Skin Reactions from Radiation Treatments
Skin reactions are a common side effect of
radiation treatments. They are caused when
repeated doses of radiation pass through the
skin. Skin reactions occur within “treatment
fields.” Treatment fields are the parts of the
body that are treated with radiation. Skin
reactions can worsen as more treatments are
given. They can continue to worsen for 7-
10 days after treatments end. Most skin
reactions heal 1-2 weeks after treatments
Skin reactions can vary. They can be mild
with the skin turning light pink or brown.
They can be more severe and look like a
sunburn. In some cases, the outer skin peels
off to reveal a layer of moist, “weepy” skin.
Areas of bleeding, blisters, or crusting can
The skin within treatment fields can also
become tender to the touch. It can become
dry and itchy. This is because the oil and
sweat glands in the treatment fields can shut
down for a short amount of time.
Sometimes a mild pinpoint type rash will
occur. Repeated treatments can also lead to
hair loss. If the total dose given is high
enough, the hair loss can be long-term.
What type of skin reaction will I get?
The type of skin reaction that occurs
depends on many factors. One factor is the
total dose of radiation given. This dose is
prescribed by your doctor. Higher total
doses more often lead to more severe skin
The shape and size of the treatment fields
will also affect how severe the reaction will
be. Small, flat treatment fields (the middle
of the chest, for instance) will often have
little or no skin reaction. Larger treatment
fields with curves (the pelvis and groin, for
instance) will often have a more severe
reaction. If skin folds are present in the
treatment fields, the skin within the folds
will have a more severe reaction.
Other factors can play a role in how severe
the skin reaction may be. These factors
include age (older people have thinner skin),
and the type of medicines you take on a
daily basis (some cause the skin to thin).
Certain types of chemotherapy (chemo) can
also make skin reactions worse. Some types
of chemo can lead to an acne-like rash. If
you are getting chemo during your radiation
treatments, talk to your doctor or nurse. He
or she can tell you how your chemo may
impact the skin reaction.
Other health issues can affect the type of
skin reaction that occurs. People with
diabetes, kidney disease, or lupus may have
more severe skin reactions. If your skin is
extra sensitive to soaps, lotions, and
perfumes, you may get a more severe
reaction. People who smoke or who use
excessive amounts of alcohol may also be at
risk for a more severe reaction.
Sometimes skin reactions do not occur. This
can be because the total treatment dose is
small, or the size of the treatment field is
small. At other times people who are
thought likely to get a severe skin reaction
do not get a severe skin reaction. The
reasons for this are not fully known.
Your doctor or nurse can advise you on the
type of skin reaction you may be likely to
get from your treatments. The radiation
therapists know a lot about what might
happen to your skin from your treatments.
How do I care for myself and my skin
during my treatments?
There are things you can do to help yourself
and your skin during your treatments. These
Handle the skin in treatment fields
Clean the skin in treatment fields
Keep yourself well nourished and
Avoid smoking and excessive
amounts of alcohol.
Get enough rest and sleep.
Get some mild exercise everyday
These suggestions may not lessen the
severity of your skin reaction, but they may
help you to feel better. The last four are
considered “good health” habits. Keeping a
healthy lifestyle may help you to feel better
during your treatments.
Below is a list of recommendations that
have traditionally been given to patients
getting radiation treatments. If you have
questions or concerns about anything in this
list, please talk to your doctor or nurse.
How do I care for the skin in the
Common skin irritants include
lanolin, perfumes, and dyes.
Camphor, menthol, zinc, and
aluminum can also cause problems.
Alcohol is drying to the skin. You
may wish to avoid skin care products
that contain large amounts of these
items. Your pharmacist, doctor,
nurse, or radiation therapist can help
you understand product labels.
Avoid extremes of hot and cold on
treated skin as they may cause
further damage to the skin. The use
of ice packs and heating pads is not
Avoid exposing treated skin to direct
sunlight. This includes tanning beds.
You may also wish to avoid
swimming pools or hot tubs. They
contain harsh chemicals that can dry
and irritate the skin.
Avoid applying any friction to the
skin in treatment fields. Try not to
rub or scratch your treated skin.
Avoid “rough” clothing or clothing
that rubs back and forth over treated
You may find that soft cotton
clothing that has been washed in
mild baby soap provides comfort to
If you need to reduce chafing or
friction within skin folds, use a
product called Zeasorb® Absorbent
Powder. It can be bought at drug
stores. Do not use cornstarch as the
starch may “feed” on a normal body
flora and lead to a fungal infection.
You may also wish to avoid baby
powder or other talc products that
contain perfumes and dyes.
Avoid high pressure shower sprays.
They may cause further damage to
Do not use tape on treated skin.
Removing it can cause damage.
Tell us if your skin becomes sore or
tender to the touch. Your doctor or
nurse may advise you to take
Tylenol® or ibuprofen for
discomfort. If your skin soreness
disrupts your sleep, you may want to
take one of these at bedtime.
If you need to shave in areas where
your skin is being treated, use an
electric, rather than a normal razor.
If you use a thick, ointment type
moisture cream, do not apply it
directly onto the skin. Rubbing thick
ointments onto treated skin can cause
further damage. This damage occurs
through a “shearing” of the sweat
and oil glands in the skin. Instead,
“melt” thick ointments in the palm of
your hands. Then, gently pat it onto
If your head or scalp area is getting
treated, it is okay to wash your hair
gently with a mild shampoo. Do not
use hair dye or apply permanent
wave solutions to your scalp until
well after your treatments are
How do I clean the skin in the treatment
Gently wash the skin in treatment
fields. Use warm water alone, or
warm water with a mild soap
Try to avoid washing any of the
plastic dressings or short-lived marks
placed on your skin by the therapists.
Wash your treated skin with your
hands or a soft washcloth. If you use
soap, be sure to fully rinse it off. Pat
your skin dry with a soft clean towel.
You can also let it air dry.
Breast patients: It is okay to use a
non-aluminum antiperspirant or
deodorant on your treated side.
Here is a partial list of mild soaps that you
Value Rite® skin cleanser
What should I know about creams and
Keeping treated skin clean, soft, and moist
by using creams and lotions is endorsed by
most radiation doctors. Your skin will most
likely feel softer and suppler with the use of
creams and lotions. Using creams and
lotions will not reduce how severe your
skin reaction becomes. Creams and lotions
may help your skin to feel more
comfortable. You may use a skin cream or
lotion up to 1-2 hours before your treatment.
Because skin reactions from radiation
treatments are common, researchers persist
in trying to find ways to prevent them or
lessen their severity. Many studies have
been done with a wide range of skin care
products. Many more will most likely be
done. Other studies have looked at oral
agents or wound dressings. Thus far, there
is little data to show that any one product
works better than another. You should use
what works for you.
There are many skin care products on the
market. You can keep using your normal
products on your treated skin if they do not
cause burning, tingling, itching, or a rash. If
burning, tingling, itching, or a rash
begins, stop using these products. You
may then want to switch to products that are
made for sensitive skin. Use products that
do not contain any alcohol or perfumes. A
list of recommended skin care products are
Elta® Lite lotion
ProShield® Plus Skin Protectant
Vaseline Intensive Care lotion
What should I do for itchy skin?
Sometimes the skin in treatment fields
becomes itchy. Again, this is because oil
and sweat glands can “turn off” for a period
of time. If this happens, talk to your doctor,
nurse, or radiation therapist. He or she will
be able to help you with this.
What should I do if my skin becomes
“weepy” or if bleeding or blisters occur?
Talk to your doctor, nurse. He or she may
want you to use a germ-killing ointment.
You may also be given special dressings to
use. These will help your skin to heal and
may be soothing.
How do I keep myself well-nourished and
During your treatments, it is vital to eat well
and drink plenty of fluids. Your body needs
nutrients and water to repair treated skin and
tissues. Patients who eat well and drink lots
of fluids tend to feel better than patients who
do not. Your doctor and nurse can help you
to find ways to maintain your food and fluid
intake. Family members can also help.
May I keep smoking?
Smoking is not considered a good health
practice. There is some research to suggest
that people who smoke during their radiation
treatments have poorer outcomes than
people who do not smoke. If you are a
smoker, please cut back, or better yet, quit
smoking completely. If you need help with
this, speak to your doctor or nurse. He or
she will help you get in touch with to the
supports you need.
What about alcohol use?
In general, people getting radiation
treatments should try to avoid large amounts
of alcohol. There is some research to
suggest that people who drink alcohol
during their radiation treatments have poorer
outcomes than people who do not drink
alcohol. If you think you may have a
problem with alcohol, talk to your doctor or
nurse. He or she will help you get in touch
with to the supports you need.
How much sleep do I need?
It is vital to get enough rest and sleep during
your treatments. Your body needs sleep in
order to repair normal tissues. If you are not
sleeping well, let your doctor or nurse know.
The doctor may be able to prescribe
something. The nurse may be able to
suggest ways to get better sleep. If you have
chronic problems with sleeping, you should
talk to your primary care doctor. Getting
enough “good sleep” is a key factor in
How do I care for my skin after
Most skin reactions will appear to fully heal
1-2 weeks after treatments end. But the
deeper parts of your skin and tissues will
need more time to fully heal. In some cases,
the skin in treatment fields can change over
time. The skin can toughen, darken, or form
brown scaly spots or broken blood vessels.
This can happen weeks to months after
You should continue to clean, moisturizing,
and handling your treated skin gently for at
least six months after your treatments end.
When outdoors, always use a good
sunscreen (SPF 30 or higher) on treated
skin. Treated skin is at a higher risk for
developing a certain kind of skin cancer.
Your treated skin may also remain dry and
itchy. You may need to continue using
creams or lotions. You may also find that
your treated skin is more sensitive. You
may need to use soaps and lotions made for
sensitive skin. You should also continue to
protect your treated skin from hot and cold
extremes; friction, or other kinds of stress.
If your treated skin persists in being a
problem, talk to your Radiation Doctor or
Nurse. He or she will help you to form a
long-term plan to manage your treated skin.
The Spanish version of this Health Facts for You is #7098
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is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 6/2017. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4621