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Protecting Your Skin During Radiation Therapy

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Q: I’m starting radiation treatments soon for my newly diagnosed breast cancer. How can I help keep the treatments from burning my skin?

Nearly 8 out of 10 people with cancer who are treated with radiation will get skin irritation from it, called “radiation dermatitis” by doctors. It starts out with redness and warmth like a mild rash, then becomes increasingly sensitive to touch and may even feel “tight”. As radiation damage progresses your skin feels “dry”, starts to itch and can eventually peel, exposing tender red skin which oozes clear fluid.

You’re more likely to have a serious skin reaction from radiation treatment if you have another skin surface rubbing up against the skin that is being radiated, if you’ve had surgery in that spot before, or if you smoke or have diabetes.

Post-radiation skin irritation tends to peak about a week after treatment, so treat your skin gently by avoiding rubbing or scratching the area being radiated. Applying a moisturizing cream to the radiated area faithfully and drinking plenty of water helps keep your skin from painful blistering.

It’s okay to use soap; in fact, washing your skin gently with mild soap and water has been shown to cause less skin reaction compared to just rinsing with water. Most patients who start 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, but 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 can help protect your skin from dryness, irritation and skin breakdown. There’s a new option now available to help protect your skin from radiation damage.

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. Your skin cells start out nice and plump, then gradually drying out and flattening into overlapping layers. Then the top layer flakes off, exposing the next layer down, continuing the cycle.

Ceramide molecules support the barrier function of healthy skin. A lower level of  ceramides is found in dry, damaged skin compared to healthy skin, and 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 and was recommended to one of my patients. I decided to compare it to my previous favorite, Arbordoun’s Abundantly Herbal Calendula Cream, to decide for myself if the claims about ceramides was real or just good marketing. I was QUITE impressed! My skin absorbed the CeraVe® very quickly, there wasn’t any oily residue, and my skin felt super smooth, even hours later.

My previous favorite moisturizer has calendula in it: Arbordoun’s Abundantly Herbal Calendula Cream ($20 for a 7-ounce jar). With olive oil, calendula and lavender, Arbordoun’s can help protect your skin from radiation damage, but after applying it you’ll need to allow it a little time to get completely absorbed. Letting it soak into your skin for about 5 minutes before putting on your clothes helps keep it from sticking to clothing.

You can also apply pure Aloe Vera juice directly to your skin. My stepmother, Joyce, applied undiluted Trader Joe’s Aloe Vera Juice to her skin after each radiation treatment, with excellent results.

Her 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.

  1. Stay out of hot water.

Avoid using hot water or strongly scented soaps when washing or bathing.

  1. Don’t scrub.

Treat your skin gently. Avoid washing using harsh scrubbing tools like exfoliating cloths, rough washcloths, or loofahs.

  1. Keep yourself hydrated.

Irritated skin loses water more easily, making it feel dry and itchy. Drink plenty of water to help keep your skin well hydrated.

  1. Apply a soothing cream.

Support the barrier function of your skin by protecting it with a skin moisturizer after each radiation treatment. Creams containing ceramides (CeraVe®, Curel®) or calendula can be particularly helpful.

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  • ABOUT DR. LOUISE

    Dr. Achey graduated from Washington State University’s school of pharmacy in 1979, and completed her Doctor of Pharmacy from Idaho State University in 1994.

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