Radiation Dermatitis: Skin Care Questions

Radiation therapy often makes the skin in the treated area red, dry, sore or peeling. Doctors call this radiation dermatitis. This page walks through everyday skin care during treatment, from washing to sun protection, and the questions to ask your radiation team.

The most useful habit during radiation is to check first. The American Cancer Society says to "ask your cancer care team before using any skin products on the area during treatment and for several weeks afterward," and its list is long: "powders, creams, perfumes, deodorants, body oils, ointments, lotions, hair-removal products, or home remedies." That includes things you have used for years without trouble.

The National Cancer Institute makes the same point from the other direction. It says to steer clear of products with alcohol or fragrance as an ingredient. Ask your team which products they recommend.

You do not have to keep the area untouched. Wash it, gently. ACS: "Use only lukewarm water and mild soap. Let water run over the treated area but don't rub." NCI adds: "Take short showers or baths in lukewarm, not hot, water," and "use mild soaps that are gentle on your skin." Pat dry instead of rubbing.

Protect the ink marks while you wash. ACS says to "avoid rubbing away the ink marks needed for your radiation therapy."

NCI's advice is to apply skin cream or ointment "after drying off from a shower but while your skin is still a little damp." Ask your own team whether to put anything on in the hours before a session. Some centers want the area clean and product-free at the machine.

NCI's wording is that if you are receiving radiation therapy, you should ask about skin products, "such as powder or antiperspirant, that you should avoid using before treatment." Ask about the specific product you own, and about the hours right before a session.

For shaving, NCI's guidance is to shave less often, or stop, if the skin is tender. Use an electric razor instead of a regular one. ACS says to check with the care team before shaving the treated area at all.

ACS: "Avoid tight, rough-textured, or stiff clothes." NCI suggests a loose-fitting long-sleeved shirt and pants when outdoors.

ACS: "Do not put heat or cold on the treatment area without talking to your cancer care team first. This includes heating pads, heat lamps, and ice packs." NCI says the same about heating pads, ice packs and bandages. ACS also says not to rub, scrub, scratch or use adhesive tape on treated skin.

Sun protection matters on treated skin. ACS recommends "a broad-spectrum sunscreen with an SPF of at least 30." Ask your team which product to use. ACS's instruction about afterward is short: "Continue this extra protection even after radiation therapy ends." NCI suggests a loose-fitting long-sleeved shirt, pants, a wide-brimmed hat, and sun-protective lip balm.

NCI's goal here is infection control: "try to keep the area clean and dry so it does not become infected." NCI says your nurse may prescribe special dressings, antibiotics, or both. That is a prescription decision rather than a drugstore one, so ask in advance who to call at night.

• Which cream or ointment do you want me using, and how often?
• Should I put anything on before a session, or only afterward?
• Is my deodorant allowed, and is there one you prefer?
• Can I shave this area, and with what?
• Can I use sunscreen on the treated skin, and which product?
• If the skin opens or weeps, what do I do that evening, and what number do I call?
• How long after my last session do these rules still apply?

NCI's baseline instruction covers anything you are unsure about: "Let your health care team know if you notice any skin changes so they can be treated promptly."

For what the skin reaction itself looks like as it develops, see Radiation Dermatitis & Skin Care Management and Side Effects Overview.

• National Cancer Institute, Skin and Nail Changes during Cancer Treatment
• American Cancer Society, Radiation Therapy Effects on Different Parts of the Body
• American Cancer Society, Radiation Therapy: What It Is and What to Expect