Radiation therapy may involve side effects, and symptoms can vary depending on the area treated. For example, a breast cancer patient may notice skin irritation on her chest, like a mild to moderate sunburn, while a patient with cancer in the mouth may have soreness when he swallows. Some patients who are having their midsection treated may report feeling sick to their stomach or diarrhea. I will be focusing on skin changes and self- care tips for patients receiving radiation therapy.
Why is the skin affected?
Radiation is especially effective on cells that are rapidly growing, such as skin cells. The skin in certain areas will be more sensitive to the effects of radiation. These areas include where two skin surfaces touch or are thinner (breast, buttocks, armpit, groin, face and genitals) or where there was an incision or previous injury. The amount of redness varies from person to person and depends on the length of treatment, radiation dosage, area being treated and skin type.
Common skin changes
- Redness. Your skin in the treatment area may look as if you have a mild to severe sunburn or tan. This can occur on any part of your body where you are getting radiation.
- Pruritus. The skin in your treatment area may itch so much that you always feel like scratching. This causes problems because scratching too much can lead to skin breakdown and infection.
- Dry and peeling skin. This is when the skin in your treatment area gets very dry – much drier than normal. In fact, your skin may be so dry that it peels like it does after a sunburn.
- Moist reaction. Radiation kills skin cells in your treatment area, causing your skin to peel off faster than it can grow back. When this happens, you can get sores or ulcers. The skin in your treatment area can also become wet, sore, or infected. This is more common where you have skin folds, such as your buttocks, behind your ears, under your breasts. It may also occur where your skin is very thin, such as on your neck.
- Swollen skin. The skin in your treatment area may be swollen and puffy.
It usually takes two or three weeks of treatment before you can notice much redness, dryness or itching. The following measures for self-care are recommended by the U-M Department of Radiation Oncology:
- Gently clean the treatment area. You may use a mild soap, lukewarm water, a soft cloth and a gentle patting motion. Rinse the area thoroughly and then gently pat it dry with a soft towel. Be careful not to wash off your marks.
- Avoid wearing tight-fitting clothes over the skin in the treatment area. Collars, bras, girdles and belts are major causes of discomfort. If possible, expose the skin in the area to air.
- Avoid wearing scratchy fabrics next to the skin; lightweight cotton is most comfortable.
- Avoid excessive exposure of the skin in the treatment area to sunlight. If it is an area usually exposed to the sun, wear protective clothing such as a wide-brimmed hat or scarf when out in the sun.
- Avoid all sources of heat on your skin. Hot water bottles, heating pads and sun lamps should not be used.
- Avoid exposing your skin to cold temperatures, including ice bags and winter weather. Warm, protective clothing is necessary when your skin is exposed to cold temperatures and wind.
- Avoid the use of all medications, deodorant, perfumes, powders or cosmetics on your treated skin. Tape, dressings and band-aids should also be avoided unless permitted by the therapist.
- Avoid shaving. Use an electric razor if shaving is necessary in the treatment area.
- If you develop more than dry peeling of the skin, notify your nurse so that she can give you additional care instructions.
After treatment is completed
You will continue to see the effects of radiation therapy on your skin after you have finished treatment. Generally, you will have redness, dryness and peeling of the skin in the treatment area for about two weeks following the end of treatment. You may have more than peeling on the skin surface, depending on the extent of the redness when treatment ended. You may use baby oil or a lubricating cream of your choice on the dry skin area. Your skin will gradually return to its normal color, although there may always be a slightly deeper tone.
Do you have any helpful tips for dealing with skin changes related to radiation therapy? Please feel free to share your suggestions and leave a comment.
Take the next step:
- Read advice from U-M health professionals on radiation side-effects in this article from Thrive magazine.
- Learn from the National Cancer Institute about radiation therapy side effects and ways to manage them.
- Still have questions? Call the nurses at the University of Michigan Cancer AnswerLine™. They can help patients or their loved ones find a clinical trial or provide insights into the newest and latest cancer treatments. Feel free to call at 1-800-865-1125 or send an e-mail.
The Cancer AnswerLine™ nurses are experienced in oncology care, including helping patients and their families who have questions about cancer. These registered oncology nurses are available by calling 800-865-1125 Monday through Friday, 8 a.m. – 5 p.m. Your call is always free and confidential.
The University of Michigan Comprehensive Cancer Center’s 1,000 doctors, nurses, care givers and researchers are united by one thought: to deliver the highest quality, compassionate care while working to conquer cancer through innovation and collaboration. The center is among the top-ranked national cancer programs, and #1 in Michigan according to U.S. News & World Report. Our multidisciplinary clinics offer one-stop access to teams of specialists for personalized treatment plans, part of the ideal patient care experience. Patients also benefit through access to promising new cancer therapies.