Skin Care for Patients Receiving Radiation Therapy

Nursing Responsibilities

a) Teach the patient about the following:

 Wash the area with warm water and mild, non-perfumed soap. Avoid using hot water.
 Wash the area gently by hand or with soft washcloth, rinse thoroughly and pat dry with a
soft towel.
 Keep all skin folds dry by exposing them to air as often as possible.
 Do not use deodorant if the armpit is being treated.
 Avoid using powders, lotions, creams and alcohol on the treated skin.
 Protect the skin from friction and rubbing by wearing loose-fitting, cotton clothing over the
treated area.
 Protect the treated area from the sun.
 Do not expose the treated area to extreme hot or cold temperatures.
 Do not use heating pads, heat lamps, or ice packs in the treated area.
 If shaving is necessary in the treated area, use an electric razor only.

b) Assist the patient when bathing.

c) Encourage to increase the amount of fluid intake.
d) Suggest use of cornstarch or olive oil as a substitute for lotion and talcum powder.

Stages of Skin Reaction that Occurs when Receiving Radiation Therapy

Followed by the Nursing Responsibilities

(I) Erythema and (II) Dry Desquamation

 Advise the patient to use ointments for inflamed skin because they generally allow the greatest
absorption.
 Patients should be instructed to apply the ointment after bathing to ensure that the skin is free
from residual product.
 A thin film of cream or ointment is generally sufficient when the nurse, the patient or the
significant other is applying it.
 The nurses should be aware that topical steroids should not be applied to infected skin because
they may mask the clinical signs and symptoms of infection.
 The patient should be made aware that commercial products that include alcohol, phenol, or
menthol may enhance irritation and should not be applied to irradiated skin.
 Petroleum jelly should not be advised because they are not water-soluble and can be difficult to
remove completely, thus potentially resulting in a bolus effect and increased skin dose.
(III) Moist Desquamation

GOAL:
- Minimize trauma and discomfort
- Promote healing
- Preventing infection

 The site should be cleansed gently with 1/4-strength to 1/2-strength hydrogen peroxide.
Explain to the patient that this strength of hydrogen peroxide solution sufficiently
debrides the wound of purulent debris without harming granulating tissue.
 The nurse should be aware that full-strength hydrogen peroxide, povidoneiodine, and
wet-to-dry dressings can harm granulating tissue and should be avoided
 The skin may be effectively dried gently by using a hair dryer on a cool setting or by
gently patting with a soft, clean cloth.
 If superficial crust formation occurs, Wet soaks with an astringent will effectively loosen
the crusts before additional care is applied so administer soaks for 20 to 30 minutes, 3
to 4 times daily. Include the patient and the family in this plan of treatment.
 Dressings may need to be remoistened with astringent solution and reapplied every 10
minutes to effectively remove crusts and exudates.
 Moist desquamated wounds should not be occluded with ointment and topical steroids
are not recommended.
 Moist desquamation often occurs in the folds of skin, making it difficult for patients to
reach for cleaning so to provide comfort as well as a mechanism for cleaning these hard-
to-reach sites, assist patients in showers and baths.
 Provide Sitz baths and apply Burow’s solution to patients receiving radiation therapy in
the perineal area.
 Apply moisture-vapor permeable (MVP) and/or hydrocolloid dressings to promote
healing of moist desquamated wounds by allowing moisture to enhance re-
epithelialization, to receive comfort, protect the wound from irritation or trauma, and
serve as a physical barrier to contaminants.

(IV) Skin Necrosis

 Provide safety to prevent further damage to the skin.

 Cover the area to protect from contaminants thus preventing infection.
 Clean the area daily with mild soap and rinse with running water.
 Turn the patient often (q4) to prevent further disintegrating of the skin.

Source: http://findarticles.com/p/articles/mi_m0FSS/is_n3_v6/ai_n18607423/?tag=content;col1