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During radiation therapy the skin can change significantly

How does radiation therapy affect the skin?

Predicting the severity of skin reactions caused by radiation therapy can be difficult due to the varying radio-sensitivity of skin and other contributing factors. Intrinsic and extrinsic factors may significantly increase the severity of skin reactions. This can delay the cancer treatment and a patient’s healing process.

What skin reactions can occur?

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Redness – the skin in the treatment area may resemble a mild to severe sunburn or tan.

Pruritus – itchiness is a normal side effect in the treated area. Scratching can compromise skin integrity.

Inflammation – swelling, pain and heat might occur in the treatment area.

Dry desquamation – the skin in the treatment area may become thicker and very dry. In most cases, the skin peels off similar to what occurs after sunburns.

Moist desquamation – skin cells are destroyed faster than they can grow back. The skin may break down, become wet or infected. This is more common where the skin is very thin or folds such as behind ears, under breasts or neck.

Skin changes caused by radiation therapy.

Radiation therapy starts

No visible changes. However, skin cells are damaged from the very first dose of radiation.

After 2 to 3 weeks of radiation therapy

The inflammatory response of the skin is activated as a response to the radiation. Damaged cells migrate to the skin surface at an increased rate.

After 4 to 5 weeks of radiation therapy

The rate of new skin cell production is increased to cope with the radiation damage. As a result, the dead skin layer becomes thicker and dry.

After 6 to 7 weeks of radiation therapy

The rate of new cell production is insufficient to replace the cells destroyed by radiation which breaks down the skin integrity. This imbalance continues until the end of the radiation therapy.

1 to 2 weeks after the end of radiation therapy

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

Healed skin

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