Working safely with melanin-rich skin in cancer touch therapy – continual professional development guidance

This guidance is for therapists who are trained in SATCC-approved touch therapy in cancer care, delivered and completed by an accredited training provider.

Current UK beauty therapy standards and National Occupational Standards (NOS) outline the need for all therapist roles to demonstrate inclusive knowledge and skills across diverse skin tones and ethnicities. In cancer touch therapy, understanding how melanin-rich skin behaves and heals is essential to maintaining safety, comfort, and professional excellence.

This guidance explores the relationship between skin tone, genetic expression, and healing, focusing on phenotyping and genotyping as they relate to the effects of cancer treatments on the skin. By broadening understanding of these factors, therapists can adapt touch therapies more effectively for every client, ensuring compassionate and culturally competent care.

Understanding melanin-rich skin

Melanin is the natural pigment that gives colour to the skin, hair, and eyes. The amount and type of melanin produced by melanocytes within the epidermis determine skin tone and its reaction to trauma or inflammation. All humans have a similar number of melanocytes; differences arise from how active they are and what kind of melanin they produce.

Key characteristics include:

• Slightly thicker epidermal structure and greater collagen density.
• Higher risk of post-inflammatory hyperpigmentation (PIH).
•  Increased likelihood of keloid or hypertrophic scar formation.
• Erythema (redness) is less visible, so irritation can be overlooked.
•  Some natural UV protection, but not immunity to damage.

Phenotyping and genotyping in practice

The genotype refers to a person’s genetic code; the inherited blueprint that influences biological traits such as melanin production, inflammation response, and collagen repair. Although therapists cannot directly assess genotype, it is important to recognise that genetic diversity contributes to how skin reacts, heals, and responds to touch.

The phenotype is the visible expression of the genotype, shaped by environmental factors such as sunlight, climate, lifestyle, and health. A person’s phenotype determines their observable skin tone, texture, and sensitivity. In beauty therapy, we assess phenotype to inform how we adapt pressure, technique, and product choice.

The traditional Fitzpatrick Skin Phototype Scale (I–VI) remains useful but limited, as it focuses mainly on reaction to sunlight. Modern inclusive practice also considers ancestry, skin behaviour and healing response.

How melanin-rich skin heals differently

During and after cancer treatment, the skin’s healing processes may slow or change due to chemotherapy, radiotherapy, or surgery. For clients with melanin-rich skin, this is further influenced by pigmentation, collagen activity, and inflammatory response.

Healing considerations include:

1. 1. Inflammation and pigmentation: Healing may lead to uneven pigmentation or dark marks after minor trauma.
   2. Collagen and scar formation: Greater fibroblast activity can lead to thicker scars or keloid development.
   3. Barrier and moisture balance: Treatments may deplete oils, causing dryness or sensitivity.
   4. Detecting sensitivity: Redness may not be visible; rely on touch and client feedback.

Therapist considerations:

• • Conduct thorough consultations about pigmentation, scarring, and past reactions.
  • Use tactile cues and temperature awareness rather than visual redness.
  •  Apply gentle, slow, and mindful pressure on compromised skin.
  • Select hypoallergenic, pH-balanced products suitable for sensitive skin.
  • Provide aftercare advice on hydration, sun protection, and pigmentation management.
  • Acknowledge the emotional impact of skin tone or pigment changes due to treatment.

Glossary of terms

Melanin: Pigment produced by melanocytes that determines skin, hair, and eye colour.

Melanocyte: A pigment-producing cell located in the basal layer of the epidermis.

Phenotype: Observable characteristics of an individual influenced by genetics and environment.

Genotype: The genetic code inherited from one’s parents, determining biological traits.

Post-Inflammatory Hyperpigmentation (PIH): Darkening of the skin following inflammation or injury.

Keloid: An excessive overgrowth of scar tissue that extends beyond the original wound.

Fitzpatrick Scale: A classification system describing how different skin types respond to UV exposure.

Barrier Function: The skin’s ability to retain moisture and protect against irritants and pathogens.

Erythema: Redness of the skin caused by increased blood flow; often difficult to see in darker skin tones.      

Find out more about SATCC-approved training providers for touch in cancer care