Skin care in patients with cancer before, during and after treatment: a narrative review and guide for aesthetic and micropigmentation professionals, with medical referral criteria

Objective. To provide aesthetic and micropigmentation professionals with a literature-based guide to skin care for people with cancer before, during and after oncological treatment, together with explicit criteria for referral to the medical team. Methods. Narrative review of clinical practice guidelines (MASCC, ESMO, ASCO/SIO, ASCO/IDSA), systematic reviews, meta-analyses and trials on cutaneous toxicity of cancer treatment, hygiene and photoprotection, supplements, lymphoedema and complications of tattooing and micropigmentation. Every reference was checked through its DOI. Prior teaching material of the Instituto Nacional de Micropigmentación (INM) was reviewed claim by claim: unsupported statements were removed, and consensus-based or author-based recommendations are labelled as such. Results. Chemotherapy, targeted therapy, immunotherapy and radiotherapy cause frequent and largely class-predictable skin changes: xerosis, hand-foot syndrome, acneiform rash, alopecia, nail changes, immune-related reactions and radiation dermatitis. About 36% of irradiated patients develop moderate-to-severe reactions with moist desquamation. Washing with water and mild soap and using deodorant do not worsen radiation dermatitis, and daily sunscreen reduced squamous cell carcinoma in a general-population trial. Most preventive measures with stronger support require medical prescription. No studies were found supporting specific cosmetic ingredients, topical probiotics or so-called "oncology cosmetics" as a category with proven benefit. Timing for skin-breaking procedures, not yet specifically evaluated in the literature, is proposed on the basis of the authors' clinical experience and the published evidence in related settings. Conclusions. The aesthetic professional's role is to protect the skin barrier with simple care, avoid interfering with treatment, defer procedures that break the skin or deliver energy, and recognise signs that require referral. A treatment-related skin-change table, a phase-by-procedure table, a traffic-light referral system, a decision algorithm and a patient information sheet are proposed. Preprint not peer reviewed. Informational document for professionals; it does not replace the assessment or instructions of the medical team.