Skin Reactions After Radiation Exposure

During today’s visit, your doctor used x-rays for your procedure. X-ray guided procedures are often long and complex. They can require high doses of radiation. Even though we take precautions to keep the level as low as we can, some people develop skin reactions. This handout helps you know when this might occur, what to look for, how to report it, and how to take care of your skin.

What a Reaction Looks Like

When skin receives radiation, the oil-producing glands in skin shut down. The oil is no longer there to hold in the moisture. A reaction can look like a suntan or sunburn. Skin reactions can be pink, red, or tan. It can be dry and itchy or tender. Sometimes, small blisters appear, or areas become open and weepy. You may also notice hair loss in the same area. This hair loss often happens within 3 weeks and will likely grow back.

What to Expect

Changes to the skin begin before you can see or feel them. How severe the reaction is, depends on the total dose of radiation used and your own skin’s sensitivity to it.

If a reaction does occur, it is often delayed by a few hours to a few days and may fade quickly. If you do not notice it within 4 days, it is not likely that you will have a reaction. If you have a reaction that fades, you may notice a second reaction 1-2 weeks later. This time, the redness would likely get worse during the second and third week and then slowly fade away.

Treatment

If you have a reaction, we may have you use different products. Hydrocortisone cream may be used for itching. Sometimes, an antibiotic ointment may be prescribed. There are special dressings to use if your skin becomes open and weepy.

Pain

Sometimes, skin reactions can be painful enough to require medicines. Tylenol® or ibuprofen is most often strong enough to ease the pain. If you have pain or other concerns, talk with your doctor or nurse.

How to Care for Your Skin

There are many thoughts about what product(s) to use on the skin after radiation exposure. There are many good products. The list below includes the most common ones used. If you have a skin care product you use now, check with your nurse before using it on your affected area. You may use skin care products twice a day.

No matter which product you choose, clean the skin gently, rinse it well, pat or air dry, and moisturize.

• Mild soaps: Aveeno, Dove, Basis, Neutrogena, Cetaphil, Ivory, Value Rite skin cleanser

• Lotions: Aveeno, Curel, Lubriderm, Nivea, Eucerin, Neutrogena

• Creams: Biafine, Cocoa Butter, Vanicream
  
  

What You Can Do to Help Your Skin

• During the first 4-6 weeks, avoid direct sunlight, electric heating pads, hot tubs, tanning booths, etc.

• Do not use any product on the area exposed to radiation that contains talc, zinc, aluminum, camphor, menthol, or alcohol. This includes deodorants, antiperspirants, perfumes, colognes, and aftershaves. These can increase the irritation to the skin.

• Avoid friction. Do not scratch or scrub the skin. Wear soft clothing made of cotton or other natural fibers. Synthetic fibers can be too rough on the skin. Do not shave the treated area with a blade razor. Instead, use an electric razor.

• If there are skin folds in the area exposed to radiation, the friction of skin rubbing on skin may make the reaction worse. Plain cornstarch or cornstarch-based baby powder can help to reduce the friction. Do not use talc powders.

• Do not use extreme heat or cold on the treated skin. This includes heating pads, hot water bottles, ice packs, hot bath water, etc.

• Do not use tape since the fragile skin can pull off with the tape.

• Keep the treated skin away from the sun or sunlamps. If clothing does not cover the area, use sunscreen with SPF 20 or higher when outdoors. Do this for at least 1 year after your treatment is over.

• Avoid chlorinated pools and hot tubs during and after your treatments until the skin has healed.
  

When to Report Skin Reactions

We want to know about any problem that you notice, whether it occurs hours, days, or weeks after your procedure. Call us right away if you notice any redness or hair loss. When you call, we will ask you:

• When did you first notice the redness or hair loss?

• Where is it?

• How large is it?

• What shape is it?
  

Who to Call

If you have a reaction, please call:
__________________________________. You may need to be seen and scheduled for follow-up visits.

If no skin reaction has occurred, please contact our staff by ______________ (date) to give us an update.