# Skin care during radiotherapy and acute radiation dermatitis

Source: https://onco.cc/protocols/radiation-dermatitis-skin-care/  
OnCo record `radiation-dermatitis-skin-care` (Protocol). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Radiotherapy often makes the treated skin pink or darker, dry, itchy and sore, and sometimes it peels. Wash the area gently with water and mild soap, use your usual moisturiser and keep using deodorant unless it stings. If your risk is high, as with breast or head and neck treatment, your team may suggest a thin film dressing or a steroid cream from the start. Report blisters or pain.

## Summary

Prevention. The MASCC 2023 Delphi guideline (42 experts, interventions reaching 75% consensus) recommends six interventions for prevention: photobiomodulation and Mepitel film in breast cancer, Hydrofilm, mometasone, betamethasone and olive oil; most others were not recommended for lack or conflict of evidence. Its systematic review found that washing with water and soap and deodorant use do not worsen dermatitis but did not find enough evidence to recommend them for prevention. Two 2023 meta-analyses go further: washing with or without soap reduced severe dermatitis (OR 0.32) and moist desquamation (OR 0.25), and deodorant made no difference, so the evidence does not support advising against it. The Canadian breast Delphi (2025) reached consensus for education, moisturising and washing for every patient, and Mepitel film and mometasone for high-risk patients. MASCC clinical practice statements since then recommend Mepitel film or Hydrofilm prophylaxis in breast and selected head and neck cancers (2025), medium-potency topical steroid such as mometasone furoate 0.1% for high-risk head and neck and breast patients (2026), and barrier-forming agents, StrataXRT having the most evidence, where the contour is irregular (2026). The ONS guideline (2020, GRADE) made a conditional recommendation for deodorant and suggested against emu oil, calendula and non-steroidal agents.

Management. MASCC 2023 recommends Mepilex Lite dressings for established dermatitis; the 2026 steroid statement allows topical steroid for early dermatitis without moist desquamation and asks for weekly skin review, stopping the steroid if moist desquamation appears. Most of this rests on abstracts; the full MASCC 2023 text and the UK Society of Radiographers guideline could not be read.

## Fields

- Kind: Protocol
- Last checked: 2026-11-11
- Also known as: radiation dermatitis; radiodermatitis; radiotherapy skin reaction; radiotherapy skin care; moist desquamation; Mepitel film; StrataXRT; mometasone for radiotherapy skin; can I wash during radiotherapy; deodorant during radiotherapy

## Connected records

- protocols: [Breast radiotherapy positioning, immobilisation and daily set-up verification](https://onco.cc/protocols/breast-radiotherapy-positioning-and-setup/)
- cancers: [Breast cancer (all types)](https://onco.cc/cancers/breast-cancer/), [Head and neck squamous cell carcinoma](https://onco.cc/cancers/head-and-neck/)
- technologies: [Photobiomodulation (low-level laser) for oral mucositis](https://onco.cc/technologies/photobiomodulation-mucositis/)
- terms: [Radiation dermatitis (skin reaction)](https://onco.cc/terms/radiation-dermatitis/), [Radiotherapy](https://onco.cc/terms/radiotherapy/)
- ideas: [Tell people having radiotherapy that they can wash the treated skin and use deodorant](https://onco.cc/ideas/idea-pu-washing-and-deodorant-during-radiotherapy/)

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