patients. When applying the skincare regimen throughout the entire continuum of cancer care, optimal outcomes can be achieved, improving patients' QoL.


The authors disclosed receipt of the following financial support for the research, authorship, and publication of this article: This work was supported by an unrestricted educational grant from La Roche-Posay European Nordic countries. The authors received consulting fees from RCB Consultants.