Yes, it's possible! Eliminating the rash, the unbelievable dryness and the discomfort of "Tarceva skin"
(Revised Feb. 17, 2006)
The most common side effect of Tarceva is skin problems. The Tarceva literature calls it a rash, but there’s more to it than that. When I first went on the medication, I developed red spots and tiny pimples that would arise quickly and go away in a few days, only to be replaced with new splotches. But even after I found a way to keep that from happening, I had more frustrations. The medication makes the skin of the face, neck, ears, and chest so dry - it’s hard to describe, but if you're experiencing it, you know what I mean. When I would get up in the morning, the skin across my cheeks would be pulled so tight that I actually had horizontal wrinkles on each side of my nose, stretched across my cheeks, and my upper eyelids would be pulled half closed. Once I would get it wet, the skin would relax and re-hydrate, but then as soon as the water dried, so did my skin. My chest turned bright red, and the skin on my face and even my ears was flaky and peeling. Plus, it hurt! It looked and felt like I was sunburned all the time, and I looked 10 years older! As a vain woman with (previously) great skin, this was horrifying! So, I spent a great deal of time and effort finding ways to make my skin look and feel as healthy and beautiful as possible. I finally have a system that works. My skin looks good again, and it feels comfortable too. My doctors and nurses have asked me what I do to keep my skin looking so good on Tarceva. Well, it takes consistent effort, but none of these products are expensive, and the results are definitely worth it.
(Absolutely NO photo retouching on any of these photos)
Get a flat, black washcloth - the flatter the better. You want to be able to see the flakes of skin on the washcloth, and if the terry cloth is all fluffy and plush, you won't be able to. It needs to be dark so you can see them, unless your skin is very dark, in which case, a white cloth would be what you need. Take a close look at your skin before you wet it to see if you see any areas that are already flaking or peeling. Once you get your skin wet, you won't be able to see this flakiness, so look now so that you can pay particular attention to these areas as you exfoliate. Also use your fingers to feel the skin for dryer spots that might be ready to flake.
Fill your sink basin with warm water. Spread some Aloe Vera 80 facial wash on your face, neck and chest and any other affected areas. Using the wet (flat, black) washcloth, wipe all the aloe vera facial wash off, then rinse the washcloth clean in the sink. Rub the washcloth firmly against a small area of your face, starting with any areas you may have noticed that were already flaking or extra dry, then look for little flakes of skin on the washcloth. (Put your cursor on the picture of the washcloth above to see close up what you're looking for.) Swoosh the washcloth in the water to get rid of the bits of skin, then wipe the area firmly again. Continue to rub the area, examine the cloth, and rinse the skin flakes off until it comes away clean. Do all areas of your face, neck and chest, paying special attention to the entire nose (especially inner & outer nostrils, eyebrows, sides of the nose beside your eyes, and inner & outer ears, in all the little folds.) When you can’t find any flakes on your washcloth, no matter where you rub, rinse it and splash fresh water over the area. Take the time to do this thoroughly; the dead skin on top is part of what makes your face feel so very tight when it isn't wet. Also, by removing the dead surface skin, you make the healthy smooth skin underneath be the surface skin, plus you take away the dead skin that the bacteria like to get at, therefore this also helps keep red splotches and pimples away.
CAUTION: If your skin is very irritated when you begin this regimen, don't rub with the washcloth until it improves. If you rub aggressively at skin that is red and painful, this will only make it MORE red and painful. Only rub repeatedly at spots that are flaking: that means the skin there is ready to come off. Don’t do anything to your skin that hurts. If it hurts, you are further damaging it. Exfoliating will not feel at all uncomfortable if the skin is ready to come off, and you will know it's ready to come off if it is flaking.
After you've rinsed, don't dry your face. You want that water to get sealed in under the oil and Eucerin. So, right on the wet skin, put a generous amount of almond oil (sold at natural food stores; other oils work too - jojaba, apricot kernel oil) all over the face, neck, ears and chest. Try not to get the oil in your eyes, but put it on your eyelids and as close as possible. (If you do get a little in, it doesn't hurt or anything, but... you don't want oil in your eye, you know, as a general rule :D )
Then put a generous layer of Eucerin (this is a one-of-a-kind moisturizer sold at drug stores - in the moisturizer section) You must put the oil on before the Eucerin. Eucerin will not spread on water, but it will on the oil. Massage it into the skin until it's not white any more.
Eucerin is the only moisturizer I have found that is effective against the severe dryness Tarceva causes. Some moisturizers can actually further irritate the skin. Anything that makes the skin sting is BAD, though I have recceived input saying that on very cracked/irritated skin, even Almond oil and Tarceva will sting a little for the first couple days. By day 4, the skin was vastly improved.
At this point, your face will be very shiny and oily looking. That’s good. Take this time to get dressed, brush your teeth, eat breakfast, whatever. You skin will soak some of this in during this time.
Put on a sunscreen formulated for babies (that's the best choice for sensitive skin)
with a high spf, like 40 or 50.
Your face will still be greasy after the ten or so minutes you spent getting dressed, etc. Put your makeup on right on top of this. Use a creamy foundation, not a powder finish. Don’t blot it, just blend the makeup in until it's smoothly blended. This will take much of the shine off of your face, but it will still be a bit greasy-looking. That’s good - you will need that moisture because as the day progresses, your skin will absorb more and more of it. If you've skimped on the oil and Eucerin and your skin is not at all shiny when you leave the house, it will be parched by the time an hour or two go by and it won't look or feel as good as it could. The picture of me in my wig at the top of this page was taken immediately after I put on my makeup. You can see that my face is a little bit shiny, but by the time I get to work 45 minutes later, it will hardly be shiny at all, and my skin will look and feel good all day long, with perhaps one oil/Eucerin touch-up in the afternoon.
You can blot a little bit on the eyelids, eyebrows and lips to put on your eye makeup and lipstick, 
but use creamy makeup, not powders.
Powder will turn to glop and it absorbs oil too, which is not what you want with Tarceva skin. You want the makeup to be full of moisture, actually part of the protection of the skin, as well as to even skin tone and make you look polished. Use waterproof mascara, cream eyeshadow, and a liquid eyeliner. You can use regular lipstick, but it should be glossy, or put a gloss on top because your lips should be shinier than your face, not the other way around!
MEN:
After you’ve given your skin about 10 minutes to absorb some of the oil and Eucerin, use the palms of your hands to blot your face a little. Your skin should still be a bit shiny when you leave the house because within the hour, your skin will absorb more and more of it.
Keep small containers of oil and Eucerin in your purse or keep in your desk at work. (Eucerin is available in a tube, and I found the oil in a little squirt bottle that I use over and over.) If your face starts to feel a little tight in the afternoon, put a little more oil and Eucerin on. They can go right over your makeup, (except mascara, avoid the eyes) and fresh makeup can be applied right over top of it.
Repeat the washing with Aloe Vera 80 & the black washcloth step at night, then put on the Almond Oil and a heavy layer of Eucerin. If you are a side or stomach sleeper, it's best to do this an hour before bed, so it has time to absorb into the skin. If you can sleep on your back, do so, as your skin will stay more moisturized this way.
Make sure you start your day with step #2, cleaning with aloe and the washcloth, every day. Even if it looks and feels great, don’t just put more oil and moisturizer on it becausethe skin desperately needs the water to re-hydrate and you need to keep the skin very clean at all times to prevent the red splotches from forming.
Look at how awful my skin looks without the oil and Eucerin! Go on - put your mouse over the first picture for a close-up. Augh! I look like a mummy or something. And it feels as tight and dry as paper when it’s like this. The picture doesn’t even really do justice to how bad it looks, as you can’t really see the peeling skin around my nostrils and nose. Now look at the second picture after I have taken the proper steps. The skin has what it needs now and it shows. The third picture is with my makeup on.
Take 2 tablespoons of Cod Liver Oil daily to help replenish your body's oil from within. It doesn’t taste at all bad and it's good for you in other ways too. Nordic Naturals is the kind I use.
ADDITIONAL SUN PROTECTION NOTE:
Tarceva makes you extremely sensitive to the sun, so you should wear a hat with as wide a brim as possible every day, even just walking to your car. Also, when considering what hat to wear for sun protection, hold it up to the light to see how much light shows through. You want a nice dense weave. The first hat I tried didn't have a wide enough brim or a dense enough weave, and I actually got sunburnt right through it! (The sun protection is much more of an issue if you live in a sunny area. I live in Florida, and the sun is quite strong, but when I visited my parents in New York state in the winter, I didn't need the big hat, although I did still wear the sunscreen.)
This process gets me through the day looking good and feeling comfortable, and while it seems like a lot when you are reading it the first time, it's really not any more involved than some of the multi-step skin care regimens that cosmetic companies sell through department stores.
Well, that's it... best of luck to you!
Keep in mind... If your skin is really aggravated when you start this regimen, these steps will help it feel better quickly, but of course it will take some time, maybe two weeks or more to heal and improve and look it's best. And, of course, I'm not a dermatologist and I'm not authorized to offer any medical advice. Every one's different, and it's always possible that something that worked wonderfully for me won't for you... disclaimer, disclaimer disclaimer. But these steps have so revolutionized my Tarceva skin that I really believe that they could help people who are experiencing the same problems. If you'd like to comment, ask questions or request clarification, or send me before & after photos of your skin, please send me an email - healthyskin@practicaltruisms.com
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