Skin Discoloration

Breast cancer patients can report pain in the irradiated breast for years after treatment. Quality of life studies have actually been to assess this issue. In one study, it showed roughly the same percentage of chronic pain (25%) after lumpectomy + RT and after mastectomy without RT. Other prospective trials followed women after lumpectomy WITHOUT radiation and women WITH radiation. One study showed no difference in breast pain between the two groups at 1 year. The other study showed women who received RT to have more pain in the first 2 years but after the 2-year mark, both groups were the same. After lumpectomy, with modern equipment and technology, skin changes referred to as portal hyperpigmentation, should go away within a few weeks of completing therapy. Telengiectasias – or dilations of the skin vasculature — can be a late effect following radiation for breast cancer. This is much more common after mastectomy than it is after lumpectomy. Skin thickening or fibrosis (referred to here as 'scar tissue') can also occur after radiation to the breast. Most of these late toxicities are influenced by total dose and dose per fraction of the radiation when it was given. So that was the LONG answer — the short answer is that side effects from breast cancer treatment are complex. At the very least, they are quite patient-specific and likely reflect a combination of the surgical procedure and the radiation. It is very important to have good follow-up with all of your breast cancer doctors. Breast cancer patients can report pain in the irradiated breast for years after treatment. Quality of life studies have actually been to assess this issue. In one study, it showed roughly the same percentage of chronic pain (25%) after lumpectomy + RT and after mastectomy without RT. Other prospective trials followed women after lumpectomy WITHOUT radiation and women WITH radiation. One study showed no difference in breast pain between the two groups at 1 year. The other study showed women who received RT to have more pain in the first 2 years but after the 2-year mark, both groups were the same. After lumpectomy, with modern equipment and technology, skin changes referred to as portal hyperpigmentation, should go away within a few weeks of completing therapy. Telengiectasias – or dilations of the skin vasculature — can be a late effect following radiation for breast cancer. This is much more common after mastectomy than it is after lumpectomy. Skin thickening or fibrosis (referred to here as 'scar tissue') can also occur after radiation to the breast. Most of these late toxicities are influenced by total dose and dose per fraction of the radiation when it was given. So that was the LONG answer — the short answer is that side effects from breast cancer treatment are complex. At the very least, they are quite patient-specific and likely reflect a combination of the surgical procedure and the radiation. It is very important to have good follow-up with all of your breast cancer doctors.

Melasma is discoloration of the skin and is also known as hyperpigmentation. Melasma is discoloration of the skin and is also known as hyperpigmentation.

If you are experiencing skin discoloration or hyperpigmentation due to medications, specifically chemotherapy medication treatment, this discoloration usually disappears about 10 to 12 weeks after the completion of treatment. Your old skin cells are replaced with new skin cells.

As with all side effects and their treatment discuss your concerns with your physician.

Here are links to more information on skin discoloration:
http://www.breastcancer.org/treatment/side_effects/skin_discolor.jsp
http://www.chemocare.com/managing/skin_reactions.asp If you are experiencing skin discoloration or hyperpigmentation due to medications, specifically chemotherapy medication treatment, this discoloration usually disappears about 10 to 12 weeks after the completion of treatment. Your old skin cells are replaced with new skin cells.

As with all side effects and their treatment discuss your concerns with your physician.

Here are links to more information on skin discoloration:
http://www.breastcancer.org/treatment/side_effects/skin_discolor.jsp
http://www.chemocare.com/managing/skin_reactions.asp

Hyperpigmentation is a skin reaction in which patches of skin or the skin overall may become darker in color due to the release of melanin. Melanin is a pigment in skin cells that gives the skin its color. Hyperpigmentation is usually a harmless condition that resolves itself at the end of the treatment.

Hyperpigmentation may be caused by medications or it may be a phototoxic reaction. Some chemotherapy agents can cause blotchy or generalized hyperpigmentation. This darkening of the skin may occur around the joints or under the nails, in the mouth or along the vein used to infuse chemotherapy drug. Sometimes it's limited just to the site of infusion; but sometimes it's more generalized and covers larger areas of the body.

This blotchiness or darkening of the skin often appears 2 to 3 weeks after chemotherapy treatment begins and disappears or goes away as new skin cells are generated and replace the dead cells 10 to 12 weeks after treatment is over. Chemotherapy agents associated with temporary pigmentation are melphalan, busulfan, cyclophosphamide, 5-fluorouacil, adriamycin, daunorubicin, bleomycin, and topical BCNU.
Hyperpigmentation is a skin reaction in which patches of skin or the skin overall may become darker in color due to the release of melanin. Melanin is a pigment in skin cells that gives the skin its color. Hyperpigmentation is usually a harmless condition that resolves itself at the end of the treatment.

Hyperpigmentation may be caused by medications or it may be a phototoxic reaction. Some chemotherapy agents can cause blotchy or generalized hyperpigmentation. This darkening of the skin may occur around the joints or under the nails, in the mouth or along the vein used to infuse chemotherapy drug. Sometimes it's limited just to the site of infusion; but sometimes it's more generalized and covers larger areas of the body.

This blotchiness or darkening of the skin often appears 2 to 3 weeks after chemotherapy treatment begins and disappears or goes away as new skin cells are generated and replace the dead cells 10 to 12 weeks after treatment is over. Chemotherapy agents associated with temporary pigmentation are melphalan, busulfan, cyclophosphamide, 5-fluorouacil, adriamycin, daunorubicin, bleomycin, and topical BCNU.

Over the counter treatments for hyperpigmentation are:
- Hydroquinone is a bleaching agent that blocks melanin by decreasing the manufacturing of melanin and assisting in the breakdown of melanin in the skin. Weaker concentrations of hydroquinone (2-4%) may be obtained over the counter.
- Alpha hydroxy acids, such as 8 percent glycolic acid, are water soluble acids which work by renewing skin cells and correcting the darkened skin.
- Beta hydroxy acids (such as salicylic acid) are exfoliants which cause flaking off of the skin.
- Kinerase is a C8 peptide containing kinetin which increases cell division, thereby the darker skin cells are eliminated.

Prescription treatments are:
- Higher doses of hydroquinone.
- Topical retinoid (derived from Vitamin A), is called Retin-A. It is an exfoliating agent which speeds up new skin growth, diminishing dark skin pigmentation. Prescription products of stronger concentrations are: Retin-A, Renova, Avita, etc.
- A combination prescription product called Tri-Luma contains both hydroquinone and Retin-A Cream (fluocinolone acetonide 0.01%, hydroquinone 4%, tretinoin 0.05%)

Chemical peels which are skin pigmentation treatments may also be considered. The different products are: alpha hydroxy acid peels, beta hydroxy acid peels, Jessner's peel, retinoic acid peel, trichloroacetic acid peels, phenol peels. Over the counter treatments for hyperpigmentation are:
- Hydroquinone is a bleaching agent that blocks melanin by decreasing the manufacturing of melanin and assisting in the breakdown of melanin in the skin. Weaker concentrations of hydroquinone (2-4%) may be obtained over the counter.
- Alpha hydroxy acids, such as 8 percent glycolic acid, are water soluble acids which work by renewing skin cells and correcting the darkened skin.
- Beta hydroxy acids (such as salicylic acid) are exfoliants which cause flaking off of the skin.
- Kinerase is a C8 peptide containing kinetin which increases cell division, thereby the darker skin cells are eliminated.

Prescription treatments are:
- Higher doses of hydroquinone.
- Topical retinoid (derived from Vitamin A), is called Retin-A. It is an exfoliating agent which speeds up new skin growth, diminishing dark skin pigmentation. Prescription products of stronger concentrations are: Retin-A, Renova, Avita, etc.
- A combination prescription product called Tri-Luma contains both hydroquinone and Retin-A Cream (fluocinolone acetonide 0.01%, hydroquinone 4%, tretinoin 0.05%)

Chemical peels which are skin pigmentation treatments may also be considered. The different products are: alpha hydroxy acid peels, beta hydroxy acid peels, Jessner's peel, retinoic acid peel, trichloroacetic acid peels, phenol peels.