How Will Radiation Therapy Affect My Skin

How radiation therapy affects skin function

Radiation therapy starts

No visible changes.

Your skin is still soft, supple, clean, odor free and intact.

However, skin cells are damaged from the first dose of radiation.

After 2 to 3 weeks of radiotherapy

The inflammatory response is activated after radiation.

You will notice the appearance of a faint or dull redness (erythema).
A mild tightness of the skin and itching may occur.

This is because damaged cells migrate to the skin surface at an increased rate.

After 4 to 5 weeks of radiotherapy

You will notice a bright erythema/dry desquamation on your skin. Your skin will feel sore, itchy and tight.

The reason is that the rate of new skin cell production is increased to cope with the radiation damage – dead skin layer becomes thicker and dry.

After 6 to 7 weeks of radiotherapy

Your skin may develop patched areas of moist desquamation. They may produce a yellow/pale green exudate. You may feel soreness.

This is because the rate of new cell production is insufficient to replace those lost to radiation, which causes a breakdown in the integrity of the skin.

This imbalance continues until radiation therapy is stopped.

1 to 2 weeks after stopping radiotherapy

What was patchy moist desquamation turns into a confluent moist desquamation. The color of the wound fluid (exudate) is still yellow/pale green. You will still have a feeling of soreness.

New healthy skin cells begin to recover. However, the integrity of the skin may continue to deteriorate until the new cells repopulate the area.

Skin heals

Skin in the treated area may not fully recover and have the same appearance as before.

Images courtesy of The Princess Royal Radiotherapy Review Team, St James’s Institute of Oncology, The Leeds Teaching Hospitals NHS Trust. Taken from the publication “Managing Radiotherapy Induced Skin Reactions, a Toolkit for Healthcare Professionals”.