Your 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 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, itchy, 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 you have treatment to the front of your chest. This is because the skin can also 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 or stop 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 under the breast.

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 radiographers or 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 in the treatment area include:

• Don't rub the area too hard because this makes it sore.

• Don't use perfume on the area as this can irritate the skin.

• Continue to use normal deodorant (unless this irritates the skin), but stop using it if the skin is broken.

• Wash your skin gently with soap and water and gently pat dry.

• Avoid shaving and don't use heat and cooling pads/ice, or wax and creams for hair removal in the treatment area.

• Men can use an electric trimmer instead of shaving.

• Don't use dressings on the treatment area unless your specialist or radiographer has told you to.

• Wash your hair gently with your usual shampoo (if your scalp is in the treatment area) but don't dry it with a hairdryer.

• Use your usual moisturiser unless this irritates your skin.

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.

The skin in the treatment area is sensitive so try to avoid cold winds and strong sunshine. Protect the area from direct sunlight and use a high SPF sunscreen or sunblock.

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.

Continue to protect the treated area from the sun for at least one year after you have finished treatment. Your skin will be more sensitive, use sunscreen with SPF 50 (sun protection factor 50).

Swimming

Chlorinated water might cause irritation in the treatment area. If your skin is not blistered or peeling, you may go swimming. It is best to shower immediately afterwards to wash off the chlorine and then apply moisturiser. You must stop swimming if it irritates your skin.

If you have a bad skin reaction with broken skin, you shouldn't swim until it is healed. 

Some doctors prefer you not to swim until your treatment is finished, ask your radiographers for advice if you are unsure.

Long term side effects

You might find that the treatment area is permanently darker 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.

Worries about treatment side effects

You may feel anxious about radiotherapy side effects and this is normal. It can help to talk through any worries you have with your doctor, nurse or radiographer.