Skin Care Guidelines for Patients Receiving Radiation Therapy

This information describes skin reactions to look out for during your radiation therapy and how to manage them.

Skin Reactions From Radiation Therapy

Skin changes are common and expected during radiation therapy. Each person reacts to treatment in a different way. The likelihood and severity of a skin reaction depends on:

  • The area being treated
  • The type and dose of radiation given
  • Whether or not you are also getting chemotherapy

After 2 or 3 weeks of radiation therapy, your skin may become pink or tanned. As your treatment continues, your skin may become bright red or very dark. Your skin may also feel dry and itchy and look flaky. Some people develop a rash or blisters in the treatment area. These blisters may open and peel. If you develop skin reactions, it will most likely improve 3 to 4 weeks after your treatment is finished. 

Talk to your radiation oncologist or dermatologist about using steroid cream to prevent skin reactions.

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Caring for Your Skin During Radiation Therapy

Keep your skin clean

  • Bathe or shower daily using warm water and a mild, unscented soap. Examples of soaps you can use include Neutrogena®, Dove®, baby soap, Basis®, and Cetaphil®. Rinse your skin well and pat it dry with a soft towel.
  • When washing, be gentle with your skin in the area being treated. Do not use a washcloth or a scrubbing cloth or brush.
  • The tattoo marks you received before treatment are permanent and won’t wash off. You may get other markings during treatment such as an outline of your treatment area with a purple felt-tipped marker. You can remove these markings with mineral oil when your radiation oncologist says it’s okay.
  • Do not use alcohol or alcohol pads on the skin in the area being treated.

Moisturize your skin often

  • If you are likely to get a skin reaction, your nurse will recommend that you start using a moisturizer. You should start using it the first day of your treatment to minimize the reaction. If you are not likely to develop a skin reaction, you will not need a moisturizer unless your skin becomes dry or itchy. Your nurse will give you instructions. If you are not sure whether you should use a moisturizer, please ask your nurse.
  • There are many moisturizers you can use. Some can be purchased over the counter and some require a prescription. There is no evidence that any one moisturizer is better than another. Over-the-counter moisturizers you can use include Aquaphor®, Eucerin®, or calendula.
  •  If you don’t like the feel of the moisturizer your doctor or nurse recommends, let them know. He or she can select another product for you to try.
  • Apply the moisturizer at least 2 times a day.
    •  If your radiation treatment is in the morning, apply it:
      • After your treatment
      • Before you go to bed
    •  If your radiation treatment is in the afternoon, apply it:
      • In the morning before your treatment
      • Before you go to bed
    • On days you are not being treated, apply it:
      •  In the morning
      • Before you go to bed
  • Do not wash off the moisturizer before your treatment. Your skin could become irritated.

Avoid irritating your skin in the treatment area

  • Wear loose-fitting, cotton clothing over the treated area.
  • Use only the moisturizers, creams, or lotions that are recommended by your doctor or nurse.
  • Do not use any of the following in the area being treated:
    • Makeup
    • Perfumes
    • Powders
    • Aftershave
  • You can use nonaluminum-based deodorant on intact skin in the area being treated. Stop using it if your skin becomes irritated. Examples of these deodorants include Toms of Maine® and crystal deodorants.
  • Do not shave the treated skin. If you must shave, use only an electric razor.
  • Do not put any tape on the treated skin.
  • Do not let your treated skin come into contact with extreme hot or cold temperatures. This includes hot tubs, water bottles, heating pads, and ice packs.
  • Do not apply any patches to the treated area, including pain patches.
  • If your skin is itchy, do not scratch it. Ask your nurse for recommendation on how to relieve the itching.
  • If you have no skin reactions, you can swim in a chlorinated pool. However, be sure to rinse off the chlorine right after getting out of the pool.
  • Avoid tanning or burning your skin during and after you are finished with treatment. If you are going to be in the sun, use a PABA-free sunblock with an SPF of 30 or higher. Also, wear loose-fitting clothing that covers you as much as possible.
  • If you have any silver-containing bandages, remove them and clean the area before treatment.
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Call Your Doctor or Nurse if You Have:

  • A temperature of 101° F (38.3° C) or higher
  • Pain
  • A rash or blistering of your skin in the treated area
  • Drainage from your skin in the treated area
  • Any other new symptoms or problems
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