Treating the Many Shades of Rash

Over the course of nearly four years, I have learned to cope with a variety of skin conditions brought on by various treatments for my lung cancer. The rashes that developed have had different levels of intensity, ranging from their color and texture to the amount of discomfort and discharge they bring. Across them all, there have been a few similarities, and I have learned a thing or two about how to help the skin feel better in the process.

What does my rash mean?

Some rashes are more like tricky cases of teenage acne while others seem closer to full-blown eczema or psoriasis. An oncologist can prescribe oral antibiotics that help reduce the boils or blemishes associated with acne. While this may not make the acne go away completely, it can help greatly to keep it under control. The downside is that sometimes the medication can affect a patient's joints and the tradeoff might be that he or she simply has to deal with a little more acne. There are also topical antibiotic solutions, lotions, and ointments that are available when oral medications are not possibilities. These require a little more work, but can also effectively spot-treat these rashes and even can be used on larger areas like the back or chest as needed.

When the rash is inflamed, even a sometimes painful and burning red, it may be appropriate to use a topical steroid. There are liquid solutions available for treating the scalp, as well as ointments and creams for the skin. Stronger steroids should only be used for short periods of time and it is best not to use them on large areas of the skin because they can get absorbed into the bloodstream, but they tend to work effectively and quickly. Once the inflammation is under control, other products can be used to soothe the rash that remains.

Dealing with feeling dry or itchy

In many cases, a rash will leave the patient feeling dry or itchy or both. This may be due to scabbing that results from oozing or bloody acne, in which case a light antibiotic ointment may offer quick relief. If this is the case, it is important not to pick at the remaining acne blemishes or those that are now healing. If they are on the scalp, which is a particularly difficult area to ignore, it may help to wear a shower cap until the sores have healed.

When the itching is due to dryness, there are many oils and lotions that can help. Some patients respond well to natural oils which will work both on the scalp and skin. Many such oils come in liquid form, sold in bottles with convenient droppers or pumps. Others, such as coconut or shea butter, may arrive as solids and require a bit of warmth to liquify. Because many oils have strong odors and they absorb differently, patients may have to go through a bit of trial and error to find what works for them. If the rash begins to feel like a bad wind-burn, natural aloe may even offer some temporary relief.

Relief with lotions and creams

There are also a lot of over the counter options for lotions and creams that can be particularly effective. I focus on unscented lotions as a general rule, in part to minimize the chemical additives. Looking for labels that read "dermatologist recommended" and "non-comedogenic" are helpful starting places, but getting a recommendation for a brand from a real dermatologist or your oncologist is always a good idea. Then it becomes a matter of testing out a few different types. Even within a single brand, there may be various levels of moisturizing and greasiness to navigate. Plus, some creams or lotions have the added bonus of additional medicated ingredients to reduce itching or pain. When in doubt, consult your doctor, but be prepared to go through several products before finding the one or two that work best for you.

The surprising secret weapon in my rash toolbox is petroleum jelly. When the rash makes the skin extra sensitive, sometimes that is the only product that offers enough protection to let it heal. It is not something that I can use most of the time because it does not absorb into the skin, but it does wonders when the skin itself feels too raw for anything else.

No one-size-fits-all solution

There is no one-size-fits-all solution to everyone's rash problems, but if you pinpoint the issues your rash is causing there are ways to mitigate these side-effects. Some may take time to prove effective, but there is relief available. Just remember, keep your oncologist in the loop on everything you are experiencing. Doctors have a lot of experience with these side-effects and often have insight into both how to treat existing symptoms and how to prevent them from getting worse (or even make them go away). And if nothing you do seems to be helping, reach out to others through your support community because there are quite a lot of us who have recommendations we are always willing to share.

Editor’s Note: We are extremely saddened to say that on October 21, 2018, Jeffrey Poehlmann passed away. Jeffrey’s advocacy efforts and writing continue to reach many. He will be deeply missed.