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Your skin

Radiotherapy treatment can affect your skin making it sore and look redder or darker than usual.

Effects of radiotherapy on the skin

Radiotherapy can make your skin sore in the treatment area. Some people have no skin problems at all but others have very sore skin. This depends on the: 

  • the type of radiotherapy you have
  • your skin
  • the treatment area

 A skin reaction can make your skin red or darker in darker skinned people. It can also be sore, look like sunburn and it might peel and blister.

Skin reactions don't develop straight away but gradually throughout your course of radiotherapy. Your radiographer looks out for these reactions. But you should also let them know if you feel any soreness. Skin reactions usually settle down 2 to 4 weeks after your treatment ends.

You might also get redness or darkening on the other side of your body to the treatment area. For example, you may have skin changes on your back if the front of your chest is being treated. This is because the skin can be affected in the area where the radiotherapy beam leaves the body (the radiotherapy exit site). Tell your radiographer if this happens.

Rarely your doctor might delay treatment if your skin gets very sore. 

Treatment area

Radiation to certain parts of the body is more likely to cause a skin reaction than others. For example, areas where skin rubs against skin, such as the breast fold. This is the spot where your breast might rub against the skin underneath. 

Also, areas that receive a high radiation dose, such as some types of head and neck cancer, can cause the skin to become quite sore. 

As with all side effects, this does vary from person to person. 

Skin care during radiotherapy

Advice about skin care varies from one hospital to another. It is best to follow the instructions of your radiographers and doctor. The advice applies only to the treatment or exit site area. You can treat the rest of your skin normally. 

Don't use talcum powder because this can contain tiny metal particles that can make the soreness worse after radiotherapy. 

Your nurses might put on special dressings after your treatment if the cancer is affecting your skin. Don't use sticky (adhesive) tape or dressings in the treatment area.

Other skin care tips when washing and shaving include:

  • Don't rub the area too hard because this makes it sore.
  • Don't use perfume or perfumed soaps or lotions on the area.
  • Use a deodorant that is free of any metal (check with your radiographer).
  • Try baby soap or liquid baby wash but check with the radiotherapy staff in your department first.
  • Don't shave the area being treated.
  • Men can use an electric trimmer instead of shaving.
  • Don't use creams or dressings on the treatment area unless advised by your specialist or radiographer. 

Clothing during radiotherapy

During radiotherapy and for a while afterwards your skin might be sensitive. The following tips might help:

  • Wear loose fitting clothes.
  • Use clothes made of natural fibres.
  • Avoid tight collars and ties if you've had radiotherapy to your neck.
  • Avoid shoulder and bra straps – go without a bra, wear a crop top instead, or try a cotton bra.

Going outdoors

The skin in the treatment area is sensitive so try to avoid strong sun or cold winds.

Tips for going out in the sunshine include:

  • Wearing a hat and long sleeved shirts.
  • Using a high factor sunscreen.

If you're having radiotherapy to the head or neck you can try wearing a hat or a dense weave silk or cotton scarf when you go outside. You can also try putting up the collar on your shirt or jacket.

Swimming

If you like to swim, ask your radiotherapy specialist or radiographer if it is alright for you to swim. Chlorinated water might cause irritation in the treatment area. 

Some doctors prefer you not to swim until your treatment is finished. If you have a bad skin reaction with broken skin, you shouldn't swim until it is healed.

Long term side effects

You might find that the treatment area has a permanent tan after your treatment has finished. This is a long term side effect but won't harm you. 

Later, you may appear to have very tiny broken veins in the treated area. This is also a long term side effect of radiotherapy. It is called telangiectasia. Tiny veins widen in the treatment area and may show on the surface of your skin.

Your GP can prescribe camouflage make up. There are different colours for all skin tones. Some clinical nurse specialists can show you how to apply it.

Your consultant or GP can refer you to the Skin Camouflage Service run by Changing Faces. This free service teaches you how to apply the make up and creams and advises you on the best products to buy.

You can also get help from The British Association of Skin Camouflage (BASC).

Information and help

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