Skin Reactions From Radiation

Each time radiation therapy is given, small amounts are absorbed by the skin in the area being treated. About 2 to 3 weeks after your first radiation treatment, you may notice redness and/or irritation in the area of treatment. It may look like a sunburn. The skin may be itchy, dry, red or sore. These changes are an expected part of your therapy and are temporary. Your team will look at your skin to monitor for changes. In some cases, you may need to stop radiation treatments for a short period to allow the skin to heal. If the reaction becomes severe, you may need special care to help the area heal.

All patients receiving radiation therapy should take special care to protect and care for their skin. Ways to do this are:

Be extra kind to the skin in the area being treated.

• The skin in the treatment area will be more sensitive and can be harmed more easily.
• Keep your skin clean and dry.
• Wash skin in the treatment area with lukewarm (not hot) water and a mild soap, such as Dove®, Neutrogena, or a baby soap. Avoid rubbing with a washcloth or bath scrubbies/sponges. Use the palm of your hand to gently wash the skin in the treatment area.
• Dry skin gently. Pat, don't rub, using a soft towel.
• Moisturizing the skin can be helpful to reduce itching and soften the skin, making you more comfortable. Talk with your radiation team about which moisturizer you should use.
• Do not use make up or cosmetics in the treatment area.
• Do not use skin products that contain scents or perfumes.
• Radiation often causes the hair in the field of treatment to fall out. This is often temporary, though for some it may become permanent.
• If your treatment is to your head, use a mild shampoo, such as baby shampoo, and try not to shampoo every day. In addition, do not use hot curlers or a curling/flat iron, and be gentle when combing or brushing hair.
• Wear loose fitting, soft clothing over the treatment area.
• Use gentle detergents, such as Woolite®, Ivory Snow®, Dreft®, or Eucalan® to wash your clothes.
• Avoid starching the clothes you wear over the treatment area.

Avoid anything that could cause injury to the skin in the area being treated:

• Do not scratch your skin.
• Avoid using adhesive tape in the treatment area. If bandaging is necessary, use paper tape. Try to apply the tape outside of the treatment area.
• Use an electric razor if you must shave in the treatment area. Do not use a preshave lotion, aftershave or hair removal products.
• Do not use cornstarch or powders in the treatment area, especially in the area of skin folds as this can lead to fungal infections.
• Do not use heating pads, hot water bottles, or ice packs on the treatment area.
• Practice sun safety, as exposure to the sun can cause more skin damage. Your best protection is to stay in the shade and wear protective clothing, such as long sleeves, pants, and a hat when outdoors. Avoid the sun during peak hours (10am to 2pm). If you are outside in the sun, wear sunscreen with an SPF of at least 30 (including the treatment area, if your care team tells you it is ok to do so). Follow these tips in the winter months also!
• Do not smoke. Smoking has been found to worsen radiation related skin reactions.
• Talk to your treatment team before swimming, including chlorinated pools, hot tubs, and non-chlorinated water (lakes, rivers).

Check the skin in the treatment area daily. Report any cuts, open areas, or changes to your radiation oncology treatment team.

How are skin reactions treated?

Minor skin reactions caused by radiation therapy do not often need any special treatment. They should be brought to the attention of your radiation team. If, however, the skin reactions become worse or if you sustain additional damage to your skin, treatment may be needed. Your radiation oncologist may decide to stop treatments for a period of time in order to allow the skin to heal. Your radiation team will tell you how to care for any skin reactions. Do not apply anything to the area without checking with your radiation team first.

If you have any questions about skin reactions, or need additional information or direction, ask your healthcare team.