This page was last reviewed 03-04-21
Information
Some patients may develop a skin reaction during radiotherapy that is a bit like a sun burn. This will depend on the dose delivered and the area of the body treated. This reaction can continue to develop for 7-14 days after treatment, but will begin to settle after that. It will only occur within the boundaries of the radiotherapy treatment field.
Patients treated at Edinburgh Cancer Centre are provided with skincare advice and creams according to their assessed risk level for a skin reaction (low, medium or high).
Patients at a low risk for a skin reaction are not provided with any creams. If they develop a reaction they may be provided with Diprobase cream.
Patients at a medium risk for a skin reaction are provided with Diprobase cream and advised to apply it every morning and night from the start of treatment. If they develop a reaction they may be provided with Betamethasone 0.1%.
Patients at a high risk for a skin reaction are provided with Disprobase and Betamethasone 0.1%. They are advised to apply the Diprobase twice a day and the Betamethasone once a day from the start of treatment.
Patients are advised to apply any creams that have been provided by the Cancer Centre for two weeks after the completion of treatment, or until their skin reaction settles.
Who to refer:
patients with skin reactions that are worsening after the two week point following completion of radiotherapy, or have uncontrolled pain or infection within the radiotherapy treatment field, not responding to standard treatment
Who not to refer:
patients with normal expected skin reaction (including moist desquamation) within the radiotherapy treatment field
How to refer:
via on call Oncology phone number, 07798774842
Primary Care Management of symptomatic skin reaction following radiotherapy
- Keep skin clean and dry
- If not already on steroids, start on betamethasone valerate 0.1% and continue for one-two weeks after completion of radiotherapy treatment.
- Though there is no research data to support the use, anecdotally over the years patients have found profavine liquid and aqua-cool packs soothing so can be used for symptomatic benefit.
- Observe carefully for signs of supra-added infection resulting in cellulitis if there has been a breakdown of the skin. If this occurs, take a swab for MC & S and start flucloxacillin or clarithromycyn (if penicillin allergy). Do not mistake skin erythema due to radiotherapy for cellulitis.
- On completion of treatment there are two options in case of moist desquamation.
- Silver sulfadiazine cream (Flamazine) – contains a sulphonamide antibiotic and can be used if the skin is broken and superficially infected. A 3.5 mm layer should be applied once a day.
- Hydrocolloid dressings can be used.
There is insufficient evidence to support honey, sucralfate, 1% hydrocortisone or trolamine.
