You are done with treatment and you are suddenly aware that there is life—plenty of life—after cancer. You decide you want to fix the visible damage your row with cancer has caused.
Your hair has started to grow back and you aren’t sure if it’s thicker or thinner or the same texture or a different, or what’s going on with it, you are just happy to have hair.
Your eyelashes are short; your eyebrows are thin. Your skin looks like it has aged several years in the space of several months. You have red scars and tattooed dots on your chest. If you are like me, all the messing with your estrogen has caused melasma — brown spots — all over your cheeks. This is not how you are supposed to look. It’s like a kick in the face after being run over by a car: completely unnecessary.
Even without “intervention,” your hair, skin and scars will rebound. However, with the help of a dermatologist, you can speed up the process.
“We did this to you, so I’m going to fix it.”
These were the words Memorial Sloan Kettering dermatologist and Moh Surgeon, Dr. Anthony Rossi said to me three years ago when I walked into his office. I’d been referred to him because I couldn’t get rid of the melasma on my cheeks with the over-the-counter potions I’d been trying. I was also not thrilled about the seven black-blue dots I’d been permanently tattooed with for my six weeks of radiation. As someone who is pale and unfreckled, both new sets of spots reminded me of what I’d been through: the result of something I didn’t ask for… and something I wanted to move on from.
“For the melasma, we’ll do a series of peels and laser treatments and I’ll prescribe Triluma, which you’ll use for about twelve weeks, and, because it has some steroid in it, you’ll then take a break for twelve weeks and use your otc creams during that ‘off’ period, and alternate like that to maintain it.”
It took time, but my melasma has completely disappeared, even though I’m on Tamoxifen and my hormones are still being tampered with.
“For the tattoos, we’ll laser them off. It usually takes a few times. Maybe six to eight sessions.”
My tattoos are now gone as well.
“Anything else bothering you?”
“What about the wrinkles in my cheeks? I didn’t have those before. Can you get rid of those?”
Next to my mouth, where my cheeks hollow, I’d noticed new lines develop during chemo. During treatment your skin can age prematurely, become drier, and look dull and lackluster.
“Chemotherapy, oophorectomy, and ovary ablation can induce menopausal symptoms in women; skin changes result from diminished estrogens, including decreased elasticity, increased laxity — loss of collagen — and dryness.
The Triluma has a retinol in it, so that will actually help with wrinkles too. When you aren’t using the Triluma, I’ll prescribe you a retinol to use. The retinol will help speed up cell turnover, allowing fresh skin to appear.”
“Will that take care of my eye wrinkles too.”
“I can do a little Botox for that.”
“Okay, but will I still look like a normal human, or will I be frozen like a Kardashian?”
“We won’t do too much. You squint when you smile, so it’ll just take the edge off that. Don’t worry, you’ll still have lines, just not as discernable.”
Since that first appointment three years ago, Dr. Rossi has done platelet-rich plasma (PRP) injections to my scalp (three rounds) when my hair started shedding. He’s also done non-invasive laser treatments that have brightened and, dare I say, tightened my skin. He has also lasered the scar under my arm from my sentinel node dissection and the scar beneath my breast. Both are now almost invisible.
It’s safe to say I no longer look like someone who had cancer… ever.
We are all different and our concerns post-treatment differ too. Women lose volume in their faces, their eyelashes and eyebrows don’t grow back as thick as they’d hoped. There are skin changes from radiation.
“Our breast cancer patients traditionally go through surgery, radiation, and adjuvant therapies such as tamoxifen or anastrozole. Each step of the way we can see skin changes, scarring, and related sequelae. Scarring from surgery, radiation dermatitis and blood vessel growth, as well as aging skin and hair loss, are all changes I typically see and treat with my patients. No matter what their age, patients are concerned with these and they can all impact quality of life and therefore are important to address. Many patients are surprised we can actually treat these with lasers, peels and injectables.”