News > How to clean our skin during radiotherapy

Radiation therapy, while destroying the tumor, can also affect surrounding healthy tissues, such as the skin. Radiation damage to the skin is called radiodermatitis and manifests as redness, dry or wet peeling  of the skin, and even sores. Peeling of the skin is more common in people who undergo radiotherapy in the head, neck and mouth area than in other areas of the skin. People with nasopharyngeal carcinoma will develop acute radiodermatitis at 90% to 95% of the time. One third of these cases are "wet peeling" that causes pain.

Factors that can increase the incidence of radiodermatitis
The thin skin of some people, sweating, more folds and frequent rubbing favor the development of dermatitis.

Cleaning of the skin during radiotherapy
Maintaining the cleanliness of the skin during radiotherapy concerns patients, doctors, and other health professionals, with questions such as:

Can cleanliness damage the skin?
Is soap irritating to the skin?
Should I use mild soap?
There are few studies to answer these questions. A study of women with breast cancer showed less dermatitis in groups who washed their skin in the area of ​​radiotherapy than those who did not. Another study showed less radiodermatitis in people with radiotherapy to the scalp who washed their scalp with shampoo.

In the present study, researchers examined the effect of washing with water, with or without soap, on acute radiodermatitis and its accompanying symptoms in people undergoing radiotherapy for nasopharyngeal carcinoma [1]. The soap that was used by the patients during the study did not contain lanolin and had a mild pH.

General instructions during radiotherapy
The general instructions, which were recommended to everyone during radiotherapy, were:
(a) not to wear their dentures, earrings, necklaces and other metal objects, in order to avoid increased radiation absorption,
(b) consume a high-protein diet, and more than 2 liters of water per day, in order to reduce any systemic reaction to radiotherapy,
(c) wear loose cotton or silk clothing and do not scratch the radiotherapy area,
(d) avoid using deodorants, lotions, creams, perfumes and other cosmetic products. Also, avoid direct sunlight in the area of ​​radiotherapy, iodine, alcohol and alcohol-containing antiseptics. Also, avoid hot compresses or ice cubes and use sunscreen.

The main findings measured in the study were:
(a) The incidence of acute dermatitis and wet peeling
(b) The severity of the symptoms (pain, burning, itching-rash) and the quality of life.

Results
1. The incidence of acute dermatitis was 51%, 23.5% and 18%. The difference was significant for the benefit of those who washed with soap and water. That is, those who washed with water and mild soap had the least dermatitis.
2. The onset of acute radiodermatitis was significantly delayed in the group of those who washed with mild soap.
3. The incidence of painful, wet peeling was significantly lower in the groups that washed their skin.
4. The itching was also significantly less in the groups that washed the skin that received the radiation.

Conclusions
(a) Cleaning and washing the skin, with water only or with water and mild soap, significantly reduces the incidence of severe acute radiodermatitis. (b) Washing the skin delays the onset of radiodermatitis.

Cleanliness, according to researchers, exerts its beneficial effect as it rinses and reduces bacteria on the surface of the skin, as well as reducing itching and scratching, which may lead to painful peeling.

Quality of life
Washing and cleansing irradiated skin promotes quality of life and emotional and social functions and parameters.

Source:

[1] Zhang et al. What is the appropriate skin cleaning method for nasopharyngeal cancer radiotherapy patients? A randomized controlled trial. Supportive Care in Cancer (2022), 30:3875-3883.