Skin reactions from external beam radiotherapy are a common side effect of radiotherapy treatment and these skin reactions can cause significant discomfort and pain. There is a lot of radiotherapy related skin care advice online, but much of it is conflicting and advice tends to vary from one hospital to another.
If in doubt, it is always best to check with your own radiotherapy team or clinical nurse specialist as their advice will be specific to their radiotherapy machines and treatment regimes. However, in 2020, the Society of Radiographers produced the following evidence based skin care guidance for radiotherapy.
When might my skin react to radiotherapy treatment?
The Society of Radiographers advises that a skin reaction is likely for most radiotherapy patients. Skin reactions don't happen straight away, but tend to develop gradually throughout radiotherapy treatment. Skin issues may worsen for 10-14 days after radiotherapy treatment finishes and most skin reactions will begin to settle 2-4 weeks after treatment finishes. Most patients find that their skin has improved by about 4 weeks after radiotherapy treatment, although if the skin is blistered or broken, healing may take longer.
The treated area will continue to be more sensitive to heat and light than the rest of your skin, even once you have finished your radiotherapy treatment.
How might my skin react to radiotherapy treatment?
During the course of your radiotherapy treatment you may notice your skin:
gradually becomes pinker or darker, depending on your skin colour - radiation can present differently across different skin tones
develops a rash and feel itchy - this may feel worse if you get hot
feels dry or tight and sore
blisters or peels - if this happens please seek advice from your radiotherapy team as you may need dressings or gel
You may develop an exit rash. This is where the radiotherapy beam causes a reaction in the area opposite to where it goes in. This will depend on how and where you are being treated.
What might make my radiotherapy skin reaction worse?
If you develop a skin reaction during the course of your radiotherapy treatment a number of factors may affect the reaction:
if you are prescribed a higher dose of radiation for your type of cancer
if you receive radiotherapy treatment where your skin folds - this includes the groin, breast, buttocks or armpit; these areas can be warm, moist and rub together, making the skin more sensitive
if you receive radiotherapy treatment to the head and neck area - this is due to the sensitive nature of the skin and the tendency for this area to be exposed to the sun. If you are receiving treatment on you neck, you can help by covering this area with a cotton or silk scarf when you go outside
if you smoke as this can affect the oxygen levels in your skin - please ask for advice if you need help to stop or cut down on smoking
if you have other conditions such as diabetes or heart disease
Skin care advice for radiotherapy treatment
Reactions to your skin cannot be prevented, however the Society of Radiographers recommends the following, to help you feel more comfortable:
ensure you drink 6-8 glasses of water each day. One of the most important ways to keep your skin hydrated during radiotherapy treatment is to drink plenty of water. Skin contains 30% water, which can be lost through sweat. One study has shown that staying hydrated from the inside could be as effective as applying a topical moisturiser to your skin
when washing and bathing, make sure the water is not too hot; wash the skin gently with products you would normally use and gently pat the skin dry
continue to use the deodorant you normally use, unless it irritates your skin. Stop if your skin blisters or peels.
What moisturiser can I use during radiotherapy treatment?
The Society of Radiographers doesn't recommend a specific skin moisturiser for use during radiotherapy treatment as there is not specific evidence to support the use of one product over another. They provide the following advice regarding the use of skin moisturisers during radiotherapy treatment:
continue to use your normal skin moisturiser
use moisturiser frequently - gently smooth it onto your skin until it is absorbed. The aim is to help keep your skin supple
don't apply moisturiser immediately before your treatment
stop using a moisturiser if it irritates your skin
If your skin blisters of peels, the Society of Radiographers recommends that you stop using your normal moisturiser in that particular area and speak to your radiotherapy team for more advice.
Things to avoid during radiotherapy treatment
The Society of Radiographers recommends that you avoid the following:
rubbing the area being treated
using sticky tape on the area being treated, such as elastoplast or micropore
shaving the area being treated, reduce shaving if possible unless advised differently by your radiotherapy team
using wax, cream or lasers for hair removal on or close to the treated area
using makeup, hair dye, perfume and aftershave on or close to the treated area
Always tell your radiotherapy team or clinical nurse specialist if you see or feel anything on your skin that concerns you. Also ensure you tell them if your skin reaction is painful as they can recommend pain relief for you.
The Society of Radiographers leaflet outlining their radiotherapy skin reactions information for patients can be viewed here.
CancerPal stocks a range of skin care products to help you look after your skin during radiotherapy treatment in the skincare section of our CancerPal MarketPlace.