• Reference Number: HEY-072/2019
• Departments: Radiotherapy
• Last Updated: 31 July 2019

Introduction

This leaflet will provide you with advice on how to help limit the skin reaction within the treatment area whilst you are having radiotherapy.   Most of your questions should have been answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation; please discuss this with a member of the healthcare team.

How might my skin react to treatment?

During and after radiotherapy your skin within the treatment area may:

• Feel warm and more sensitive.
• Be pinker in colour than usual, this is called erythema, unless you have dark skin when you may notice it becomes deeper in colour.
• Flake or sometimes weep towards the end of treatment or a few days after your treatment has finished. Should this happen you will be assessed by a member of the nursing team.
• Sweat less.

What can affect my skin reaction?

• Having treatment to areas where there are skin folds can make your reaction worse. This includes groin, breast, buttocks or armpit because they can be warm, moist and rub together causing friction.
• Treatment to the head and neck area may mean a worse skin reaction.
• Having chemotherapy alongside radiotherapy can make your skin reaction worse.
• Smoking can make your skin reaction worse – if you need help to stop, please ask for advice.
• A skin reaction is more likely if you are overweight due to more skin folds.

Your treatment team will monitor your skin through treatment and will advise if any changes are required. Please talk to them if you have any concerns.

How you can help

We suggest the guidelines below are followed from the first day of treatment – do not wait for a skin reaction to occur.  The following information and advice is related to skin within the treatment area and will help you to look after your skin and prevent further problems arising.

• Continue with your usual skin routine unless you have been requested not to by a member of the radiotherapy team.
• If any of your usual products are found to irritate your skin you may be asked to stop using them.
• Do not use wax or other hair removal products, perfumes or talc within the treated area.
• For hair removal within the treatment area, use an electrical razor rather than a wet shaver.
• Deodorant may continue to be used unless it is found to irritate your skin.
• Wear loose comfortable clothing next to treated skin and try to avoid anything tight such as bras, belts, collars or tights on the treated skin. Cotton clothing next to your skin is better than nylon or polyester.
• Keep the treated area out of the sun and cold winds. The use of heat pads, sun lamps, hot water bottles and ice packs etc. are to be avoided where possible. Please ask a member of the radiotherapy team if you are unsure.
• You may swim if your skin is not broken. Shower after swimming to wash off the chlorine and apply your usual moisturiser. Please stop swimming if it irritates your skin.
• It may also help to keep up a good fluid (non-alcoholic) intake and eat a nutritionally balanced diet.

Your treatment team will monitor your skin through treatment and will advise if any changes are required. Please talk to them if you have any concerns.

Washing you skin and hair

The skin within the treatment area should be gently washed using your usual product. We may ask you to stop using it, if it is found to irritate your skin. The skin should be patted dry with a soft dry towel. Do not rub.  Shower or bath in warm water but do not soak.
If your scalp is in the treated area wash with a mild shampoo and be gentle, do not rub. Pat dry with a soft towel, do not use a hairdryer.

After you have finished radiotherapy

If you experience a skin reaction during treatment it may worsen for the next 7-10 days before starting to improve. Most patients find their skin has healed by about 4 weeks after treatment finishes. If the skin has broken healing may take longer than this. If your skin begins to peel or weep, please contact the nursing team on telephone number (01482) 461134 for advice.

Your skin and the sun

The skin in the area that was treated by radiotherapy will stay sensitive for many years and you are at a higher risk of long-term sun damage, including skin cancers. You should take extra care to protect the treated area from the sun.

Avoid sun exposure and protect the area from direct sunlight. You can wear a wide brimmed hat and/or cover up with clothing. Be careful in the sun for at least a year after you have finished. Use a sunscreen with a minimum UVB sun protection factor (SPF) of 30 and a UVA protection as your skin will be more sensitive.  Your treatment team will let you know if this advice changes during treatment.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Information & Support Team Telephone number: (01482) 461206 or Email:  hyp-tr.radiotherapy.information@nhs.net

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.