Radiation Burn

What is radiation burn?

Radiation burn, or radiation dermatitis, is a side effect of radiation therapy to treat cancer. Each year, an estimated 4 million people in the United States receive radiation therapy, and more than 90% will develop radiation burn.

Most radiation burn symptoms are mild and easily treated. An estimated 20% of people who receive radiation therapy may develop more serious symptoms that affect their daily life and may make them reluctant to continue radiation therapy.

Your healthcare provider understands the ways that radiation therapy may impact your skin. They’ll work with you to monitor for radiation burn and provide care as needed to minimize discomfort and aid healing.

What does radiation burn look like?

A radiation burn may look like a sunburn or blotchy patches of skin that are red (on light skin) or darker than the surrounding skin tone (on dark skin). Sometimes, what starts as itchy, dry skin may progress to what looks like a sunburn and then a moist or wet patch of skin.

What are the symptoms of radiation burn?

Radiation therapy can take place over days to several weeks, with radiation dermatitis symptoms happening during treatment or after therapy is done. Common radiation burn symptoms are:

• Reddening of white skin or darkening of black or brown skin.
• Itchy skin.
• Dry and peeling skin.
• Swelling or blistering at the treatment area.
• Open sores that may appear where your skin is sweaty or damp, such as your armpits or under your breasts (sometimes called “weeping radiation burns”).

Will I notice symptoms right away?

If treatment is close to your skin’s surface, your skin may feel itchy and dry during your first treatment. But many people don’t notice symptoms until a few weeks (or about a quarter of the way) into treatment. This is because radiation treatment is cumulative, which means the effects intensify with each session.

Some people don’t develop radiation burn until after their final session. That’s because the effects of radiation stay with your body and continue to destroy cancer cells for weeks after you finish treatment.

What causes radiation burn?

Radiation burn (radiation dermatitis) is a common side effect of external beam radiation therapy to treat some forms of cancer. This type of radiation therapy delivers radiation through a machine that targets cancerous cells. The treatment itself isn’t painful. But it can make skin at the treatment site feel sore, peel, itch or turn red or discolored. That’s because radiation passes through your skin to reach its target.

Risk factors

Radiation dermatitis can happen to anyone who receives radiation therapy. But studies show radiation burn is most common for people who have radiation therapy for breast cancer, head and neck cancers or cancers that develop on or near your skin, like skin cancer or anal cancer.

You may be more likely to develop radiation burn if:

• You smoke.
• You have a history of sunburns.
• You’re getting radiation to a large area of skin.
• You’re getting radiation alongside other cancer treatments, like chemotherapy.

How are radiation burns diagnosed?

Healthcare providers know radiation therapy can cause painful or irritating skin problems. As you go through treatment, your provider will ask if you’re having trouble with your skin. They may also check your skin for signs of radiation burn.

How is radiation dermatitis treated?

Your healthcare provider may recommend creams to ease symptoms like dry, itchy skin. Common advice is to only apply unscented moisturizing creams that don’t contain lanolin. They may also prescribe special creams to treat severe radiation burns. For example, if you’re receiving radiation therapy for breast cancer, your provider may prescribe a steroid cream to reduce your risk of developing radiation dermatitis.

Ultimately, the best thing to put on a radiation burn is the products your provider recommends. Talk to your provider before using any cream, moisturizer or other skin care product. They’ll let you know what products are safe and how often to use them.

How do I prevent radiation burn?

Radiation burn isn’t something you can prevent. Talk to your healthcare provider about your specific treatment, including the area of your body being treated and the treatment technique. They’ll recommend ways to reduce your risk of radiation dermatitis or ease your symptoms.

What can I expect if I have radiation dermatitis?

Radiation therapy can make your skin feel dry, very itchy and painful. But there’s an end in sight. Most radiation burn symptoms subside or go away a few weeks after you finish treatment.

In the meantime, you can make the experience more manageable by taking extra care of your skin and working with your healthcare provider to develop a skin care regimen. They can let you know what products you should use and when you should use them.

How long does it take for radiation burns to go away?

Most mild radiation burn symptoms start to improve a few weeks after you finish treatment. But your skin may remain sensitive for up to a month. Healing a radiation burn completely may take longer. While you’re healing, you should continue being extra careful with your skin, like avoiding sun exposure.

Ask your healthcare provider if your radiation therapy might cause delayed radiation dermatitis symptoms.

How do I take care of myself if I have radiation burn?

The most important thing is to be gentle with your skin. How you wash your skin, the clothes you wear and the ways you protect your skin from sunlight — all these routine things are extremely important when it comes to caring for radiation burn.

Your healthcare provider knows radiation therapy can take a toll on your skin. They’ll check your skin throughout your treatment. But you should keep a close eye on your skin’s condition and let your provider know any time your skin hurts, itches or you notice other changes.

Are there steps I can take to help heal or reduce symptoms?

Here are some ways you can help protect your skin and ease your radiation burn symptoms:

• Cleanse gently. Wash your irritated skin with mild soap and lukewarm water. Use your hands instead of a washcloth or loofah.
• Don’t rub or scratch your skin. Avoid the urge to scratch even if your skin’s itchy. Pat dry with a towel after showers or baths instead of rubbing.
• Use electric razors only. If you need to shave the treatment area, use an electric razor to avoid irritating your skin. Regular razors may scrape against your skin, damaging it.
• Don’t use heating pads or ice. Extreme temperatures can irritate your skin.
• Wear loose, soft clothing. Choose clothes that don’t rub against or irritate skin affected by radiation.
• Avoid securing bandages with strong adhesives. If you cover your treatment area with bandages, secure the bandages with paper tape so you don’t pull on your skin. Try to place the tape away from your treatment area and don’t put the tape in the same place each time.
• Stay out of the sun. Wear protective clothing any time you’re exposed to sunlight. Ask your healthcare provider if you should use sunscreen and what kind is best.
• Stay cool. Your skin may feel better if you’re able to spend time in cool, humid environments. Use cool mist humidifiers to add moisture to the air.
• Talk to your provider before putting anything on your treatment area. This includes cosmetics, hair removal products, powders, creams, lotions, oils, ointments and perfumes.
• Use creams as directed. Only use creams (including moisturizing, numbing and anti-itch creams) that your provider recommends or prescribes. Some over-the-counter skin care products, especially scented ones, can irritate your skin.

When should I go to the emergency room?

You should contact your healthcare provider immediately or go to the emergency room if you notice signs that your skin is infected.

Signs to look out for include:

• Fever of 100.4 degrees Fahrenheit (38.3 degrees Celsius) or more.
• Skin in the treatment area that’s warm to the touch and/or discolored (unusually red on white skin or dark on black or brown skin).
• Skin in the treatment area begins to drain liquid that smells bad.

What questions should I ask my healthcare provider?

Radiation burn (radiation dermatitis) is a very common radiation therapy side effect. Here are some questions to help you prepare for your treatment and its effect on your skin:

• How will radiation therapy for my cancer affect my skin?
• What are radiation dermatitis symptoms, and when do they occur?
• Is there anything I can do to reduce the severity of radiation burn?
• Are there soaps, lotions and creams I can use, or should avoid?

Will I need to stop radiation therapy if I have radiation burn?

No, most people don’t need to stop radiation treatment because they develop radiation dermatitis. But your healthcare provider may adjust your treatment so your current symptoms don’t get worse or so you don’t develop new symptoms.