How Do You Take Care of Your Skin During Radiation Therapy?

To look after your skin during radiation therapy, keep the treated area clean, gently moisturised and protected from friction, harsh products and sun. In practice that means washing with lukewarm water, patting dry, using only products your radiation team has approved, wearing loose clothing and keeping the area out of the sun. Most people get some redness or dryness, and it usually settles a few weeks after treatment ends.

According to Dr. Sandeep Nayak, who provides cancer treatment in Bangalore, says skin reactions are what patients worry about most, because they can see them. “Most are mild and they settle after treatment, and good habits keep them milder. The rule I give is simple. Nothing goes on the skin that your radiation team hasn’t approved, nothing rubs, and nothing gets hot or sunburnt. And if the skin breaks, blisters or starts to weep, don’t wait. Call the same day, because that’s when we can help most.”

You don’t need a long routine. These are the basics:

• Wash gently, and pat dry. Use lukewarm water, and a mild unscented soap if you like. Don’t scrub, and don’t rub with the towel. Dry the creases well, such as under the arm, under the breast or in the groin.
• Moisturise intact skin. Use a fragrance-free cream your team recommends, and not right before your session. Some people are given a mild steroid cream such as mometasone to calm itching and redness, mostly for breast and head and neck treatment. Don’t start one on your own.
• Ask about deodorant before you assume. Many centres now allow it with breast radiation as long as the skin is unbroken, but not within about two hours of treatment on that side. Check with your team first.
• Leave the markings alone. Don’t scrub off the ink marks or tattoo dots that guide the treatment, and avoid sticking tape, plasters or other adhesives on the area. Our radiation therapy page explains how the planning works.

It helps to know what counts as normal, and what doesn’t:

• Redness, dryness, itching and darkening are normal. The skin can look like mild sunburn, and it may peel a little, which is called dry desquamation. It usually starts after a couple of weeks, peaks around the end of treatment or a week or two after, and heals over the following weeks. Up to 95% of people having breast radiation get some reaction.
• Call the same day if the skin blisters, weeps or breaks open. That’s called moist desquamation, and it needs proper dressings, usually silicone or non-stick ones, and sometimes treatment for infection. Don’t pop blisters or tape over them.
• Also call for signs of infection or severe pain. Fever, pus, a bad smell, or redness and warmth that keep spreading are all reasons not to wait for your next appointment.
• Protect the skin from the sun, heat and cold. Cover the area, avoid hot water, heating pads, ice packs and saunas, and wear loose cotton clothes. Eating well and not smoking

Skin care isn’t identical for everyone. A few things decide what your team recommends:

• The area being treated. Breast, head and neck and skin folds such as the underarm or groin react more, and they’re where steroid creams and extra care are most often used.
• The dose and the technique. Higher doses cause stronger reactions, and newer techniques such as IMRT tend to lower how often and how badly they happen.
• What else you’re having. Some chemotherapy and targeted drugs make the skin more sensitive to radiation, so your team plans around them.
• Your own skin and health. Fair skin, diabetes, smoking, extra weight and earlier sun damage can all make reactions worse.
• How your skin is doing week to week. It’s checked regularly, and the plan changes if it needs a steroid cream, a dressing or a break from treatment.