CANCER INFORMATION HUB
Dermatitis During Cancer Treatment
Understanding skin reactions during radiotherapy and how to support healing
Radiotherapy is carefully designed to destroy cancer cells while protecting as much healthy tissue as possible. However, because the skin often lies within the treatment area, many people experience changes ranging from mild redness to more significant irritation.
These skin reactions are known as radiodermatitis or radiation dermatitis.
Although they can be uncomfortable, most reactions are temporary and improve gradually once treatment has finished. Understanding why they occur and how to care for your skin help make treatment more comfortable and support recovery.
What Is Radiodermatitis?
Radiodermatitis is an inflammatory reaction of the skin caused by exposure to radiotherapy.
Unlike a burn caused by heat, radiotherapy does not burn the skin directly.
Instead, radiation affects rapidly dividing skin cells, temporarily reducing the skin's ability to repair itself during treatment.
As treatment continues over several weeks, these effects gradually accumulate, which is why skin reactions often become more noticeable towards the end of a course of radiotherapy.
Why Does Radiodermatitis Occur?
The outer layer of the skin is continually renewing itself.
Radiotherapy temporarily slows this natural renewal process within the treated area.
At the same time, inflammation develops as the body responds to treatment.
This combination may lead to:
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Redness
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Dryness
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Increased sensitivity
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Peeling
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Moist skin reactions in some patients
The severity depends on several factors, including:
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The total radiation dose
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The number of treatment sessions
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The area being treated
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Individual skin sensitivity
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Smoking
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Diabetes and other medical conditions
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Previous surgery or chemotherapy
Not everyone experiences the same degree of skin reaction.
When Do Skin Reactions Develop?
Most people notice little or no change during the first one to two weeks of treatment.
Skin reactions commonly begin to appear after approximately two to three weeks and may continue to develop until one or two weeks after radiotherapy has finished.
Healing then usually progresses gradually over the following weeks.
Some changes, such as altered skin colour or firmness, may persist for several months or become permanent.
Common Symptoms
Radiodermatitis varies from person to person.
Common symptoms include:
Redness
The treated skin may become pink or red, similar to mild sunburn.
Itching
Some patients experience mild to moderate itching.
Scratching should be avoided whenever possible to reduce irritation.
Peeling
As treatment progresses, the outer layer of skin may begin to peel.
This is often part of the normal healing process.
Dryness
The skin may feel dry, tight or flaky.
Tenderness
The treated area may become sore or more sensitive to touch.
Moist Desquamation
In more severe reactions, the outer layer of skin breaks down, leaving moist, weeping areas.
These reactions require assessment and management by the radiotherapy team.
Long-Term Skin Changes
Most skin reactions improve after treatment.
However, some people may experience longer-term changes, including:
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Skin thickening
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Increased firmness (fibrosis)
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Altered pigmentation
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Small visible blood vessels (telangiectasia)
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Increased sensitivity
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Reduced flexibility of the skin
The likelihood of these changes depends on the treatment received and individual healing.
Looking After Your Skin During Radiotherapy
Your radiotherapy team will provide specific advice appropriate for your treatment.
General recommendations often include:
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Wash the treated area gently using lukewarm water.
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Use products recommended by your radiotherapy team.
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Pat the skin dry rather than rubbing it.
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Wear loose-fitting, soft clothing.
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Protect treated skin from sun exposure.
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Avoid perfumes, alcohol-based products or adhesive dressings unless advised otherwise.
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Avoid scratching irritated skin.
Always follow the instructions provided by your treating hospital, as recommendations may vary between radiotherapy centres.
Why Early Support Matters
Many people wait until skin reactions become uncomfortable before seeking additional support.
However, skin changes often develop gradually during treatment.
Supporting skin health and monitoring changes early may help maintain comfort throughout treatment and encourage recovery once radiotherapy has finished.
How Rowan Health Supports Patients with Radiodermatitis
At Rowan Health, skin reactions are considered within the wider context of recovery rather than as an isolated symptom.
We develop personalised supportive care protocols according to:
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The area being treated.
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The stage of radiotherapy.
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The severity of skin changes.
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Associated symptoms such as fatigue or pain.
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The individual's overall recovery goals.
Depending on the individual's needs, protocols may combine education, symptom management, recovery support and selected therapeutic interventions, including acupuncture and neuro-coaching.
In our clinical experience, many patients following these personalised protocols report:
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Improved comfort during radiotherapy.
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Reduced skin irritation and sensitivity.
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Better tolerance of treatment.
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Progressive improvement as healing develops after radiotherapy.
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Greater confidence in managing skin changes throughout treatment and recovery.
As with all aspects of supportive care, outcomes vary between individuals and depend on the treatment received, skin type and general health. Our aim is to optimise the conditions for healing and recovery while working alongside your oncology and radiotherapy teams.
Rather than waiting for skin reactions to become established, we believe that supporting tissue health throughout radiotherapy helps many patients remain more comfortable during treatment and recover more smoothly afterwards.
When Should You Contact Your Radiotherapy Team?
You should contact your radiotherapy team promptly if you develop:
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Severe or rapidly worsening redness.
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Broken or weeping skin.
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Signs of infection, including increasing pain, swelling, pus or unpleasant odour.
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Fever (38°C or above) or feeling generally unwell.
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Bleeding from the treated area.
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Pain that is becoming difficult to control.
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Any skin change that concerns you.
Early assessment often prevents more serious complications.
Recovery
Most skin reactions improve gradually over the weeks following completion of radiotherapy.
Healing continues beneath the surface even after visible redness has settled.
Some people recover within a few weeks, while others notice gradual improvement over several months.
Looking after the treated skin, allowing adequate time for healing and seeking advice if symptoms worsen can all contribute to a smoother recovery.
Looking for Personalised Support?
Every person's skin responds differently to radiotherapy, and recovery is influenced by the treatment received, the area treated and individual healing.
At Rowan Health, we provide personalised supportive care protocols designed to work alongside your radiotherapy team. By anticipating potential challenges and adapting support throughout treatment, our aim is to help optimise comfort, tissue recovery and quality of life.
Learn how our personalised supportive care programmes help patients navigate treatment-related symptoms, recovery and life beyond cancer.
About this information
This article has been prepared by Julien Baron-Meyet, Consultant in Integrative & Supportive Care, with over 20 years' clinical experience supporting people living with cancer and complex health conditions.
The information on this page is intended for education and should complement—not replace—the advice of your healthcare team.
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