Managing Radiotherapy side effects during treatment


Skin reaction and care

External radiation passes through the skin, and the skin can react to the radiotherapy with a redness that usually starts two to three weeks after the first radiotherapy fraction. The skin can also feel itchy or tender. Skin reactions might get worse for 7 to 10 days after the last radiation treatment, but then recover within 2-4 weeks. Hair may be lost from the skin, but will usually grow back again, depending on the dose.

How to care about your skin after radiotherapy.

It is important to take special care of the irradiated skin during and after radiotherapy:

  • Showers are preferred; avoid baths (also to preserve the markings on the skin that are necessary to perform the radiation treatment).
  • Do not go swimming with an irritated skin.
  • Do not remove any non-permanent radiotherapy markings on the skin until after the last treatment.
  • Do not expose the treatment area to extreme heat or cold. Avoid heat treatments, hot tubs, heating pads, high temperature blow dryers, and ice packs.
  • Wash with mild, pH balanced soap. Use a mild shampoo such as baby shampoo. Avoid scented soaps.
  • Pat the irradiated skin dry with soft cloth. Do not rub or scrub the area.
  • Do not shave the treatment area.
  • Do not use deodorants or antiperspirants if receiving radiation treatments to the armpits.
  • Do not wear tight, scraping clothes on the irradiated area.
  • Do not scratch the irradiated skin. It can worsen the skin reaction and increase the chance of infections.
  • Do not put any band aids, tape or sticky plaster on the irradiated skin during and in the weeks after radiotherapy.
  • Do not use perfumes, oils, lotions, salves or creams on the irradiated skin. Ask the radiation oncologist or nurse which specific cream to use.
  • Protect the irradiated skin from the sun; the treated area will easily develop sunburn. Keep the skin covered when outside as much as possible. Your child can wear a hat if the skin of the scalp or face is irradiated. After the skin reaction has healed, be sure to always keep the skin protected from the sun with sunscreen, preferably an SPF of 30 or higher.
  • The radiotherapy team will give you advice on how to take care of the skin and which creams, or potentially bandage material, to use. Monitor the changes and have the team regularly check as well. If you see signs of infection, such as a quick increase in swelling, redness, new blistering or pain, consult with your radiation oncologist or nurse. 

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Hair loss

If the area that is irradiated has hair growth, hair loss can occur. This is most visible if radiotherapy is given to the head, where the hair of the scalp or eyebrows can fall out. A few months after the radiotherapy, the hair will start to grow again. Sometimes, hair loss can be permanent. It depends on the radiation dose that was given to the skin and other therapies that influence hair growth. Discuss with the radiotherapy team how to take care of the skin in this area and which options are available to cover the head when hair loss occurs. Some children prefer to wear a wig or hairpiece that can be individually adjusted, others prefer to wear headbands, caps or hats.

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Eating and drinking

Your child’s appetite may be lower during the radiation treatment. In general, it is advisory to maintain a healthy balanced diet to keep up energy levels during and after treatment. If your child is assisted by a dietician, discuss a dietary plan. Ask your child’s radiation oncologist if there are any dietary restrictions or regulations.

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