Protecting your skin during radiation treatment

Q: I’m starting radiation soon for breast cancer. How can I help keep the treatments from burning my skin? 
During radiation treatments for cancer, nearly 8 out of 10 people will develop some form of skin irritation, called “radiation dermatitis”. Radiation often creates redness and warmth to the area, much like having a mild rash. Skin may also become more sensitive to touch and feel "tight." As radiation treatments continue, skin will often feel “dried out”, start itching, and can eventually peel off to expose raw, red patches that ooze a clear fluid. 
Your skin is more likely to become irritated by radiation if you have another skin surface rubbing up against the skin being treated, like under large breasts or your armpits. 
People who smoke, are diabetic, or who 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. To reduce your risk of radiation dermatitis, treat your skin gently. Avoid rubbing or scratching the area being radiated. Drinking plenty of water and applying moisturizing cream to the area faithfully can help keep your skin from peeling. 
It’s okay to wash with soap. Washing your skin gently with mild soap and water has been shown to cause less skin reaction than just rinsing with water. Most patients starting radiation treatment are advised to use a "mild, non-alkaline soap, preferably unscented." 
Unfortunately, there isn’t much agreement about which soaps are best and no clear evidence that any specific soap is superior. Mild soaps like Dove®, Ivory®, or Neutrogena® are considered safe to use, while most experts agree that highly scented soaps such as Coast® and Irish Spring® should be avoided when undergoing radiation treatment. 
You can safely wear deodorant or antiperspirant during treatment unless the skin of your armpit develops a cut, scratch, or blister. 
Applying a moisturizer after radiation sessions is one of the best ways to protect your skin from dryness, irritation, and skin breakdown. 
Your skin consists of a series of layers of flattened cells that form a flexible, self-renewing barrier that protects your body against exposure to infection and toxins. Deep in your skin, your cells start out nice and plump, then gradually dry out, creating thin, overlapping layers that are water-resistant. As the top layer rubs or flakes off, it exposes the next layer down, continuing the cycle. 
Ceramide molecules support the barrier function of healthy skin. A lower level of ceramide 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 has 3 essential ceramides. I compared it to my previous favorite, Arbordoun’s Abundantly Herbal Calendula Cream because I wanted to decide for myself if the claims about ceramides were real or just good marketing. The CeraVe® was impressive! My skin absorbed it quickly, it didn’t feel greasy, but it made my skin feel super smooth, even hours later.  
Another favorite moisturizer of mine is Arbordoun’s Abundantly Herbal Calendula Cream, around $15 for a 4-ounce jar. With olive oil, calendula, and lavender, Arbordoun’s helps protect your skin from radiation damage. However, it takes a little time to absorb completely. I always let it soak into my skin for about 5 minutes before putting on clothes so the fabric doesn't stick to it. 
You can also apply pure Aloe Vera juice directly to your skin for protection. My stepmother, Joyce, used Trader Joe’s Aloe Vera Juice after each radiation session and didn't develop any burns.
Here are 5 tips to help protect your skin during radiation treatment:
1. Avoid rubbing or scratching. 
Itching causes the urge to scratch even when you sleep, so keeping your fingernails cut short and wearing cotton gloves or socks over your hands at night can really help.
2. Stay out of hot water.
Avoid using hot water or strongly scented soaps when washing or bathing.  
3. Don’t scrub.
Treat your skin gently. Avoid washing using harsh scrubbing tools like exfoliating cloths, rough washcloths, or loofahs.
4. Keep yourself hydrated.
Irritated skin loses water more quickly, making it feel dry and itchy. Drink plenty of water to help keep your skin well hydrated.
5. Apply a soothing cream. 
Support the barrier function of your skin by protecting it after each radiation treatment. Moisturizing creams containing ceramides (CeraVe®, Curel®) or calendula can be  incredibly helpful.  
Dr. Louise Achey, Doctor of Pharmacy, is a 40-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Check out her NEW website for daily tips on how to take your medicine safely. ®2020 Louise Achey


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