{"entity":{"id":"idea-pu-washing-and-deodorant-during-radiotherapy","kind":"idea","name":"Tell people having radiotherapy that they can wash the treated skin and use deodorant","aka":[],"tldr":"Old advice told people not to wash the treated area or use deodorant during radiotherapy. Pooled randomised trials found that washing, with or without soap, reduced severe skin reactions, and that deodorant made no difference to them, so neither ban is supported.","summary":"Washing. A 2023 systematic review found four randomised trials of washing during radiotherapy; two could be pooled, and washing with or without soap reduced severe radiation dermatitis (odds ratio 0.32, 95 per cent confidence interval 0.19 to 0.55) and moist desquamation (odds ratio 0.25, 0.12 to 0.52). Washing was associated with better quality of life in one trial, and the review's conclusion is that it \"should be advocated as part of routine skin care during RT\".\n\nDeodorant. A meta-analysis of five randomised trials in breast radiotherapy found that antiperspirant or deodorant use did not change the incidence of grade 1 or worse dermatitis (odds ratio 0.81, 0.54 to 1.21), grade 2 or worse (0.90, 0.65 to 1.25) or grade 3 (0.54, 0.26 to 1.12), nor itching or pain, and concluded that the evidence does not support recommending against it. The same authors note that recommendations on deodorant \"remain highly variable\".\n\nWhy it is an upgrade. Both bans cost the patient something real, especially across three or five weeks of daily treatment in warm weather or at work, and neither protects the skin. Changing the advice sheet is the whole intervention. How many departments still advise against washing or deodorant is not measured by any survey OnCo found.","asOf":"2026-10-20","links":[{"label":"Chan et al., Prevention of radiation dermatitis with skin hygiene and washing: a systematic review and meta-analysis (Supportive Care in Cancer 2023)","url":"https://doi.org/10.1007/s00520-023-07720-8"},{"label":"Salvestrini et al., The effect of antiperspirant and deodorant use on acute radiation dermatitis in breast cancer patients during radiotherapy: a systematic review and meta-analysis (Supportive Care in Cancer 2023)","url":"https://doi.org/10.1007/s00520-023-07657-y"}],"tags":["protocol-upgrade","upgrade:proven-unevenly-used","evidence:moderate","breast"],"related":["idea-pu-five-fraction-breast-default"],"cancers":["breast-cancer","head-and-neck"],"sections":["radiation"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["radiation-dermatitis"],"trials":[],"people":[],"bottlenecks":["b-toxicity-qol","b-knowledge-diffusion"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Replacing restrictions on washing and deodorant in radiotherapy patient information with permission to wash with mild soap and use usual deodorant reduces severe skin reactions and improves patient-reported comfort during breast and other radiotherapy.","rationale":"Pooled randomised trials show benefit from washing and no harm from deodorant; the review authors report that advice still varies.","test":"An audit of patient information leaflets across radiotherapy departments for restrictions on washing and deodorant, followed by an implementation study measuring severe dermatitis and patient-reported skin comfort before and after leaflets are changed.","maturity":"being-tested-at-scale","actor":"clinic","cost":"small","horizonYears":1},"route":"/ideas/idea-pu-washing-and-deodorant-during-radiotherapy/","neighbours":{"idea":[{"id":"idea-pu-five-fraction-breast-default","kind":"idea","name":"One week of breast radiotherapy in five treatments as the default after surgery","route":"/ideas/idea-pu-five-fraction-breast-default/"},{"id":"idea-pu-tattoo-free-set-up","kind":"idea","name":"Radiotherapy set-up without permanent ink tattoos, using surface guidance or invisible ink","route":"/ideas/idea-pu-tattoo-free-set-up/"}],"cancer":[{"id":"breast-cancer","kind":"cancer","name":"Breast cancer (all types)","route":"/cancers/breast-cancer/"},{"id":"head-and-neck","kind":"cancer","name":"Head and neck squamous cell carcinoma","route":"/cancers/head-and-neck/"}],"section":[{"id":"radiation","kind":"section","name":"Radiation Therapy","route":"/fronts/radiation/"}],"term":[{"id":"radiation-dermatitis","kind":"term","name":"Radiation dermatitis (skin reaction)","route":"/terms/radiation-dermatitis/"}],"bottleneck":[{"id":"b-knowledge-diffusion","kind":"bottleneck","name":"Knowledge reaches practice too slowly","route":"/bottlenecks/b-knowledge-diffusion/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}]}}