Putting a brave face on illness

Cancer treatment can damage looks and self-esteem. Now help is at hand from the cosmetics industry, reports Belinda Gallon

"WHEN I looked in the mirror an unrecognisable face stared back at me ... and the shock I got when I inadvertently caught a glimpse of my reflection as I passed a shop window was even worse." Tracey Gay had just turned 29 when ovarian cancer was diagnosed last year. Although an aggressive course of chemotherapy killed the cancer cells, it also indiscriminately destroyed her youthful good looks.

The transformation was dramatic. Her blonde hair fell out in large handfuls, virtually overnight, and was swiftly followed by her eyelashes, eyebrows and the rest of her body hair. An unnatural acceleration of the ageing process etched incongruous lines and wrinkles into her china-doll features, and a grey pallor replaced a radiant complexion. Her eyes lost their sparkle and her teeth darkened and took on an unhealthy translucency. Her nails peeled and broke easily and her cuticles became dry and cracked.

"People seldom realise just how traumatic it can be to lose control over what is happening to one's appearance," she says. "While the prospect of losing my hair was terrifying in itself, I had not contemplated the consequences of all the other changes. My boyfriend found me sexually repulsive, and I no longer felt like a woman."

As Tracey suffered the combined loss of her femininity and sexuality, her self-esteem and confidence plummeted.

"Our identity, our sense of self is intimately bound up with how we look," says Julian Allason, a counsellor and therapist who specialises in helping people undergoing life crises. "Our face is our primary means of expression and communication with others - so it's hardly surprising that any perceived impairment of our looks can have such a profound psychological effect."

So what can be done to help cancer sufferers cope with the ravaging effects of chemotherapy? A beautician may not be able to wave her nailfile to restore long fingernails, and only time will promote new hair growth after treatment has ended - but there is still plenty that can be done to alleviate both physical and psychological effects produced by the illness and the treatment.

Self-esteem is often referred to as "the fuel of life". If this is the case, elevating cancer sufferers' self-esteem by improving the way they look during the illness will play an invaluable role in helping them cope with the effects of treatment.

With this in mind, the Cosmetic, Toiletry and Perfumery Foundation has now introduced a free service offering advice on skincare and make-up to women undergoing treatment for cancer. The Look Good ... Feel Better programme holds small informal group sessions at cancer units in 12 hospitals in the UK. With guidance from professional beauty advisers, the sessions provide a "hands-on" approach to help women learn new techniques to help restore and enhance their appearance.

Recent clinical research has confirmed that for many people, if they can manage to take care of their appearance during an illness and look as good as possible, they probably also feel better.

While hair loss is the most recognisable side-effect associated with chemotherapy, the treatment can take its toll on every aspect of the physical appearance, and clever use of cosmetics, as well as finding "quick-fix" props, can offer a tremendous psychological boost.

Cancer drugs can destroy the nail bed, causing nails to peel and break and at worst fall out; cuticles can become dehydrated and sore. Nails are best filed short and can be nourished by daily use of almond oil, which will help to improve both the condition of the nail and the cuticle. Nail-strengtheners and frosted polishes can exacerbate the problem of dehydration and are best avoided.

Choosing a different foundation and using new colours to redress the balance in skin tone can provide an intant fix of confidence, and although existing pigmentation may become more pronounced during treatment, the combined use of concealers and careful blending will disguise darker areas.

False eyelashes are readily available from the local chemist and provide the perfect solution for lost lashes. As a special service for people who have lost their natural lashes through alopecia or cancer, a London- based company, Original Editions, will, upon receipt of a doctor's letter, supply Eyelure false eyelashes at a discount.

For those who have lost most or all of their eyebrows, Wig Specialists in London will make natural- looking false eyebrows to order - although they can only be worn a couple of times before they disintegrate. Expensive at around pounds 50 per pair, these should probably be held in reserve for special occasions.

The superficial can be crucial, and while the medical profession continues to use powerful drugs to defeat cancer, aesthetics can play a significant role in the battle to combat their apparent side-effects.

8 Cosmetic, Toiletry and Perfumery Foundation, Josaron House, 5/7 John Princes St, London W1M 9HD