# Cosmeceuticals and Thalassotherapy: Recovering the Skin and Well-Being after Cancer Therapies
## 3 Cosmeceuticals for Skin Care of Oncologic Patient
### Vitamins
#### 3.2.13 Other Compounds of Interest  
In this review on active ingredients for cosmetic use in cancer patient care, it is important to mention the ingredients of sunscreens, which are essential for protecting the skin against the most harmful solar radiation. Sunscreens with inorganic filters (also called physical filters) are recommended, because they form a barrier on the epidermis that reflects radiation and does not penetrate the skin. The most used components are titanium dioxide and zinc oxide. We can also include so-called biological filters, which are antioxidants and free radical scavengers, among which are vitamin E and some of the botanicals mentioned earlier. Among the moisturizing compounds, in addition to those mentioned, is urea, which is used in creams in concentration of 5-10% to prevent and improve cutaneous xerosis [100]. Emollients with urea have also been shown to be effective in preventing hand-foot syndrome induced by sorafenibib [101; 102]. An asset of interest that has also been used in creams for the prevention and treatment of dermatitis is \(\beta\)-Glucan. \(\beta\)-Glucans are polysaccharides which are found in cereals (barley and oat), yeast, mushrooms and algae, with immunomodulatory properties, among others [103; 104; 105]. Emulsions containing \(\beta\)-Glucan have been used to prevent radiodermatitis, causing an increase in skin hydration and reduction of itching [99]. Another study where patients were prescribed moisturizers to prevent radiation-induced damage with measurement of hydration using biometric techniques (Corneometer) showed that in all cases it is possible to reduce the symptoms of skin toxicity. The products used included product A with pure vitamin E; product B with Omega-3,6,9; product C with natural triglycerides-phystorels, product D with beta-glucan and sodium hyalurone; and product D with _Vitis vinifera_ extract, the latter two being the most effective ones [106]. There are few studies on the use of growth factors, although some describe their effects on healing, which seems to be a promising area of research. In a multicenter prospective cohort study of 1172 patients undergoing radiotherapy for variable malignancies, an EGF-based cream was used to assess the effectiveness and safety in the prevention of radiation dermatitis in patients with cancer. The cream contained a 0.005% recombinant human EGF with additional ingredients such as ceramide, hyaluronic acid, Inca omega oil (_Plukenetia_volubilis_ seed oil), _Portulaca olerca_ extract, mango butter, and meadowfoam oil. The results suggested that a recombinant human EGF-based cream could be safely applied to prevent or alleviate radiation dermatitis [107]. It may also be of interest to use copper peptides for improving wound contraction and epithelization [108]. Taking into account the important role that calcium plays in maintaining the epidermal barrier [109], products that contain calcium in their formulation may be appropriate, constituting a possible area of research; there are already patents on the market (patent US8535904B2) that also include plant extracts. Other studies show that the use of sucralefate with Cu and Zn salts can delay the onset of radiodermatitis, although more studies are needed that compare results with the control group [110]. Dressing films are also of interest in both prophylaxis and the treatment of radiotherapy-induced skin reactions. Silicone dressings are suitable for patients with fragile skin and do not cause tissue trauma during removal [111]. However, for patients with moist desquamation it is important to minimize excess of moisturizing and skin macetation, so another dressing was launched into the market to prevent this problem (Mepitel). Mepitel dressing is vapor permeable, which allows excess moisture to evaporate through the dressing; it is therefore intended for superficial wounds in which moist environment promotes healing.