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May 09, 2023

Radiation burns are common during cancer treatment; here's how to alleviate the symptoms

The side effect affects nearly everyone who undergoes radiation therapy. Special creams are sometimes prescribed, but there are other ways to reduce the discomfort

Illness Cancer
Radiation Therapy Burns Nati Melnychuk/

Every year, about 4 million people in the United States undergo radiation therapy to treat cancer. About 95% of them develop radiation burns. Doctors sometimes prescribe special lotions to alleviate the pain caused by radiation burns.

Painful skin rashes and lesions are common during and after radiation therapy, but many cancer patients are unprepared for the ways the side effect can affect their quality of life and treatment outcomes, experts say.

But new research suggests bacteria on the skin may explain why radiation dermatitis – also known as radiation burn – occurs and offers hope for better treatments.

Every year, about 4 million people in the United States undergo radiation therapy. About 95% of them develop radiation burns. Symptoms include reddening of white skin or darkening of skin that is black or brown, itchy skin, dry and peeling skin, blisters and open sores that may appear where skin is sweaty or damp. Sometimes, changes to the skin are permanent.

Though anyone undergoing radiation therapy can develop radiation dermatitis, studies show that it is most common for people receiving radiation for breast cancer, head and neck cancers, and cancers that develop on or near the skin, such as skin cancer and anal cancer.

Most patients will experience mild to moderate symptoms, but about 20% develop severe radiation burns, according to the Cleveland Clinic. When symptoms are severe, radiation may need to be stopped or reduced, which can impact the effectiveness of the cancer treatment.

What causes radiation burn?

Dermatitis has been considered an expected result of radiation therapy, some scientists say bacteria may be to blame for the most severe cases. 

A new study found that 48% of people who developed severe radiation dermatitis tested positive for Staphylococcus aureus bacteria after treatment compared to 17% of those who only developed mild skin issues. 

Staph bacteria can live on the skin without causing an infection. But when the bacteria gets into breaks in the skin, an infection can result. 

The researchers theorized that radiation therapy may weaken the structure of the skin in the treatment area, making it easier for the bacteria to break through the skin. They also found that many of the patients tested positive for nasal staph, suggesting that bacteria in the nose can spread to the skin.

Another study tested suggests that using an antibacterial body cleanser, chlorhexidine, and an antibiotic nasal ointment, mupirocin, may reduce the likelihood of developing severe radiation burns. The patients in the study used the experimental treatment for 5 days, every other week, while undergoing radiation treatment. 

The study participants that received the experimental treatment all developed mild-to-moderate radiation symptoms, but none of them developed severe burns. By comparison, 23% of the participants who received standard care – normal hygiene practices and the use of moisturizers like Aquaphor – developed severe dermatitis. 

More research is needed to confirm the findings of both these studies.

The Cancer Network lists several factors that may influence the likelihood of developing severe radiation burns. They include the type of radiation energy used, the dose and how close it gets to the skin. The size of the treatment area and whether the patient is undergoing chemotherapy at the same time also may be factors.

How to protect your skin

Because radiation burn is common, health care providers may prescribe a steroid cream to reduce the risk of developing it. Special creams also are prescribed to relieve symptoms to people who develop burns. 

People undergoing radiation therapy are advised to talk to their health care providers before applying anything to their treatment areas, including creams, moisturizers, oils, lotions and cosmetic products. Not all of them are safe to use while undergoing treatment. Here are some other ways to protect one's skin and ease symptoms:

Use mild soap and lukewarm water when washing irritated skin• Don't rub or scratch irritated skin• Don't use heating pads or ice on your treatment area• Wear loose, soft clothing so nothing is rubbing up against your skin• Stay out of the sun and wear protective clothing when it can't be avoided• Use cool mist humidifier to keep your skin from drying out

Severe dermatitis can lead to skin infections. People are advised to visit the emergency room if their skin looks unusually red or becomes red very quickly, or if their treatment areas begin to drain liquid that smells badly.

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