Radiation therapy is an important part of treatment for many people with breast cancer. While it is carefully planned to target cancer cells, the skin in the treated area can also be affected. One of the most common side effects is skin irritation, which may look and feel similar to a sunburn.
Radiation related skin changes can be uncomfortable, but they are usually temporary and can be managed with the right care. Knowing what to expect and how to protect your skin can make the treatment period easier.
Why Does Radiation Affect the Skin?
Radiation works by damaging the DNA of cancer cells so they cannot continue to grow. However, healthy cells in the treatment area may also be affected. Because the skin constantly produces new cells, it can become sensitive when exposed to repeated radiation.
Skin changes do not always appear immediately. They may become more noticeable after several treatment sessions and can sometimes continue for a short period after radiation has finished.
The skin may become red, darker, dry, itchy, tender or slightly swollen. Some people may develop peeling or moist areas, particularly where the skin folds or where there is friction.
Keep the Skin Clean and Gentle
During radiation treatment, treat the skin in the treated area gently.
Wash with lukewarm water and a mild, fragrance free cleanser if recommended by your treatment team. Avoid scrubbing, rubbing or using rough towels. After washing, gently pat the area dry rather than rubbing it.
Do not apply new creams, oils, powders, deodorants or other products to the treated skin without checking with your radiation team. Some products may irritate sensitive skin or interfere with treatment.
Moisturise as Advised
Keeping the skin moisturised can help reduce dryness and discomfort. Your doctor or radiation care team may recommend a particular moisturiser or cream.
Apply it as directed and avoid putting products on the skin immediately before a radiation session unless your treatment team has specifically advised that it is safe. If the skin has already started peeling or has become moist, ask your team before applying any product.
Reduce Friction and Irritation
Friction can make radiation related skin irritation worse. Choose soft, loose fitting clothing that does not rub against the treated area. Cotton fabrics may feel more comfortable for some people.
Avoid scratching the skin, even when it feels itchy. Keeping fingernails short can help prevent accidental damage if you scratch while asleep.
Try to avoid activities or clothing that create repeated rubbing or pressure around the treated area.
Protect the Area From Heat and Sun
Radiation treated skin can remain sensitive even after treatment has ended. Avoid exposing the area to direct sunlight and do not use tanning beds.
Your radiation team can advise you about when sunscreen can be safely used on the treated skin. Until then, covering the area with suitable clothing can provide protection.
It is also best to avoid very hot baths, heating pads and hot water bottles over the treated area unless your doctor has advised otherwise.
What If the Skin Starts Peeling?
Peeling can occur as treatment progresses. Do not pull off loose skin or try to remove peeling areas yourself. If the skin becomes open, wet or painful, inform your radiation team.
They may recommend a specific dressing, cream or other treatment depending on the severity of the reaction. Keeping the area protected and following their instructions can help the skin heal properly.
When Should You Contact Your Doctor?
Mild redness or dryness can be expected, but you should tell your treatment team about any skin changes that are causing significant discomfort.
Contact them promptly if you notice severe pain, extensive peeling, bleeding, discharge, signs of infection, increasing swelling or skin changes that are rapidly worsening.
Do not wait until your next appointment if you are worried about your skin. Your treatment team can assess the area and recommend appropriate care.
Dr. Pragati Singhal
