Radiation and the Skin

Radiation and the Skin

All patients treated with radiation therapy will experience some degree of skin reaction in the treatment area (within the markings on your skin). The most common skin changes are dryness and redness. It is possible far some patients to have blistering.

Your skin is especially sensitive while you are receiving radiation treatments. The nurses and therapists have samples of skin care products your doctor would like you to use on your skin during treatments. We use these particular products because they do not contain alcohol or preservatives that will irritate your skin.

Remember you will experience skin changes only in the area being treated with the radiation. Feel free to use your home skin care products everywhere but in the treatment area. If you have any questions about where you can apply lotions, please ask your therapist or nurse. Some advice on tips to minimize skin problems are noted below (there have been a number of studies looking at different creams, though no specific one has been found to be best...read here.)

typical appearance of radiation dermatitis on the left chest wall at completion of breast radiation (a) and the same woman one month later (b)

RTOG Radiation Skin Morbidity Scores
	0	1	2	3	4
acute	No change over baseline	Follicular, faint or dull erythema/ epilation/dry desquamation/ decreased sweating	Tender or bright erythema, patchy moist desquamation/ moderate edema	Confluent, moist desquamatiom other than skin folds, pitting edema	Ulceration, hemorrhage, necrosis
chronic	None	Slight atrophy,Pigmentation change,Some hair loss	Patch atrophy; Moderate telangiectasia; Total hair loss	Marked atrophy; Gross telangiectasia	Ulceration

Helpful Skin Care Hints To Use During Treatments

Use gentle soap when bathing. After rinsing, pat skin dry. Avoid any friction in the treatment area.
Avoid tight fitting clothes or harsh fabrics against area being treated. Wear soft, cotton clothing when possible
Avoid sun exposure to treatment area and protect it with clothing such as long sleeve shirts, hats or scarves. Protect your skin by using a sunscreen with SPF 15 or higher, and if possible, one that is lanolin and alcohol free.
Avoid extreme temperature changes (very hot or very cold) to the treatment area, such as ice packs or heating pads.
Do not shave in the treatment area except with an electric razor. If aftershave lotion is used, select a brand that has no alcohol.
Do not use deodorant in the treatment area. You may use some cornstarch or baking soda in your underarms if needed.
Check your skin daily for blisters. Report any to the nurse before treatment.

USE:

Products You Can Use On Your Skin In The Treated Area

Aquaphor Cream
Biafine RE
Keri Lotion
100% Aloe Vera Gel

AVOID:

Products To Avoid Using On Your Skin In The Treatment Area

Lotions with alcohol
Steroid Creams
Medicated creams for sore muscles

If you have any questions about taking care of your skin during treatments, please ask a nurse.

MANAGING SKIN REACTIONS

You may develop a dry or moist skin reaction from the radiation treatments. All new patients should use Aquaphor Cream or Biafine RE radiodermatitis emulsion on their first day of radiation and through the completion of their radiation treatments to protect against skin reactions. Use these creams seven days a week while receiving radiation treatments. If your skin is Red and Moist, please check with the nurse.

Here are things we would like you to do to take care of skin reactions if they develop:

1. Protection Against Skin Reactions and/or Dry, Itchy Skin: You may use Aquaphor Cream or Biafine RE radiodermatitis emulsion.

For the aquaphor cream: Gently massage a small amount of Aquaphor Cream to the treatment area three times a day, seven days a week. Begin applications immediately following first radiation session. Do not apply Aquaphor Cream within four hours of a radiation session. It is important that your skin is clean and dry before and during the treatment. If you are unsure whether your skin is dry enough, simply wipe the treatment area gently with a soft tissue before your radiation treatment.
For the Biafine RE radiodermatitis Emulsion: Gently massage Biafine RE into the irradiated area, three times per day, seven days a week. Begin applications immediately following first radiation session. Do not apply Biafine RE within four hours of a radiation session. It is important that your skin is clean and dry before and during the treatment. If you are unsure whether your skin is dry enough, simply wipe the treatment area gently with a soft tissue before your radiation treatment.

2. Dry and/or red skin (Dry desquamation/Erythema) You may use Aquaphor Cream or Biafine Re radiodermatitis emulsion

For the Aquaphor Cream: Gently apply a small amount of cream to the affected treatment area three times a day, seven days a week. Do not apply Aquaphor Cream within four hours of a radiation session. It is important that your skin is clean and dry before and during the radiation treatment. If you are unsure whether your skin is dry enough, simply wipe the treatment area gently with a soft tissue before your radiation treatment.
For the Biafine RE radiodermatitis emulsion: Gently massage Biafine Re cream on and around the affected treatment area, three times day seven days a week. Do not apply Biafine Re cream within four hours of a radiation session. It is important that your skin is clean and dry before and during the radiation treatment. If you are unsure whether your skin is dry enough, simply wipe the treatment area gently with a soft tissue before your radiation treatment.