Radiation skin reactions are a result of damage to the basal cell layer of the skin
How to measure radiation dermatitis
Predicting the severity of skin reactions can be difficult due to the varying radio-sensitivity of the skin and a number of contributing factors. Intrinsic and extrinsic factors may significantly increase the severity of radiation therapy skin reactions which may delay the healing process.
Individuals with darker skin may notice that the skin in the treatment field starts to darken. Regular skin assessments are essential to ensure that the right interventions are implemented at the right time. The skin reactions of every patient are different which demands a close observation of the patients’ side effects.33
First symptoms: 10 – 14 days after the first radiation therapy dose
In general, radiation skin damage can be seen approximately 10–14 days after the first dose of radiation. This corresponds with the time it takes for impaired cells to migrate to the surface of the skin. If the new cells reproduce faster than the old cells are shed, the skin will become dry and flakey (dry desquamation).33
When radiotherapy continues, the body may not produce enough new cells to replace the old ones. As a result, the outer layer of the skin may break and start to ooze – so called moist desquamation has developed.15
The severity of skin reactions may increase for 2 more weeks after the completion of radiation therapy. Each hospital has a different way of managing radiation dermatitis, based on the skin’s condition.
Radiation dermatitis: scales and grading systems
A number of different systems have been developed to measure and describe the spectrum of radiation dermatitis. The research institutes which define the radiation dermatitis scales include organizations such as the National Cancer Institute (NCI), the Radiation Therapy Oncology Group (RTOG), the World Health Organization (WHO) and the European Organization for Research and Treatment of Cancer (EORTC) to describe the spectrum of radiation dermatitis.