Radiation therapy, or radiotherapy, is one of the principal forms of cancer treatment. Radiation may be employed alone or in conjunction with surgery or chemotherapy. External radiation treatments involve delivery of the radiation through the skin to the cancerous target. As a rapidly dividing tissue, the skin is susceptible to the effects of radiation. Skin problems, known as radiation dermatitis, frequently develop during the course of radiation treatment and range from mild to severe.
Discoloration
The earliest visible skin change that occurs with radiation exposure is the development of redness in the affected area, according to the National Cancer Institute. Initially, the skin exhibits a faint blush, similar to a mild sunburn. With continued treatment, redness typically intensifies. Alternatively, the skin may darken, similar to a suntan.
Skin with previous sun exposure may become discolored more quickly than skin that has had little previous exposure to the sun. Once skin discoloration develops during radiotherapy, it characteristically persists through treatment completion.
Tenderness and Swelling
The American Cancer Society reports that skin in the radiation treatment field often becomes tender and swollen during treatment, frequently in parallel with evolving redness. Skin changes typically develop during the first few weeks of treatment and persist throughout the duration of therapy, notes the National Cancer Institute.
Skin tenderness in the treatment field is similar to the pain experienced with a sunburn. Although the area may look and feel like a sunburn, creams or lotions commonly used for a sunburn may further irritate the area. Perfumed or harsh soaps may also increase skin irritation. The radiation treatment team provides guidance about skin products to avoid during radiotherapy.
Peeling
Skin in the radiation treatment field may peel during the course of therapy. The skin often becomes dry and itchy with patches of peeling superficial skin, similar to the reaction that occurs after a sunburn. Alternatively, the skin may blister and peel, exposing moist, pink skin beneath. This side effect of radiotherapy, known as a moist reaction, most commonly occurs in skin folds and creases, advises the National Cancer Institute. The radiation treatment team may prescribe topical medications to prevent infection in areas manifesting a moist reaction. Healing typically occurs in the weeks following the completion of therapy.
Hair Loss
Hair loss commonly occurs in a radiation treatment field. Loss of scalp hair typically proves most noticeable, although localized body hair loss also occurs. Scalp hair thins or may be completely lost with radiation treatment to the brain.
The National Cancer Institute notes that hair loss typically begins during the second or third week of radiotherapy. Hair regrowth may occur in the months following completion of radiotherapy, depending on the total dose of radiation to the affected area. In some people, hair loss may be permanent.
References
- National Cancer Institute: Cancer Therapy Evaluation Program, Common Toxicity Criteria Manual
- National Cancer Institute: Radiation Therapy Side Effects and Ways to Manage Them, Skin Changes
- National Cancer Institute: What To Do About Hair Loss (Alopecia): Managing Radiation Side Effects
- American Cancer Society: Understanding Radiation Therapy, Skin Problems
- "Annals of Dermatology"; The Clinical Features and Pathophysiology of Acute Radiation Dermatitis in Patients Receiving Tomotherapy; Ji Hyun Lee, M.D., et al.; 2009
