Box 1 Evidence-based skin care plan to follow during and after radiation (32).
| During radiation therapy, many people experience a skin reaction called radiation dermatitis ranging from slight to severe. Our goal is to work with you to protect your skin during radiation therapy and improve your comfort. Follow this skin care plan throughout treatment and for 2 weeks following treatment |
| • A clinician will see you weekly or more often if needed. For immediate assistance between visits, you can receive help 24/7 by calling (name and/or phone number). _____________________________ |
| • Keep a daily diary of skin changes/reactions to be shared with your radiation team members at each visit. |
| ○ Skin red or pink color ___ Areas that blister, weep, or peel___ |
| ○ Tanned color of skin_____ Signs of crusting ___ |
| ○ Dry, itching, or flaking ___ Signs of ulceration ___ |
| ○ Tender to touch ___ Exudate/discharge ___ |
| ○ Decrease in sweat ___ Blackening of the skin ___ |
| • Report symptoms of pain, burning, or itching so that your clinician can prescribe oral medications to alleviate symptoms and promote your comfort. |
| • Please follow the directions below to prevent or lessen radiation dermatitis. |
| ○ Protect the skin in the treatment area from sun and cold. |
| ○ Do NOT use hot packs, cold packs, or heating pads on the treatment area. |
| ○ Do NOT take baths, use hot tubs, or swim in lakes or pools if your skin is not intact. |
| ○ Wear soft, loose comfortable cotton clothing. Avoid underwire bras during the remainder of treatment. |
| ○ Do not rub or scratch the skin in the treatment area. Avoid shaving the armpit with a straight razor. May use an electric razor or do not shave if preferred. |
| ○ Perform standard washing and skin care: |
| ❖ Shower before each treatment with a mild unscented soap (i.e., Dove, Neutrogena, or baby soap) and warm water. ❖ Wash affected area and gently remove the skin product and deodorant during the shower. Do NOT scrub. ❖ Dry treatment area with a clean, soft towel. Gently pat dry. ❖ Apply an emollient cream, such as Aquaphor or Eucerin, to moisturize the skin in the treated area following a shower. |
| ○ You may use a non-metallic or metallic deodorants/antiperspirants as they promote comfort and do not cause harm. Use of deodorants is based on your preference. |
| ○ From the day of your first treatment until two weeks after treatment, apply a thin layer of mid to high potency topical steroid cream (e.g., over the counter: hydrocortisone 1% (twice a day); prescription: betamethasone 0.1% (once or twice a day); fluticasone 0.05% (twice a day), triamcinolone 0.1% (twice a day), mometasone furoate 0.1% (once a day), clobetasol 0.05% (twice a day) to the radiation area after treatment. (Over the counter or prescription steroid creams may be used). NOTE: When using a topical steroid, apply moisturizer after the topical steroid. Use topical steroids only on intact skin. Further, if you are a patient diagnosed with diabetes, consult with your primary care physician regarding the use of steroids. |
| ○ Speak with your clinician if your skin is NOT intact for additional skin treatments. |
| ○ Use no other skin care product on the irradiated area throughout treatment, including perfume or make-up. |
| ○ Avoid the use of tape and adhesives in the treatment area. |
| ○ Realize that fatigue may occur during radiation treatment; however, report to your clinician signs of systemic illness, such as fever, chills, or generalized weakness. |
| ○ Eat a healthy well-balanced diet to promote skin healing and increase your energy. |
| ○ Discuss with your clinician any physical, emotional, social, spiritual or functional issues you are experiencing. |
| ○ Make notes as a reminder of issues to discuss with your clinician. |