Skin Care During Radiation Therapy

How does radiation therapy affect your skin?

During each treatment, radiation is aimed at an area of your body called the “treatment field.” Radiation passes through the skin of the treatment field (front to back). Likely,  some changes to your skin will start to happen during the second week of treatment. You may find that your skin is red, irritated, peeling, tanned, or looks sunburned. Skin reaction can be worse or happen more often in people who have fair skin.

How do you protect your skin?

There are some things you can do to protect your skin when you are having radiation therapy:

• 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.
• 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.
• Your provider may order certain bland ointments to help with dryness and itching. Ask your provider if it is safe to use an ointment before treatment.
• 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.
• If your treatment is to your head, use a mild shampoo, such as baby shampoo, and try not to shampoo every day. Do not use hot curlers or a curling/flat iron, and be gentle when combing or brushing hair.
• Do not rub or 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.
• 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).
• Talk to your providers before swimming, including chlorinated pools, hot tubs, and non-chlorinated water (lakes, rivers).
• Do not use hot water bottles, ice bags, heating pads, or heating lights on the treatment area.
• Do not smoke. Smoking has been found to make skin reactions from radiation worse.
• 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.
• 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.

Any skin reaction can get worse during treatment, until about seven days after your last treatment, and then it will start to go away. You can expect your skin to be a little thinner and drier in the treatment area. This area may have a higher risk of infection and breakdown. Protect the area with sunscreen and use a thick ointment or lotion to keep that area moisturized.