Radiation treatments for cancer can cause “radiation dermatitis"

Q: I’m starting radiation treatments soon. Is there a way to keep my skin from peeling?

During radiation treatments for cancer, nearly eight out of 10 people will develop some form of skin irritation called “radiation dermatitis." Radiation can cause redness and warmth, much like having a mild rash. Your skin may become more sensitive to touch and feel "tight." This can progress to dryness, itching, and peeling, exposing raw red patches that may ooze clear fluid.

Skin damage from radiation treatments is much more common under your armpits or breasts, and wherever another skin surface comes in contact with the skin being treated.

People who smoke, have diabetes, or who have had a previous surgical procedure in the treated area are more likely to develop radiation dermatitis.

Post-radiation skin irritation tends to peak about a week after treatment. The higher the number of radiation sessions, the greater your risk of skin inflammation. Treating your skin with extra care can reduce your risk of developing radiation dermatitis.

It's essential to avoid rubbing or scratching the area being radiated. Drinking plenty of water and applying moisturizing cream to the area faithfully can also help keep your skin from blistering or peeling.

Washing gently with mild soap and water has been shown to cause less skin reaction than just rinsing with water. Most radiation treatment patients are advised to use a "mild, non-alkaline soap, preferably unscented."

Very little guidance exists on which soaps are best to use when undergoing radiation. There's no clear evidence that any specific soap is superior. Mild soaps like Dove®, Ivory®, or Neutrogena® are considered safe, while highly scented soaps such as Coast® and Irish Spring® should be avoided.

You can safely wear underarm deodorant or antiperspirant during treatment unless your skin develops a cut, scratch, or blister.

Applying a moisturizer helps protect radiated skin from dryness, irritation, and skin breakdown. To minimize the potential of changing how your skin will absorb radiation, always wait until AFTER your radiation sessions before applying creams or lotions.

Your skin consists of layers of flat cells that form a flexible, self-renewing barrier, protecting you from exposure to infection and toxins. Although your skin cells start out nice and plump, they gradually dry out as they get closer to the surface, creating water-resistant thin, overlapping layers. As the top layer of flattened skin cells rubs or flakes off, it is replaced by the cells underneath.

Ceramide molecules support the barrier function of healthy skin. A lower ceramide level is found in dry, damaged skin than in healthy skin. Applying ceramide-rich creams can help heal skin damage. Lotions and creams containing these vitally important compounds can restore skin integrity faster than creams containing only traditional moisturizing agents.

CeraVe® Moisturizing Cream contains 3 essential ceramides. When I compared CeraVe® to my previous favorite skin moisturizer, Arbordoun’s Abundantly Herbal Calendula Cream, CeraVe® delivered. My skin absorbed CeraVe® quickly with no greasy residue and my skin felt smoother for hours longer than other creams. 

Calendula is a natural source of soothing relief from skin irritation. Arbordoun’s Abundantly Herbal Calendula Cream® contains olive oil, calendula, and lavender and works well to protect your skin from radiation damage. Unlike CeraVe®, Arbordoun’s takes time to become completely absorbed. I make sure to let it soak into my skin for at least 5 minutes before putting on clothes to avoid having fabric touch it. 

Recently, turmeric cream with sandalwood oil (Vicco) was shown to help prevent radiation dermatitis when compared to Johnson & Johnson's baby oil. Turmeric has anti-inflammatory properties, and Vicco has been a popular acne remedy in India for over 40 years. If sandalwood’s fragrance bothers you, try turmeric without sandalwood oil (Vicco WSO) instead.

Here Are 5 Tips to Help Protect Your Skin During Radiation Treatment:

1.                     Don’t rub or scratch the treated area.

Itching causes the urge to scratch, even when you sleep. Keeping your fingernails short and wearing cotton gloves or socks over your hands at night helps protect your skin.

2.                     Avoid hot water and strong soaps.

Use lukewarm water and mild soaps when washing or bathing. 

3.                     Be gentle.

Avoid harsh bathing scrubbing tools like exfoliating clothes, rough washcloths, or loofahs.

4.                     Stay hydrated.

Irritated skin loses water more quickly, making it feel dry and itchy. Drinking plenty of water helps keep your skin well-hydrated.

5.                     Apply a soothing cream.

If your doctor approves, a moisturizing cream with ceramide (CeraVe®, Curel®) or an anti-inflammatory agent like calendula or turmeric can reduce your chances of developing radiation dermatitis.

Dr. Louise Achey, Doctor of Pharmacy, is a 43-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Get clear answers to your medication questions at her website and blog TheMedicationInsider.com.

2023 Louise Achey