Radiotherapy is much gentler on the body than most people expect. You lie still, nothing hurts, and you're usually in and out in minutes. The part that catches people out is the skin.
Somewhere around week two or three, the area being treated often starts to change. It might go pink or darker, feel warm, get dry and flaky, or become itchy and tight. It's a bit like sunburn, and it's a normal reaction rather than a sign anything's gone wrong.
The advice on this has relaxed considerably over the years as previously many were told not to wash the area or use deodorant, that's out of date and the current guidance is far more sensible.
Read your own radiotherapy leaflet first
Every radiotherapy department gives you written skin care advice, and yours is the one that counts. Your team knows your treatment area, your dose and your skin.
If you've lost the leaflet, ring and ask for another. If something below contradicts what your radiographers told you, go with their advice over mine every time.
One important thing to understand is that all of this applies only to the area being treated. The rest of your skin carries on as normal.
Washing during radiotherapy treatment
You can wash your skin when undergoing radiotherapy, but bear the following in mind:
- Use warm water, not hot, and avoid long soaks in a hot bath
- Showering suits most people better than bathing
- Wash gently with the products you'd normally use, or a mild soap or shower gel
- Pat skin dry with a soft towel rather than rubbing
- Don't use a flannel, sponge or loofah on the treated area
- Skip talcum powder completely
If your scalp is being treated, you can wash your hair with a non-medicated shampoo. Dry it naturally if you can, or use a hairdryer on the cool setting, and brush very gently.
Can I use moisturiser during radiotherapy?
Moisturising helps keep the skin comfortable, and most departments suggest starting from day one rather than waiting for a reaction.
The Society of Radiographers doesn't recommend one particular product over another, because there's no strong evidence that any single cream beats the rest. What most trusts suggest is something fragrance-free, and many specifically suggest a moisturiser free from sodium lauryl sulphate, often labelled SLS-free.
A few practical points:
- Apply a thin layer once or twice a day and smooth it on gently in the direction the hair grows
- Patch test any new product on skin away from the treatment area first
- Don't put moisturiser on immediately before a session, though you don't need to wipe off what you applied earlier
- Stop if it stings or irritates, and speak to your team
- Never apply moisturiser to broken skin, and tell your team straight away if the skin breaks, because they'll give you something different
If you don't normally use a moisturiser and don't know where to start, ask your radiographers. They'll suggest options.
Using deodorant during radiotherapy treatment
You can carry on using your usual deodorant unless it irritates your skin. Stop if the skin blisters, peels or breaks. If your upper chest or armpit is in the treatment area, a roll-on is often suggested over a spray.
What to avoid in the treated area
- Shaving, and reduce it as much as you can, though men are usually told an electric trimmer is fine
- Waxing, hair removal creams and laser
- Perfume, aftershave and make-up
- Hair dye if your scalp is being treated
- Hot water bottles, heat pads, ice packs and anything at an extreme temperature
- Sticky tape and plasters directly on the area
- Dressings, unless your team has specifically told you to use them
- Strong sunlight
What to wear to your radiotherapy session
Loose fitting clothes beats tight fitting garments, and natural fabrics beats synthetic.
Cotton next to the skin is the usual advice. If your chest is being treated, swap an underwired bra for something soft, and a cotton prosthesis or even a cotton handkerchief between your skin and a prosthesis can stop rubbing. Avoid tight collars, tight waistbands and anything that sits on a seam.
If your head or neck is in the treatment area, soft seam-free headwear is far kinder than a scratchy hat. Our chemo hats and scarves are fully lined and made without rough seams for exactly this reason, though do check with your radiographers before wearing anything over treated skin.
Drink plenty of water
The Society of Radiographers puts real weight on this. Aim for six to eight glasses a day. Skin holds a lot of water, and there's evidence that keeping hydrated from the inside is as useful as what you put on the outside.
Smoking makes skin reactions worse. If you've been thinking about stopping, this is a good reason, and your team can help.
The bit nobody expects
Your skin reaction often gets worse for ten to fourteen days after treatment finishes.
This is completely normal and it throws people badly, because you've finished, you're supposed to be improving, and instead your skin looks angrier than ever. It will settle. Keep following the advice you were given until things return to normal, and stay in touch with the review team.
When to speak to someone
Contact your radiotherapy review team if:
- The skin blisters, peels, breaks or weeps
- The area becomes very painful
- You see signs of infection like heat, swelling or pus
- Your usual moisturiser starts stinging
- Anything worries you, even if it isn't on this list
Don't wait for your next appointment. Review teams exist for exactly this, and they have creams and dressings that can make you a great deal more comfortable. If your skin is painful, say so, because pain relief is available.
What happens after radiotherapy treatment?
Treated skin stays more sensitive, sometimes permanently. The colour may not go back to exactly what it was, and the area can stay drier.
Sun protection matters long term. Keep the area covered or use a high factor sun cream on it in summer, for years rather than months. If you've had treatment to your head or neck, a hat is the easiest answer.
Once the skin has fully healed, you can go back to your normal products.
Frequently asked questions
Can I wash during radiotherapy? Yes. Wash the treated area gently with warm water and pat dry with a soft towel. Avoid hot baths, flannels, loofahs and talcum powder.
Can I use deodorant during radiotherapy? Usually yes. Current UK guidance says to continue with your normal deodorant unless it irritates your skin, and to stop if the skin blisters, peels or breaks.
What moisturiser should I use during radiotherapy? There's no single recommended product. Most trusts suggest something fragrance-free and free from sodium lauryl sulphate, applied thinly once or twice a day. Ask your radiographers if you're unsure, and patch test anything new.
Why is my skin worse after radiotherapy finished? Skin reactions commonly peak around ten to fourteen days after the last session. It's expected, and it settles. Keep following your skin care advice and contact the review team if you're worried.
Can I go in the sun after radiotherapy? Treated skin stays more sun-sensitive, often for good. Keep it covered or use a high factor sun cream on that area long term.
Not medical advice. We're a headwear company, not clinicians. Your radiotherapy team's own instructions always come first.
