The cold and dry air of fall and winter causes chapping of the inside of the nose for almost everybody.
Chemotherapy also causes dry nose.
That means that this fall and early winter I combined cold and dry weather with intensive chemotherapy treatments to win me a really dry and chapped nose! This skin problem was one of the biggest surprises for me with my chemo treatments. It also gave me a good "living laboratory opportunity" to try a variety of home remedies on myself to soothe dry nasal passages and treat nasal chapping - oh boy!
On chemo, the lining of my nose was dry and chapped, yet my nose was runny – a lovely combination of suffering and the perfect storm for nasal lining injury and abrasions every time I'd blow my nose! As a dermatologist, I know that this combination of a fragile skin barrier and frictional abrasion and trauma is the perfect setup for skin breakdown, and skin breakdown can lead to infection. That's not good, especially in an immunosuppressed chemo patient. As a doctor, I also know that the nose is at particular risk for a Staph infections, and I did not want one of those; I'm not fond of taking oral antibiotics, so I made it my priority to take good care of my nasal passages while I survived chemo this winter, and my efforts paid off. I hope what I learned will help you, whether you are on chemo or not.
Why is a dry nose particularly prone to infection?
The infecting skin germ Staphylococcus aureus often resides asymptomatically in the nose. That means that the germ may live there without you even knowing it. When the skin in the nose becomes irritated, chapped, and breaks down this germ is at-the-ready to cause an infection. On chemotherapy, when the body is immunosuppressed, the infection can become severe and require oral antibiotics to treat. I was trying hard to avoid antibiotics and saw this dry nose issue as a threat I needed to address.
Why was it important to me to avoid antibiotics on chemotherapy?
The human body contains a balance of good bacteria and yeast and scientists are just beginning to realize how important this resident population of "good germs" is to the stability of our overall health. These good germs live in many places in and on our bodies, including the skin, gut, vagina, ear canals, nasal passageways, etc. This population of “good germs” is called the microbiom. Click here to see some of the interesting connections it has to health and disease. Oral antibiotics disturb the balance of this microbiom and can lead to overgrowth of some of the harmful germs that are normally kept in check by the resident good germs. Immunosuppressed people, including chemotherapy patients (like me), are particularly prone to the misadventures that would ensue.
How did I, a dermatologist, keep my nose from becoming irritated during chemotherapy?
I applied mupiricin ointment three times a day to my nasal mucosa (the name of the skin inside the nose) on a cotton-tipped applicator. It’s how I treat Staph nasal carriage in my patients who have repeated Staph skin infections, including MRSA type of Staph infections. I used the same mupiricin ointment during chemo to control the risk of other skin infections too.
As a dermatologist, I know that the moisturizing ointment base in the mupiricin is capable of helping heal chapped nasal skin and skin abrasions from blowing my nose. As a dermatologist, I also know that all skin moisturizing treatments are more effective when applied after water contact. Thus, I would either take a shower or use a nasal rinse System (requires doctor’s supervision in anyone who is immunosuppressed) first and then apply the mupiricin to my lower nasal mucosa with a cotton-tipped swab. It worked like a charm and I never ended up with severely chapped or infected nasal skin - even though my nose ran like a faucet all throughout chemo.
Before I started chemo, I would do a similar treatment with a non-medicated ointment base, typically Vaseline. On chemo, I wanted the additional protection from the Staph germ, so chose mupiricin ointment. Remember, before a chemo patient starts any treatment, either medicated or not, they need approval from their oncologist!
Oh the lovely little details of the nasal mucosa, especially during cancer chemotherapy treatment.
Learn more about how I, a dermatologist, kept my overall skin healthy and comfortable during my chemotherapy treatments in my article, Dermatologist's Advice for the Best Skin Care During Chemotherapy
During treatment for breast cancer I developed my Chemotherapy Skin Care Kit – a combination of being both a dermatologist and cancer patient. I donate 50% of the profits to cancer advocacy and research. Click here to learn more about my Chemotherapy Skin Care Kit.
This information is also relevant to everyone's skin care in a dry climate, even if they are not being treated for cancer.