Skin Reactions From Radiation

Each time radiation therapy is given, small amounts are absorbed (taken in) 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 providers will check your skin for changes. In some cases, you may need to stop radiation treatments for some time to allow your 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.

Caring for the Skin 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 with lukewarm water and gently pat the skin dry. If you need to use soap, use a mild one like 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 lessen itching and soften the skin, making you more comfortable. Talk with your providers about which moisturizer you should use.
• Do not use makeup or cosmetics in the treatment area.
• Your providers may tell you not to use deodorant, perfume, cologne, aftershave, lotion, or powder on your skin in the treatment field. It was thought that these things may contain metals that could increase skin reaction. However, recent research has shown that this is not the case, so less providers are recommending this. Ask your provider before using products on your skin.
• 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. (using starch to make your clothes stiff).

How to Avoid Injury to the Skin in the Area Being Treated

• Do not scratch your skin. Keep your nails short.
• Do not use adhesive (sticky) tape or band-aids on your skin in the treatment area. If you need to bandage your skin, paper tape is best and try to use it outside of the treatment area.
• Do not shave hair that is in the treatment area. If you must shave, use an electric razor. Do not use a pre-shave lotion, aftershave, or hair removal products.
• Folds of skin are more likely to be irritated. Do not use cornstarch or powders in folds or in the treatment area. Check the exit site (the other side of your body) for irritation.
• Do not use hot water bottles, ice bags, heating pads, or heating lights on the treatment area.
• Practice sun safety, as exposure to the sun can cause more skin damage. It is best to stay in the shade and wear protective clothing, like long sleeves, pants, and a hat when outdoors. Avoid the sun during peak hours (10 am to 4 pm). If you are outside in the sun, wear sunscreen with an SPF of at least 30 (including the treatment area, if your providers tell you to do so). Follow these tips in the winter months as well.
• Do not smoke. Smoking has been found to make skin reactions from radiation worse.
• Talk to your providers before swimming, including chlorinated pools, hot tubs, and non-chlorinated water (lakes, rivers).

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

How are skin reactions treated?

Minor skin reactions caused by radiation therapy often do not need any special treatment, but tell your providers about them. If skin reactions get worse or if you have more harm to your skin, treatment may be needed. Your providers may decide to stop radiation treatments for some time to let your skin heal. You will be told how to care for skin reactions. Check with your providers first before using anything on the treatment area and ask them any questions you have about skin reactions.