Care of your skin during radiotherapy

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Radiotherapy can only affect the skin in the treated area. Most radiotherapy regimens even in the treated area have no significant skin damage. Those most likely affected would be the head and neck area and in your skin creases (e.g. under the breast, the groin, between the buttocks etc).

Like all radiotherapy side effect, there are two types; those which come on during or immediately after treatment (acute side effects) and those which can be long term (late side effects). Your oncologists will have taken these into account when considering the benefits of treatment and will inform you of the side effects you are likely to get.

Acute side effects

Acute side effects in the treated area may get red, itchy, dry and slightly sore as the treatment progresses. You may splash the area with water but do not use soap, aftershave or make-up. E45 or aqueous cream may improve the condition of the skin. If it gets worse, with cracking and oozing, please tell the radiographers as you may require a cream, which can be prescribed for you. It is advisable to wear loose clothing around the neck. In men, when treatment is given to the beard area, you should use an electric razor rather than have a wet shave or stop altogether. The beard hair growth may be effected by radiotherapy. in the treated area may get red, itchy, dry and slightly sore as the treatment progresses. You may splash the area with water but do not use soap, aftershave or make-up. Here are some tips to help the skin during radiotherapy:-

• Wash gently in warm water with a mild, non-perfumed soap such as simple soap. Avoid using a washcloth. Avoid using bath oil or bubble bath.

• Rinse thoroughly, and pat dry with soft, clean towel.

• Wear loose fitting, soft clothing preferably made with a natural fibre such as cotton or silk.

• Use a mild detergent to wash clothing which will be worn next to the treated area.

• Avoid frequent shaving within the treated area.

• Avoid use of deodorant within the treated area.

• Avoid friction, including rubbing, scratching or massage in the treated area.

• Avoid use of adhesive tape (e.g. elastoplasts, micropore) in the treated area

• Avoid extremes of heat in treated area – e.g. ice packs, hot water bottle, hairdryer.

• Avoid exposure to the sun or a sun lamp within the treated area for the full course of treatment and for the next year after treatment is completed.

• Use only skin creams recommended by your oncology doctor, radiographer or oncology nurse in the treated area. Normally we advise the use of aqueous cream or E45. If you know you are allergic to these, please ask your treatment team for advice.

• Avoid using aftershave, perfume and make up in treated area.

• Avoid swimming in a swimming pool with chlorine while undergoing a course of radiotherapy treatment.

Late side effects

These are usually only seen if the skin was intended to receive a significant dose of radiotherapy. Modern radiotherapy machines are designed to spare the skin as much as possible but in certain circumstances the oncologists wants to treat the skin (risk of containing cancer cells) or it is unavoidable.

The skin can become thin and fragile but the underlying tissues thickened (fibrosis). It is possible to develop dilation of the minute blood vessels in the breast (capillaries). This is not painful but can make the area noticeably red/purple. It is called telangiectasia. To avoid thickening and fibrosis it is important to gentle stretch the muscles and tissues in the affected area (e.g. see exercises after breast cancer). It is also important to exercise generally and avoid smoking. 

Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.