Radiation burns

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on April 29, 2022.

If your cancer treatment includes radiation therapy, it’s important to understand and monitor for potential side effects such as radiation burns (dermatitis).

Skin changes may be unavoidable during treatment, but there are steps you may take to prevent and manage burns or infection.

Speak with your care team if you notice any skin changes or have questions about what you should and shouldn’t use on your skin.

Radiation treatment

More than half of cancer patients need radiation therapy, either alone or in combination with other treatments, according to the National Cancer Institute. Radiation is a localized treatment, meaning it focuses on the cancer cells and immediate surrounding area—not the entire body.

  • External beam radiation targets cancer cells using X-ray beams aimed at them from outside your body. If you have lung cancer, for example, a machine aims the beams at the chest, through your skin.
  • Internal radiation treatments may also be used, where radiation sources such as seeds or capsules are placed inside your body, near the cancer.
  • Liquid radiation may be ingested as a pill or drink, or through an intravenous (IV) line.

This evidence-based treatment has been shown to help fight cancer, and you’ll work with your care team to understand its benefits and risks.

How radiation burns happen

Radiation treatment kills cancer cells, but it may also damage healthy cells. Because external radiation needs to pass through your skin to reach the cancer cells, your skin may be affected. Changes, including burns, may happen if the skin doesn’t have enough time to heal between treatment sessions.

Radiation burns, also known as X-ray dermatitis or radiation dermatitis, may start showing up about two weeks into external radiation treatment. These burns are common, but they tend to be mild and usually resolve within two months after radiation treatment ends. Burns and other skin changes may occur on and around the treated area, but nowhere else on your body.

Anyone undergoing radiation therapy may experience radiation burns, but they are especially common in patients undergoing treatment for certain cancers, such as head and neck cancers, breast cancer and cancers that form on or close to the skin, such as anal cancer and skin cancer, including melanoma.

What do radiation burns look like?

Radiation burn symptoms include:

  • Redness
  • Dryness
  • Itching
  • Peeling
  • Blisters
  • Swelling
  • Tissue damage

Other types of skin changes may occur as well. Your skin may become swollen and puffy, or have a “moist reaction” where it becomes wet, sore and prone to infection. Moist reactions, sometimes called "weeping radiation burns," usually occur around skinfolds, such as under the breasts. Other changes, like skin texture or color, may vary based on what area of your body the treatment targets.

Preventing radiation burns

You may take steps to prevent radiation burns or soothe them to lessen their severity before, during and after treatment.

Take good care of your skin. Good skin care is one of the best defenses against radiation burns or other skin changes. Ask your doctor for recommendations on creams to keep the area as healthy as possible. Don’t rub or scratch the affected area, no matter how tempted. Scratching and rubbing only make the burn worse and slow the healing process.

Shower or bathe with care. Use only mild soaps that your care team has approved. Shower or bathe with lukewarm water only. It’s OK to shower daily, but baths should be short and limited to every other day. When finished, gently pat yourself dry with a towel, being careful not to remove any ink markings that tell your radiologist where to aim the treatment.

Avoid extreme heat or cold on the treated area. Skin in the treated area is sensitive. Even hot water may sting, so avoid hot tubs during your treatment. Bundle up or limit your time outdoors when you go outside in cold temperatures.

Protect your skin from the sun. Your skin may be extremely sensitive to sunlight during radiation treatment. When outdoors, wear dark or ultraviolet (UV) radiation-protective clothing such as a hat with a broad brim and a long-sleeved shirt with long pants. Ask your cancer team if you should use sunscreen on or around the treated area.

Use skin-care products with caution. Skin-care products to avoid during radiation may include:

  • Antiperspirant/deodorant
  • Talcum powder
  • Perfume
  • Hair-removal products
  • Bubble bath products
  • Makeup

Some of these products may leave a coating on your skin that causes radiation burns or irritation, or makes them worse. Others may even affect the amount of radiation that enters your body, increasing your risk for side effects.

Run anything you want to use on your skin by your doctor, including shaving creams, gels and razors.

Wear loose-fitting, soft clothes. You may further irritate burns if your clothing rubs against skin treated with radiation. Avoid tight-fitting clothes or items with elastic that may squeeze the treatment area.

Keep an eye on moisture. Cool, humid air may help skin feel better, so use a humidifier if you can.

If you’re undergoing radiation to the rectal area, use baby wipes or a squirt of water from a spray bottle after a bowel movement to reduce irritation and burns.

Radiation burn treatment

Treatment for radiation burns often includes prescription steroid ointments and other medications prescribed by a doctor. These may include radiation burn creams and/or radiation burn lotions applied regularly over a prescribed timeframe.

Be sure to inform your care team if you notice any skin changes, including radiation burns. If you develop a sore, wound or scab from radiation burns, closely follow your doctor’s advice on how to care for it. Your care team may offer ways to lessen the discomfort and prevent further issues or infection.

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