Radiation Damage on Skin

          Radiation skin damage can happen after a person receives radiation treatment for cancer. It can also occur when a person is accidentally come in contact with unsecured radiation sources such as food irradiators, radiotherapy equipment, x-ray machines, nuclear power or nuclear weapons. Skin damage can start to show within a few hours after exposure. However, some effects may not appear for months or even years. It depends on the amount of radiation and which part of the body was exposed.

          When the skin receives a significant dose of radiation, the symptoms occurred include swelling, erythema (skin redness like sunburn), dryness, itchiness, dry desquamation (peeling), increased pigmentation, epilation (hair loss) at the site, moist desquamation (blistering) and ulceration. Later effects may include thinning and hardening of the skin and difficulty with wound healing. When radiation damages cutaneous and subcutaneous tissue, the loss and damage of sweat glands, nerve tissue, hair follicles and blood vessels may be occurred.

Examples of radiation skin reactions:

Figure 1: Erythema (skin redness)

            

Figure 2: Dry Dequamation

 

Source: BC Cancer Agency, 2006.

          Skin effects are more likely to occur with exposure to low energy gamma, X-ray or beta radiation. It usually requires doses of about 300 rad (3 Gray) to produce a visible reddening of the skin. Hair loss can occur after acute doses of about 500 rad (5 Gray). The dose required for skin blistering to occur is relatively high, which in excess of 1,200 rad. Doses of about 1500 rad (15 Gray) produce serious burns with blistering. Doses reach 3000 rad (30 Gray) may result very serious burns which requiring skin grafts or amputation. More extensive skin damage involves deeper layers of the skin, such as tissue necrosis. In addition, skin cancers, tendon and joint degeneration may occur up to years after the dose.

          For the treatment of the radiation damaged skin, keeping the skin clean and excluding infection while the skin heals. Irritating substances such as brushes and soaps should be avoided.  Patients should be encouraged to wash the irradiated skin daily using gentle soaps and are discouraged from using any perfumed or alcohol contained products which may possess chemical irritants. Rubbing, scratching and massaging the skin should also be discouraged. On the other hand, direct application of heat or cold to the irradiated area such as ice or heating pads should be avoided. Protection from sun exposure is also required. Patients should be instructed to avoid direct sun exposure by cover the irradiated skin and by the use of sunscreen products.

          For serious radiation exposure, the key treatment includes immediate care and use of medications to inhibit infection, reduce inflammation and relieve pain. For itchiness, antihistamines and corticosteroids may be prescribed. Pentoxifylline, vitamin E and interferon gamma may be prescribed to stimulate blood circulation and to reduce fibrosis or thickening of skin tissues. In some cases, plastic surgery may be recommended by the doctors. Complete healing of the skin may take from several weeks up to a few years depending on the radiation dose of the skin received. In general, all of these injuries will recover, but may leave weakened skin. However, relatively high doses of radiation will result in skin that cannot be saved.

References: 

BC Cancer Agency, 2006. Care of radiation skin reactions.

Retrieved on July 2, 2011. Available from: http://www.bccancer.bc.ca/NR/rdonlyres/79E81484-6809-41CF-8CC2-0646DA6003F8/50912/CareofRadiationSkinReactions.pdf