After radiation, surgery, chemo for breast cancer, is it possible to repair the chest skin damage?

Dear Dr Irwin, I am a 56 yr old female breast cancer survivor! (yay!) After the radiation, chemo, mastectomies, and reconstruction, I find that my chest from my chin to my cleavage has become wrinkled (maybe due to the radiation? I got very burnt near my collar bone and below....25 treatments on my left breast area 2 years ago.) I am wondering what I can do to correct this. I have very few wrinkles on my face (had combination of Erbium and profractional laser peels twice at about 3 years apart with amazing results!) but my neck and chest are yucky. I find I am needing to wear crew-neck everything to cover the furrows on my chest....after breast cancer (being bald, etc, etc...very humbling) I just want to feel good about what is left (life!). Chemo takes a toll but I figure I could maybe try to do my best! Any ideas? I live in a small town in NW Iowa. Thank you! Barbara Ann

That’s WONDERFUL!   You are a survivor and I really admire anyone who is. It’s not an easy road, as you know. The answer to your question about chest skin damage is that yes, the skin on the chest can be greatly improved, but it’s a slower process than the face, and takes some patience.  I’m a bit confused about your neck because that wouldn’t have been in the radiation field generally.

Since you live in a smaller town, it might be a bit harder to find certain lasers and doctors who do a lot of them.  Here are some things to think about.

Repairing chest skin damage after radiation treatment: this skin needs TLC:

  1. Skin, once it has been radiated, has fewer blood vessels, is usually thinner, and is less healthy in general.   A doctor/nurse doing any laser treatments on radiated areas needs to remember that and adjust the energies down significantly, at least to start out with.  Otherwise blisters and ulcers can form.
  2. Chest skin with prior radiation won’t heal as fast so be prepared for that.   If normal skin on the chest might take 2 weeks to heal from a fractionated erbium (like Fraxel 1550 nm) or fractionated CO2, then post radiation skin might take 3-4 weeks.
  3. To get healthier skin in a radiated area, the goal is to slowly and safely build the under the skin healthy blood vessels and collagen.  Radiated skin sometimes has those dilated vessels right on the surface (telangectasias).   Those ones we don’t want and are indication of damage.

For better repair, dial up your nutrition:

  • The healthier you are, the better your skin will heal and repair.   Make sure you eat mostly lean fish and meats and about 30-50 grams of protein a day depending on your activity level.   Eat lots of veggies (try for 10 different ones daily) and whole fruits (2-4 different ones a day).   Beans and any intact whole grain are good.   Avoid sugar, white anything, and more than 1 alcoholic drink at day.  A great site although not everyone agrees with their protein recommendations, is the Pritikin Center.
  • Take a daily probiotic and 500-1,000 mg of vit C (used in collagen production).  A multivitamin for women over 40 is also good, despite what the studies say.  🙂  Have your primary care doc check your vitamin D level.

Bottom line:

  • When the problem is more wrinkles on the chest, consider fractionated CO2 or erbium (like Fraxel).  Go slowly at first and start with lower energies.  Multiple treatments will be needed to slowly rebuild the skin’s health.
  • When the problem is those small red veins (telangectasias), use an IPL or a Vbeam or a combination.  Again, start with lower energies and work up if the skin tolerates well.
  • Consider light peels for superficial sun damage and fine wrinkles.
  • Sculptra can be used on the chest to rebuild the thickness of it, but it’s off-label and you would need a dermatologist  very experienced with it to do it well.   Sculptra should never be injected into or too closely to an implant pocket.
  • Use a product daily on this skin to help with texture.   Consider an antioxidant vitamin C like SkinCeuticals Neck, Chest, Hand at night with sunscreen every single morning (18% zinc like this one) unless the skin is completely covered.

Hope this helps!  Dr. I


Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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