4.+Skin+care+and+other+concerns+for+radiation+therapy+patients+(dry+and+wet+desquamation)

One of the most common side effects from radiation therapy is reddened, irritated skin. It is usually first noticed 7 to 14 days after treatment is initiated. It is important to be gentle with skin during radiation therapy. The following tips will help decrease client skin irritation and breakdown. Most skin reactions will go away a few weeks after treatment is completed.

**Daily Routine**
 * Keep skin in treated area dry.
 * Gently wash skin daily with warm water and a mild soap and pat dry.
 * Do not use any lotions, creams, perfumes, powders, cosmetics, tape or deodorants on the skin where radiation is given.
 * Do not rub or massage the treated area. Wear loose, cotton fiber clothing to reduce irritation.
 * Avoid extreme hot and cold temperatures to the skin.
 * Client may use an electric razor for shaving hair in the treated area. Men should not use after-shave if receiving radiation to head and neck area.
 * Avoid direct sun exposure to the treated area. If they must go outside, advise to wear loose fitting clothing and apply sunscreen with SPF30 or higher. Sunscreen must be used on treated skin for the rest of their life because skin that has received any radiation will be more sensitive and burn easily.

**Dry Desquamation** Every client's skin will react differently to radiation skin toxicity. Some client's skin progresses past erythema to dry desquamation. Dry desquamation is dry and flaky skin. It is usually itchy and a mild topical steriod can usually manage this condition.

** Wet Desquamation **  The next phase of skin toxicity is wet desquamation. This is the moist painful and difficult to manage. The skin now has fissures and cracks. The skin may weep or have drainage. It usually occurs during the final one to two weeks of treatment, but may persist for up to two weeks post radiation treatment. = = =** Factors That Influence the Skin’s Response to Radiation **= The way a client's skin will respond to radiation depends on a number of factors, including:
 * The daily treatment dose
 * Total dose and total time
 * Size of the area being exposed to radiation
 * Type of radiation beam
 * The area of the body being exposed
 * Other treatments the client is taking
 * Other medical problems the client may have
 * How close the tumor is to the skin surface
 * The client's nutritional status

** Client Resources - Printable Fact Sheet & Checklist for Skin Care Discussion ** []

** References ** <span style="font-family: Arial,Helvetica,sans-serif; font-size: 16px;">[]

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<span style="font-family: Arial,Helvetica,sans-serif; font-size: 16px;">Kumar, S. S., Juresic, E. E., Barton, M. M., & Shafiq, J. J. (2010). Management of skin toxicity during radiation therapy: A review of the evidence. //Journal Of Medical Imaging & Radiation Oncology//, //54//(3), 264-279. doi:10.1111/j.1754-9485.2010.02170.x

Iwamoto, R. “Radiation Therapy” in Varricchio, C. ed(1997) //A Cancer Source Book for Nurses, 7th ed// American Cancer Society Sudbury, MA (pp. 91- 103)