Skin is the largest human organ and, it naturally follows, the most sensitive part of our body. As such, it is almost invariably the most badly affected by radiation therapy. As the body’s first line of defense, your skin is the first part to be touched by beamed radiation and quite often suffers the most from the side effects of the life-saving treatment. Skin reactions occur because external beam radiation travels through the skin to reach the area being targeted for radiation treatment. What’s worse, radiation to any area of the body can cause skin reactions because wherever the cancer being targeted is, beams must first pass through the skin to get to where they are to take effect. The equipment used to deliver radiation therapy does not usually cause major skin damage, rather the radiation itself is the cause, and some people do not experience any skin reactions at all from radiation therapy.
Most skin reactions occur within the first 2 weeks of receiving external beam radiation therapy. They usually recover within 2–4 weeks after treatment is complete.
What is Skin Reaction?
Skin reaction (just like it sounds!) is the change that occurs in the skin due to the effects of radiation therapy. Naturally, skin reactions most often happen to the part of the body that undergoes the treatment. Each time radiation therapy is deliver small amounts of radiation are absorbed by the skin in the area being treated. About 2 to 3 weeks after your first radiation treatment you may notice redness, rashes, and irritation in the treated areas that may appear similar to sunburn. The skin may be itchy, dry, red, or sore. These changes are an expected part of your therapy and are temporary. In some cases, you may need to stop radiation treatments for a short period of time to allow the skin to heal. If the reaction becomes severe, you may need special care to help the area heal.
Creams and Lotions that may help your skin reaction
• Use mild soap and water to clean the area being treated. Use scent free soaps and detergents (do not use deodorants that contain aluminum).
• Your doctor may have prescribed steroid creams to prevent itching, rashes, redness and swelling — pay close attention to the instructions (usually best to apply no less than 4 hours prior to treatment).
• Be gentle with your skin by using a soft washcloth while showering or bathing — do not use loofah, scrub brushes, or sponges. Pat your skin dry after a shower or bath, instead of rubbing with a bath towel.
• Wear loose-fitting clothes, preferably cotton, to reduce skin irritation.
• Protect your skin from the sun and from general pollution — wear long-sleeved clothing and a hat to cover up and try to stay in the shade.
• Avoid extreme temperatures — take short, lukewarm or normal water baths and showers.
• Use moisturiser that are mild and without fragrances — Natural Cleanser, Natural Moisturizer and Natural Baobab oil are a few examples.
Avoid anything that could cause injury to your skin in the area being treated
• Do not scratch or rub your skin.
• Avoid using adhesive tape in the treatment area. If bandaging is necessary, use paper tape. Try to apply the tape outside of the treatment area.
• Use an electric razor if you must shave in the treatment area. Do not use a pre-shave lotion, an aftershave, or any hair removal products.
• Do not use cornstarch or talcum powder in the treatment area, especially in-between skin folds, as this can lead to fungal infections.
• Do not use heating pads, hot water bottles, or ice packs on the treatment area.
• Practice sun safety as exposure to the sun can cause additional skin damage. Wear sunscreen with an SPF of at least 15 every day (especially the treatment area). Wear protective clothing, including long sleeves, long pants, and a hat when outdoors. Avoid the sun during peak hours (10am to 2pm). Follow these tips in the winter months also!
• Do not smoke. Smoking has been found to increase radiation related skin reactions.
• Do not wear jewelry on or near the treatment area.
It is important to report skin reactions to your doctor or your healthcare team. Mild skin reactions do not usually require treatment. However, moderate to severe reactions may require medical treatment, causing delays in radiation therapy schedules in order to let the affected area recover.
Skin irritation can continue for several weeks after treatment ends, so special care may be needed for a short time afterwards. Some people choose to use makeup and/or cosmetics to help hide or camouflage skin that has been damaged and discolored by radiation therapy.
These skin changes happen gradually and can be predicted in your weekly exams with your radiation oncologist and nurse. You should be aware of the range and scope of possible skin reactions so that you're not surprised by them. Fortunately, skin irritation caused by radiation is temporary, and doctor or nurse can give you salves, medications, and prescriptions to ease any discomfort. If you find that the pain and irritation are not getting better over time, talk to your doctor and schedule a check up.
If you have peeling skin and/or wet blisters, the skin may have slowly started to grow back while you were being treated. Now that you’ve completed treatments, pearly-pink colored patches of new skin will grow back much faster on the affected areas of your body. The new skin layer is very delicate as it grows. You might still have a blister or old, dry, and flaky skin covering the new growth. Although they may not look like it, these blisters are your friends. They're protecting the new skin underneath.
The deep redness and rashes, and the skin sensitivity should start to go away during the first few weeks after treatment. Your skin will take a bit longer to return completely to its natural color. You may find that the treated area has a tanned or slightly pinkish look to it for up to 6 months after your last session of radiation therapy. If you have a very dark skin tone, by the end of treatment your skin can become even darker, and it may take 3 to 6 months (and sometimes a bit longer) for changes to go away.
Some people may continue to have a slightly pinkish or tannish hue to their skin for years after treatment. And a few people may notice a small patch of tiny blood vessels on the skin of the radiated area. These vessels — called Telangiectasias — look like a tangle of thin red lines. Don’t worry! Telangiectasias are not a sign of cancer recurrence. Although they usually don't go away on their own, there are treatments which can eliminate the problem.
If you are a smoker, stopping smoking may help your skin recover more quickly. Sometimes high intensity oxygen therapy (also called hyperbaric oxygen) can help as well. Talk to a dermatologist (skin doctor) who is experienced using lasers to remove birthmarks and other skin pigmentation.