Skin Care During Radiotherapy

Most patients who get radiotherapy notice changes in the skin of the treatment area over the weeks of treatment. These changes can usually be managed. If you know what to do from the start, your treatment course will go more comfortably.

Why does the skin change?

To reach the tumor, the beam also passes through the skin. Skin cells are constantly renewing themselves, and they are sensitive to radiation. For this reason, a few weeks after treatment starts, the skin in that area may:

• Become red and warm
• Become dry, itchy, or flaky
• Become darker
• In more severe cases, blister or break open into sores

How severe these changes are depends on the treatment dose, the part of the body, your skin type, and any other medicines you take. In most people, the skin gets better over the weeks after treatment ends. The skin may stay darker and more sensitive for a while.

What helps

Washing. Wash with lukewarm water and a mild, fragrance-free soap. Keep baths and showers short and the water not hot. Pat the skin dry gently with a soft towel; don’t rub. Keep skin folds, such as the armpit and under the breast, clean and dry.

Moisturizer. Use only a product your doctor or nurse has approved. A good time to apply it is after a bath, while the skin is still a little damp. If you want to put something on before a session, ask first.

Clothing. Wear soft, loose cotton clothing. Avoid tight clothes, belts, or tight straps over the treatment area.

Sun. Keep the treatment area out of direct sunlight. Cover up with clothing or wear a wide-brimmed hat. Talk with the care team about sunscreen.

Itching. Don’t scratch, and keep your nails short. If itching bothers you, tell the care team; sometimes a cool, damp cloth helps. Don’t use anti-itch medicine or cream without asking first.

Shaving. In the treatment area, use an electric shaver or don’t shave for now. Razors and waxing may irritate the skin.

Marks on the skin. These marks (lines or dots) keep the treatment position consistent. Don’t wash them off. If they fade, tell the radiation therapist, and don’t redraw them yourself.

What to avoid

• Alcohol-based or fragranced products on the treatment area
• Powder, deodorant, and antiperspirant in the treatment area, unless the care team has allowed them
• Adhesive bandages on the skin, hot water bottles, and ice packs in the treatment area
• Very hot baths, saunas, and swimming pools
• Rubbing and scratching the skin
• Creams, oils, and herbal or home remedies you haven’t discussed with the care team

A product being “natural” doesn’t mean it is safe for your skin during radiotherapy.

When should you tell the care team?

Don’t let a skin problem get worse. Tell the care team early if you notice:

• Blisters, open sores, or oozing
• Severe pain or burning
• Redness that spreads quickly
• Pus, a bad smell, or a fever of 38 degrees Celsius or higher

The doctor can give you a suitable dressing or cream and, if needed, adjust the treatment plan. Don’t stop a session on your own without your doctor’s opinion.

After treatment ends

The skin doesn’t get better right after the last session. Sometimes the changes continue for a week or two after treatment ends, and then slowly improve. Keep up your skin care during this time. Take sun protection seriously for a long time after treatment, because this area may stay more sensitive than before. Show your doctor any new change, such as a sore that doesn’t heal.

Everyone is different

Not every patient gets severe skin changes. Modern radiotherapy methods try to aim the beam more precisely so that skin and healthy tissue are less damaged. Even so, keep up your skin care even if your skin doesn’t change.

Every patient’s treatment plan is different; ask your doctor about your own situation.