Skin Reactions From Radiation
Each time radiation therapy is delivered, 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 that may appear similar to 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 examine your skin periodically. 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 measures to protect and care for their skin, including:
Be extra kind to the skin in the area being treated.
- The skin in the treatment area will be more sensitive and can be injured 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, especially 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 their recommendations for moisturizers.
- Do not use make up or cosmetics in the treatment area.
- Avoid perfumed or scented skin products.
- Radiation typically causes the hair in the field of treatment to fall out. This is generally 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 additional skin damage. Wear sunscreen with an SPF of at least 30 every day (including the treatment area). Wear protective clothing, including long sleeves and pants and a hat when outdoors. Avoid the sun during peak hours (10am to 2pm). Follow these tips in the winter months also!
- Do not smoke, as smoking has been found to increase 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 significant changes to your radiation oncology treatment team.
How are skin reactions treated?
Minor skin reactions caused by radiation therapy do not usually require any special treatment, though 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 necessary. 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.
Baines, C. R., McGuiness, W., & O'rourke, G. A. (2017). An integrative review of skin assessment tools used to evaluate skin injury related to external beam radiation therapy. Journal of clinical nursing, 26(7-8), 1137-1144.
Yuen, F., & Arron, S. (2016). Skin Care Products Used During Radiation Therapy. In Skin Care in Radiation Oncology (pp. 31-45). Springer International Publishing.