Table 1.
General recommendations
| General advice | ||
| • Skin cleansing | ||
| ◦ Liquid soap or dermatological soap bar with a pH close to 5, without perfume, plant or fruit extracts | ||
| ◦ Dry skin delicately but meticulously | ||
| • Skin hydration | ||
| ◦ Apply a non-comedogenic emollient cream without perfume, lanoline, 1 or 2 times per day, preferably after the radiotherapy session | ||
| ◦ Avoid applying topical creams to the radiation zone at least 1 hour before the radiotherapy session. This will avoid a bolus effect (increased radiation dose delivered to the epidermis) | ||
| • Photoprotection | ||
| ◦ Protect the irradiated skin zone from sun exposure | ||
| ◦ Apply a sunscreen SPF 50+ with UVA/UVB protection. | ||
| • Clothing | ||
| ◦ Wear ample, soft cotton clothing | ||
| ◦ Avoid wearing synthetic clothes | ||
| • Additional advice | ||
| ◦ Use an electric razor and do not shave too close to the skin. | ||
| ◦ Avoid applying products that contain alcohol (perfume, eau de toilette, ether, talcum powder) | ||
| ◦ Avoid applying sticky plaster | ||
| ◦ Avoid rubbing or scratching | ||
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| Acute radiodermatitis | ||
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| Grade 1 Mild to moderate erythema Desquamation dry and moderately sensitive |
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• Follow local hygiene routine If needed: • Emollient cream • Topical corticotherapy • Protective hydrogel, hydrobalance hydrocellular dressing • Avoid “Tulle gras” dressing • Low-energy laser (currently under evaluation) |
| Grade 2 Intense sensitive and mildly painful erythema Moist lesions confined to skin folds Edema |
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• Continue local hygiene routine If needed: • Emollient cream • Healing cream, acid hyaluronic cream • Topical corticosteroid • Drying lotion • Absorbent, nonadhesive, protective dressing (hydrogel, hydrocellular, hydrobalance) • Expose to fresh air as much as possible • Avoid antibacterial application • Low-energy laser (currently under evaluation) |
| Grade 3 Intense, painful erythema Extensive weeping moist zones larger than skin fold areas Bleeding wounds |
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If needed: Clean the wound with physiological serum • Tulle gras dressing 1 or 2 times a day • Nonadhesive, absorbent dressings, hydroabsorbant, hydrocellular • Alginate dressing if bleeding • Hydrofiber dressing if abundant exudate |
| After radiotherapy | ||
| • Continue using nonirritant local skin care, emollient, and sunscreen • Avoid wearing constricting clothing, synthetic fabric for several weeks • Watch daily for life |
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