When radiation therapy is delivered from outside the body, it travels through the skin to the tumor, damaging healthy skin cells along the way. This can lead to radiation dermatitis (irritated skin), which can last several weeks after treatment ends. Acute radiation dermatitis generally occurs within 90 days of treatment. Chronic radiation dermatitis may appear from 15 days to 10 years or more after treatment.
The severity of radiation dermatitis can vary depending on your overall health, the type of cancer, the body area being radiated, and the dose and length of treatment. The most common reaction is reddened skin that looks like a bad sunburn, but it can progress from a mild rash to itchy, peeling skin, blisters, and moist, peeling skin. If there are skin folds in the area being treated, the increased warmth and moisture can make the area more sensitive to radiation’s unpleasant effects. Here are some ways to help prevent and reduce radiation dermatitis:
- Wash the treated area gently with warm (not hot) water and mild soap.
- Shower or bathe in lukewarm water, no more than once a day.
- Pat your skin dry – do not rub.
- Don’t put anything cold or hot on the affected area.
- To prevent cuts, use an electric razor.
- Wear loose clothing made of gentle fabrics such as cotton or silk.
- Keep skin moisturized. Ask your doctor about products that reduce itching and swelling.
- Cover the treated area with clothing and/or SPF 50+ sunscreen.
- Eat a healthy diet. Drink 2-3 quarts of water a day unless your doctor limits your fluids.
- Talk to your doctor before you use any creams, soaps, or makeup on the irradiated area.
- Report discomfort to your doctor. An untreated skin reaction can lead to infection and delay treatment.
Talk to your provider before treatment-related issues become more serious problems.
Risk Factors for Radiation Dermatitis
- Poor nutrition
- Pre-existing skin disease
- Applying skin creams immediately before treatment
- Skin folds / obesity
- A total radiation dose above 55 Gy or high individual doses of more than 3-4 Gy
- People with head/neck cancer being treated with cetuximab (Erbitux®) and radiation therapy
- Having diabetes or certain infectious diseases, particularly human immunodeficiency virus (HIV)