During and after radiotherapy

During radiotherapy treatment

You will be asked to lie in the same position as when your treatment was planned. If you had a customised lead cut-out made, this will be used.

The radiotherapy machine will be carefully positioned over the treatment area by the radiographers. You might feel a small amount of pressure on your skin. The treatment is painless and you will not feel anything when the machine is switched on.

The radiographers will leave the room while the treatment is being given, but will watch you on closed circuit television. If you need help, wave your hand. The radiographer can stop the treatment and return to the room to help you.

Treatment takes 2 to 8 minutes and it’s important to keep still. You can breathe normally. When your treatment ends, the radiographers will remove any pen marks on your skin. You’ll be given details of further appointments if required, and advice on how to look after your skin.

Review appointment during radiotherapy

If your radiotherapy is longer than a single treatment (fraction), you should have a review appointment with the skins advanced practice radiographer.

This review appointment is to check how you’re managing with the radiotherapy, and give you advice on how to look after your skin and any dressings you have. They can also discuss pain management with you if needed.

This appointment should be included in the appointment list given to you on your first day of radiotherapy. Please ask the treatment radiographers if it’s not on your appointment list.

Side effects of radiotherapy

The most common side effect of radiotherapy is skin tenderness. This will only affect skin in the treatment area.

During treatment your skin may become red, itchy. Sometimes wet patches develop which can be very sore. Skin reactions usually start from your second week of treatment, and may be worse at the end and for 1 to 2 weeks after treatment.

Skin reactions may continue for 3 to 4 weeks after finishing treatment. During this time, your skin may:

• become pinker or darker
• feel dry or tight, itchy and sore
• blister, break, peel and weep (known as moist desquamation)

How to look after your skin

It’s important to look after your skin during treatment and until any skin reactions have settled.

Take care in the sun while having radiotherapy and until any skin reactions have settled. Cover the treated area and use sunscreen with a high SPF.

If your skin is unbroken

• Start using moisturiser when you start the radiotherapy and continue to apply moisturiser if your skin becomes red, darker or sore. Your usual moisturiser would be fine. Avoid using moisturiser with sodium lauryl sulphate in.
• Apply moisturiser 2 or 3 times a day, gently smooth it onto your skin. Do not put moisturiser on immediately before treatment.
• Some doctors may prescribe you a cream to use during your radiotherapy treatment. They will tell you how to use it, and how often.
• Avoid activities that cause rubbing against the treatment area. This is because rubbing can irritate the skin and make any skin reactions worse.
• Wash the area gently with warm water and your usual soap or shower gel. Gently pat the skin dry with a soft towel, and do not rub it.
• If you’re having radiotherapy to your head, wash your hair gently with shampoo, but avoid using hairdryers.
• Do not use makeup or any other products on the treatment area.
• Avoid shaving the treatment area, or near it. If you must shave, dry shave with an electric razor.
• If you’re having radiotherapy to your nose, or near your nose, you may have a small amount of bleeding from the nostrils. You might also get some crusty build-up inside the nose. If this happens, gently apply a little Vaseline (petroleum jelly) with your fingertip to help soften the skin and make it more comfortable.

You can swim during radiotherapy treatment. Wash the treatment area before and after swimming, and apply moisturiser.

If your skin is broken

If your skin is sore or it breaks, speak to your treatment radiographers.

• Do not apply moisturiser to the treatment area.
• Ask about dressings. If a dressing is needed, we recommend non-adhesive ones, or dressings made with a suitable adhesive coating.
• Ask about painkillers if your skin is very painful.
• A yellow coloured liquid (discharge) may settle over the damaged skin. This is a normal part of the skin healing process, but if an infection is suspected a sample can be taken.
• You may need a painkiller (analgesia) if the treatment area is extremely painful. Ask the treatment radiographers if you feel you need painkillers.

Follow-up appointments

You will have a follow-up appointment with either your oncologist or dermatologist. This will be 6 to 12 weeks after your treatment has finished. If you do not know when your follow-up appointment is, ask your radiographers on the last day of radiotherapy treatment.