Skincare During Radiation Treatment

Skincare during radiation treatment is essential because radiation will cause your skin to change. It’s important to know what is safe to do to care for your skin during this time. In this post I’ll share what worked for me, and also what has been helpful for others.

Note: This is my personal experience as a patient. I am not a health care provider. Please read and understand my disclaimer and only follow the instructions given by your healthcare team. 

After my lumpectomy in Fall 2019, I decided to do radiation treatment on my right breast. This additional step was important because I wanted to reduce the risk of recurrence in this breast. 

I had 20 treatments of radiation done on my breast. About 15 of those were whole breast radiation, and the last five were considered a boost. This boost was targeted directly at the site where my lumpectomy had taken place.

I experienced many skin changes during my breast radiation, and I thought I would share how I cared for my skin during treatment. I used the guidelines my radiation oncologist gave me as a basis for my care. 

As I’ve talked to other cancer patients about their radiation treatments, I’ve realized that many other products may help, besides the ones I used during my treatment. You will find these recommendations included in this post as well.

You will likely get skincare guides from your radiation oncologist if you are undergoing breast radiation. Please follow those instructions for your treatment. If you have any questions about what is safe, please bring creams to your doctor and ask if they are safe.

What Did my Skin do During Radiation?

Everyone’s skin will react differently to radiation treatment. Here is what happened to me. I got red right from the start, but it was temporary. After about a week, my skin began to darken. It got sunburn red at first, and then it got purple. The burn was square-shaped and went under my armpit as well. Then, my entire breast peeled from under my armpit to my nipple.

I had to resist the urge to pick it and observe it for infections. 

Then, once that first peel finished, it happened again. This second peel continued to progress even after my treatment finished. Thankfully, that was the last complete peel I had.  

During radiation, it looked like I had fallen asleep on my side on a topless beach! I would look at myself in the mirror and giggle. Sometimes, humor helped me cope with the trauma of treatment.

I could not believe how sunburned my skin was on that side. It was the worst I had ever seen my skin.  

After that second complete peel, my skin was tanned but not peeling anymore. I kept putting lotion on for another few months, and then I stopped.

About four months after treatment, my skin began to get itchy again. I was surprised, but I started putting the cream on again, and my skin stopped itching.

I am two years out from radiation, and my skin looks great. I’m so happy that the skin has stopped peeling, and things look normal for me again!

Your reactions may be completely different. If you are experiencing pain, rash, or anything you don’t understand, please reach out to your radiation oncologist. She should be able to help you manage the side effects and make sure that the treatment is safe for you.

Skincare During Radiation

Please make sure that you follow all of your radiation oncologist’s instructions! What was safe for me may not be safe for you! 

Affiliate Disclosure: Some of these links may be affiliate links. This means that I will earn a small commission if you buy one of these products. See my disclosures here.

 Safe Showering During Treatment

During my radiation treatment, I took great care to make my showers as safe as possible. Here is how I did that.

• Warm Water Only: Showers during my radiation were only warm, not hot. Hot water may irritate your skin.
• Back to the Showerhead: During radiation, I made sure that I didn’t let the shower water hit my breasts directly. I stayed with my back to the showerhead and allowed the water to fall over my shoulders onto my front.
• Gentle Soap: I used a gentle soap to care for my skin during my treatment. I chose Dove, and it worked well for me.  
• No Washcloths or Scrubbers: I only used my hands to apply the soap to my breasts. I didn’t use a washcloth or a shower scrubber. When I started peeling, I was even more careful not to disturb the area.
• No Armpit Shaving: I wasn’t allowed to shave my right armpit during my radiation treatment. Any type of shaving could irritate the skin during treatment.
• Gentle Toweling:  When I got out of the shower, I made sure to pat the area gently dry, not rub it. This would protect my skin from friction and additional damage.

Creams and Care

My radiation oncologist provided me with a list of approved creams for my radiation treatment. There were also samples available in the office of creams that were safe for me to try.  

I could not use some of the prescription creams, such as Silvadene, that are typically recommended to radiation patients because I am allergic to sulfa drugs. So I ended up managing my skin conditions with over-the-counter creams. Thankfully, these creams were effective enough to help me manage the discomfort.  

If your oncologist offers you a prescription cream, by all means, use that!  

• Calendula: The first cream that I began applying and used most regularly was calendula. I liked the Boiron formulation, but you will also find other brands that include this helpful botanical. I would apply this cream three times a day. First, I would use it right after my shower- because there were at least four hours before my treatment. Then, I would apply it in the dressing room after my treatment. I would also use it right before bed. I loved this cream and used it every day from the beginning of treatment. It’s important to start moisturizing right away, even before noticing the skin changing.
• Udderly Smooth: I used Udderly Smooth at the beginning of my treatment. I would alternate with this cream and the Calendula. However, I stopped using it towards the end of my radiation because I noticed that I was getting itchy after using it.
• Aquaphor: Once I started peeling, this was my go-to cream. Aquaphor is a sticky ointment that will stain your bras, so be careful. I didn’t use this at the beginning of my treatment because it was too thick. This ointment was great for my nipples once they began to peel. They were really sensitive, so the cream helped provide an excellent barrier for me and prevented the itchy feeling. I used dark bras to help prevent the staining. Aquaphor is also available in a spray formulation which has come to me highly recommended.
• Avène Thermal Water: I used Avène Thermal Water right after my showers and after my treatments in the dressing room. I called it my “magic water.” It calmed my skin down right away from any irritation that I was experiencing. I would spray this on, let it sit for about a minute, then pat it dry. Then, I would put my lotion on. Avene Thermal Spring Water has been used for years in France to help patients with various skin issues, including people who have undergone radiation treatment.  
•  Avène XeraCalm A.D: This was the lotion that I would use at night. It calmed my skin down and reduced the itching. I still use this lotion regularly since I have the occasional issue with itching.

What didn’t work for me:

• Cortisone: I tried to use this cream during the last part of my treatment. It would help for about an hour, and then I would experience extreme itching!! It was awful. I don’t know why it didn’t work for me, but I decided to stop thinking about why and threw it out. 

Additional Cream Recommendations: 

• Pure Aloe Gel: I didn’t try using Pure Aloe gel, but I have spoken to several ladies who said it worked great for them!
• Miaderm Radiation Cream: This cream combines a few ingredients into one tube, including calendula and aloe vera. They also have a soap and a cream formulated with lidocaine.
• RadiaDres Gel Sheets: According to a fellow patient, these were helpful to “cool” her skin when it began to get irritated. You could check with your medical team to see if they have those in the office for you to try out. Additionally, you can find them here on Amazon.
• PhysAssist- Oncology Body Cream: This cream has essential oils included in its formulation and calendula. It does have a scent to it, so that is something to consider as you make your cream choices.

Clothing, Bras, and Pajamas During Radiation Treatment

My skin was sensitive and itchy during treatment. I needed to be careful about what fabrics I let touch my skin. Additionally, I needed to wear a bra almost all the time during my treatment month. I found that my skin would get itchy and irritated if I tried to go without a bra. I have met many women who have had the opposite reaction. They have found great relief by going braless during their radiotherapy.  My advice is to try things and see what works for you.

AnaOno Bras and Tanks

I have been wearing these fantastic bras and tanks since I discovered them in October 2019. This company  was founded by a breast cancer survivor who found that the bra options were limited to sports bras and ugly reconstruction bras after her breast cancer treatment. I love their bras and still wear them daily. The links below are affiliate links.

Molly Plunge Bra:  This bra is comfortable, soft, stretchy, and easy to wear. The seams are hidden so that they don’t pull at the skin. It is made of modal fabric, which is exceptionally soft. This bra calmed my skin down after I put it on. I still wear these bras several times a week, and I’m two years out of treatment!

Wrap Front Camisole: I wore the original version of this camisole that didn’t have lace in the design. I don’t know how I would do with the lace in the current bust line, but you could try it out and see.

They have other bras for radiation treatment in a special section on their website.

Fruit of the Loom Front Closure Bra

I love these bras. I would wear them when I slept and when I was walking. They are comfortable and breathable. Additionally, they are more affordable than AnaOno bras. The front closure makes it easy to use, and they come in several colors. I also like that they have traditional straps, making them easier to wear underneath my clothes.

No Lace

I could not wear anything lacy at all during radiation! The lace would make my skin itch like you wouldn’t believe! This is why I’m hesitant to recommend the new version of the AnaOno camisole. There were several tops that I needed to put in the back of my closet during treatment!

Soft, Loose-fitting, Stretchy

I needed to keep my clothing soft and stretchy during radiation. Loose-fitting clothing was also crucial to my comfort. Unfortunately, I don’t have a lot of loose-fitting clothes in my wardrobe, so this made for some challenges during my recovery. There were some shirts and sweaters that I couldn’t wear during radiation.

Higher Cut Shirts to Protect Skin 

It is essential to keep the skin protected from the sun during and after radiation. I had my treatment during the winter, so it was easier for me to cover up. I wore turtlenecks when the peeling started. This served two purposes. It hid my peeling skin from everyone, and it protected my skin.

Soft Pajamas

I am a big fan of modal or microfiber pajamas. They were soft and gentle on my skin during treatment. 

These pajamas by Ekouaer are one of my favorites and come in various styles and colors. They are soft, and I think that they would work wonderfully during radiation treatment.  

During my month of radiation and weeks of recovery,  I concentrated on safe showering, creams, and soft clothing to help me manage my skin challenges during radiation treatment.

I hope that these ideas can be helpful to you as you are facing radiation treatment. If you have been through radiation treatment, what helped you manage the skin effects?