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Radiation: How To Care For Your Skin

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Radiation therapy causes skin cells to break down and die. When people get radiation almost every day, the skin cells at the radiation site do not have enough time to grow back between treatments. 

Skin changes may start a few weeks after radiation therapy begins. Many of these changes often go away a few weeks after treatment is over. However, even after radiation therapy ends, you may still have skin changes. Your treated skin may always look darker and blotchy. It may feel very dry or thicker than before. And you may always burn quickly and be sensitive to the sun. 

Common skin changes in the treatment area are the following.  Many of the changes are only temporary. 

  • Redness. Your skin in the treatment area may look as if you have a mild to severe sunburn or tan. This can occur on any part of your body where you are getting radiation.
  • Pruritus. The skin in your treatment area may itch so much that you always feel like scratching. This causes problems because scratching too much can lead to skin breakdown and infection.
  • Dry and peeling skin. This is when the skin in your treatment area gets very dry - much drier than normal. In fact, your skin may be so dry that it peels like it does after a sunburn.
  • Moist reaction. Radiation kills skin cells in your treatment area, causing your skin to peel off faster than it can grow back. When this happens, you can get sores or ulcers. The skin in your treatment area can also become wet, sore, or infected. This is more common where you have skin folds, such as your buttocks, behind your ears, under your breasts. It may also occur where your skin is very thin, such as your neck.
  • Swollen skin. The skin in your treatment area may be swollen and puffy.

Take extra good care of your skin during radiation therapy.  For examle:

DO

  • Be careful not to wash off the marks you need for radiation therapy.
  • Be gentle on your skin. Do not rub, scrub, or scratch in the treatment area. 
  • Take it easy on your skin when you shower or take a bath.
    • You can take a lukewarm shower every day.
    • If you prefer to take a lukewarm bath, do so only every other day and soak for less than 30 minutes.
    • Whether you take a shower or bath, make sure to use a mild soap that does not have fragrance or deodorant in it.
    • Dry yourself with a soft towel by patting, not rubbing, your skin.
    • Be careful not to wash off the ink markings that you need for radiation therapy.
  • Use only those lotions and skin products that your doctor or nurse approves or suggests. 
    • If you use any skin products on days you have radiation therapy, use them at least 4 hours before your treatment session.
    • If you are using a prescribed cream for a skin problem or acne, you must tell your doctor or nurse before you begin radiation treatment. 
    • It is generally okay to use a moisturizing cream such as Lubriderm, Aloe Vera gels, or Liquid Vitamin E. Still, check with your doctor before using any of these products. Perhaps he or she can give you the name of specific products that have proved to be useful for your particular situation.
    • Check with your doctor or nurse before using any of the following skin products:
    • Bubble bath
    • Cornstarch
    • Cream
    • Deodorant
    • Hair removers
    • Makeup
    • Oil
    • Ointment
    • Perfume
    • Powder
    • Soap
    • Sunscreen
  • Look for cool, humid places. Your skin may feel much better when you are in cool, humid places. You can make rooms more humid by putting a bowl of water on the radiator or using a humidifier. If you use a humidifier, be sure to follow the directions about cleaning it to prevent bacteria.
  • Use soft fabrics on your body and in bed. 
    • Wear clothes and use bed sheets that are soft, such as those made from cotton.
    • Oversize T shirts worn inside out (so the irritating seams are on the outside)
  • Wear loose, soft clothing over the affected area. For instance, oversized cotton tee-shirts which you can wear inside out so the seams do not rub.
  • Protect your skin from the sun every day. 
    • The sun can burn you even on cloudy days or when you are outside for just a few minutes. 
    • Do not go to the beach or sun bathe.
    • Wear a broad-brimmed hat, long-sleeved shirt, and long pants when you are outside. 
    • Protect your skin from the sun even after radiation therapy is over, since you will have an increased risk of skin cancer for the rest of your life. Talk with your doctor or nurse about sunscreen lotions. He or she may suggest that you use a sunscreen with an SPF of 30 or higher.
  • Shaving. Ask your doctor or nurse if you can shave the treated area. If you can shave, use an electric razor and do not use pre-shave lotion.
  • Rectal area. If you have radiation therapy to the rectal area, you are likely to have skin problems. These problems are often worse after a bowel movement. 
    • Clean yourself with a baby wipe or squirt of water from a spray bottle. 
    •  Ask your nurse about sitz baths (a warm-water bath taken in a sitting position that covers only the hips and buttocks.)
  • Talk with your doctor or nurse. 
    • Some skin changes can be serious. Report at each appointment any skin changes that you notice. Your doctor can prescribe lotions for dry or itchy skin, antibiotics to treat the infection, and other drugs to reduce swelling or itching.
    • Ask  what side effects to report and when to make a report. For instance, should you call about side effects only call during office hours, or 24 hours a day?

DO NOT

  • Do not wash off the marks you need for radiation therapy.
  • Do not put anything on your skin that is very hot or cold. This means not using heating pads, ice packs, or other hot or cold items on the treatment area. It also means washing with lukewarm water.
  • Do not wear clothes that are tight and do not breathe, such as girdles and pantyhose. Soft fabrics without annoying seams are better.
  • Do not use tanning beds. Tanning beds expose you to the same harmful effects as the sun.
  • Do not put bandages, BAND-AIDS, or other types of sticky tape on your skin in the treatment area. Talk with your doctor or nurse about ways to bandage without tape.
  • Do not take long swims. Prolonged exposure to water can cause skin problems.

You will always be at risk for skin cancer in the treatment area. Be sure to avoid tanning beds and protect yourself from the sun by wearing a hat, long sleeves, long pants, and sunscreen with an SPF of 30 or higher.

NOTE:

  • If itching becomes a problem, learn how to deal with it by clicking here. For rashes, click here.
  • If you are wondering about the safety of a particular cosmetic, you can check at EWG's Skin Deep offsite link

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