Therapeutic Radiographer, Allied Healthcare Professional, Clinical Advisor for Macmillan Cancer Support and Rad Chat Oncology Podcast Co-Host
Radiotherapy can lead to radiation-induced skin reactions, regardless of skin colour. This is why it’s important to find the right skincare for radiotherapy.
Radiotherapy is a treatment that uses radiation to kill cancer cells. Approximately 60% of cancer patients will have radiotherapy at some point within their treatment pathway, and about 95% of them will have some form of skin change.
Beliefs and inclusive radiotherapy skincare
Skin changes are called radiation-induced skin reactions or radiation dermatitis. It is caused by high doses of radiation and may include pigmentation, itching, blistering or dry, peeling skin.
However, many assumptions and suggestions around these skin changes — and skincare in general — are based on White skin. “People with Brown or Black skin haven’t really been considered,” says Naman Julka-Anderson, a radiographer awarded London and UK radiographer of the year by the Society of Radiographers.
He cites the example of considering all skin types in consent forms. “People with Black skin, they’ve consented on forms signed by doctors, which tell them to look out for redness. In pigmented or Black skin, you’re rarely going to see redness. So, from an ethical perspective, they’ve been given the wrong information.” For people with White skin tones, their skin can start to look more red from a reaction, whereas people with Brown and Black skin might see subtle darkening or changes in the colour spectrum within the treatment area.
Negative impacts of radiation-induced skin reactions
People undergoing radiotherapy for treatment of skin cancers, breast, head and neck and gynaecological cancers, can get more severe skin reactions. Anyone can experience inflammation and irritation. “It’s not like a burn, which leaves scars. Though, some might describe it as such. The skin will go back to normal, and we rarely see scars from radiation damage.” However, some people may have worse reactions than others. A radiation-induced skin reaction is unavoidable but depends on radiation dose and treatment schedules.
Another factor not often considered is how it can affect patient wellbeing. “As they develop more of a skin reaction, more people will see it. I had a patient whose skin was sore post-treatment, and she wasn’t able to attend her daughter’s wedding because she couldn’t get her dress on — it was too painful,” says Naman.
People undergoing radiotherapy for treatment of skin cancers, breast, head and neck and gynaecological cancers, can get more severe skin reactions.
Preparing the skin for radiotherapy
Skin damage can be minimised, however assessing the skin nice and early and ensuring patients have some form of topical cream is an important part of that, insists Naman. The key is to keep the skin hydrated and the treatment area clean. “I always advise patients to try and get their skin ready, maybe a week or two before treatment.”
Research from the Society of Radiographers in 2020 highlights the importance of finding skincare that works for you — and continue using that. “There are a number of companies with good products. Dressings and making sure not to wear tight clothing can also help. There are soothing creams, and other similar products, that can minimise damage effectively,” he says.
Radiaderm offers clinically proven skincare to support people undergoing radiotherapy. It can be used during and after radiotherapy, with 60% of patients from hospital-based clinical studies reporting they displayed no evidence of an adverse skin reaction during radiotherapy treatment.
Chris Curtis, CEO, The Swallows Head and Neck Cancer Support Group, says: “It is crucial that patients can get access to products that help them through the treatment pathway and into survivorship. We have seen that Radiaderm helps patients going through radiotherapy and highly recommend this to our patients.”
Ask your therapeutic radiographers for help
The Society of Radiographers offer patient leaflets with valuable advice on radiation dermatitis, and it’s free for anyone. The resources are co-produced with people who had a cancer diagnosis. “It’s important not to hesitate to ask your therapeutic radiographers for help. We know it can be uncomfortable; there’s no point suffering in silence. Even if you notice the smallest change overnight, just speak to us.”