Tending to Your Skin With Radiation Burns

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Radiation burns (radiation dermatitis) affect more than 90% of the approximately 4 million Americans who receive radiation therapy for cancer each year.

For many, radiation burns are mild and can be easily treated. However, about 20% of people who receive radiation therapy will have more serious burns with symptoms that can interfere with their daily lives.

This article examines why radiation burns occur, what they feel and look like, and how to treat them.

Radiation therapy for cancer

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Although anyone receiving radiation therapy can develop burns, studies show the burns are most common in those with breast cancer, head and neck cancers, or cancers that develop on or near the skin, such as skin or anal cancers.

What Happens When You Get Radiation Burns?

Radiation therapy uses X-ray beams aimed from outside your body to kill cancer cells inside the body. These beams can also damage healthy cells. Because the radiation beams need to pass through your skin to reach the cancer, skin changes such as burns can occur on or around the
treated areas.

Radiation burns don't appear right away. Instead, they usually appear one to two weeks after starting treatment. Burns can develop even after your final radiation session because the therapy keeps working in the body after treatment is finished.

Appearance

Radiation burns are more likely to occur in areas of the body where skin touches skin, such as the armpits or under the breast, or areas that have had a lot of sun exposure. Their appearance on the skin can include:  

  • Redness of white skin or darkening of black or brown skin
  • Dryness
  • Peeling
  • Blistering
  • Swelling

Weeping radiation burns, where the skin becomes wet and sore, can also occur and usually appears in places where there are skin folds, such as under the breasts or in the armpits.

Sensation

Radiation burns can be painful and feel similar to a sunburn. Burns may feel:

  • Itchy
  • Burning
  • Sore

What Degree Are Radiation Burns?

Radiation burns are categorized by degree, the same as thermal burns (burns you receive from coming into contact with hot objects like a stove).

First-degree burns appear as red, dry skin with moderate pain and itching. Second-degree burns occur as red, moist skin that blisters. Pain and itching can be mild to severe.

First Aid for Radiation Burns

It's important to treat your skin with care during and after radiation therapy to help you feel more comfortable and recover more quickly. Follow your healthcare provider's instructions for taking care of your skin and consult with them if you experience any skin changes or if your radiation burn symptoms are worsening.

Seek emergency care if you have radiation burns and develop any of the following symptoms, which might signal an infection:

  • A fever
  • Skin that’s unusually red or reddens quickly
  • Liquid draining or a bad smell coming from the burn

How They're Treated

If you experience radiation burns, there are at-home, over-the-counter (OTC), and prescription treatments to help, which can include:

  • Gentle washing: Clean treated skin daily with warm water and a low-pH cleanser to remove bacteria. Don’t use washcloths or loofahs; splash water on the skin.
  • Aloe vera: This plant is a natural anti-inflammatory. Applying fresh aloe vera juice daily to the affected skin can help lessen skin damage from radiation therapy.
  • Calendula cream: Known for its antibacterial, anti-inflammatory, and antioxidant effects, studies show promising results in preventing and treating radiation burns.
  • OTC hydrocortisone cream: For mild itching and burning, this cream can be applied thinly over the affected area three times a day but not within one hour of treatment.
  • Prescription creams: Your healthcare provider may give you a corticosteroid or other prescription cream for your skin. Be sure to follow directions on when to apply any prescription cream.

To protect your skin from further irritation during radiation therapy, try to:

  • Avoid putting anything too hot or cold, such as a heating pad or ice pack, or sticky, like a bandage, on your treated skin.
  • Avoid shaving or using talcum powder, antiperspirant, or any products with fragrance on the treated areas.
  • Wear sunscreen and sun-protective clothing if you go out in the sun; bundle up and cover your skin if you go out in the cold. 

Do They Go Away or Get Worse Over Time?

Radiation burns typically get better within a few weeks of radiation therapy ending. If your burns are causing more than mild to moderate symptoms, you must talk to your healthcare provider. Sometimes your radiation schedule or dosage can be changed to give burns more time to heal.

Radiation burns and other side effects of radiation therapy can also cause mental and emotional side effects. Seek help if you are experiencing anxiety or stress. Talk to your healthcare team about exercising, eating right, and getting enough rest—these things can help support your mental health during treatment.

Summary

Radiation burns are a common side effect of radiation therapy and can cause symptoms such as pain, itching, and soreness ranging from mild to severe. The burns typically appear one to two weeks after starting radiation treatment and can continue for weeks after completing it. Try at-home care and OTC or prescription creams to help prevent burns and decrease their severity.

A Word From Verywell

Protecting and caring for your skin during and after radiation treatment is important until your burns are healed. Make sure to follow your healthcare provider’s instructions and consult with them if you are experiencing symptoms that interfere with your daily life. Although radiation burns can cause uncomfortable symptoms, they typically get better within a few weeks of finishing therapy.

Frequently Asked Questions

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Penn Medicine News. Cancer patients can now use skin creams during radiation therapy.

  2. American Academy of Dermatology Association. How to take care of your skin during and after radiation therapy.

  3. Cancer Treatment Centers of America. Radiation burns.

  4. American Society of Clinical Oncology. Skin conditions.

  5. American Society of Clinical Oncology. Side effects of radiation therapy.

  6. BreastCancer.org. Radiation therapy side effects.

  7. Burn and Reconstructive Centers of America. Radiation burns.

  8. Yang X, Ren H, Guo X, Hu C, Fu J. Radiation-induced skin injury: pathogenesis, treatment, and management. Aging (Albany NY). 16;12(22):23379-23393. doi:10.18632/aging.103932

  9. Simões FV, Santos VO, da Silva RN, da Silva RC. Effectiveness of skin protectors and calendula officinalis for prevention and treatment of radiodermatitis: an integrative review. Rev Bras Enferm. 2020 Oct 19;73(suppl 5):e20190815. English, Portuguese. doi:10.1590/0034-7167-2019-0815

By Cathy Nelson
Cathy Nelson has worked as a writer and editor covering health and wellness for more than two decades. Her work has appeared in print and online in numerous outlets, including the Detroit Free Press and The Detroit News.