Loading
Some chemotherapy, many targeted and immunotherapy drugs, and radiotherapy make the skin burn more easily; treated skin stays sensitive for years. Stay in the shade at midday, cover up with a wide-brimmed hat and long sleeves, use sunscreen of at least SPF 30 with high UVA protection and reapply it, avoid sunbeds, and ask before putting anything on skin being treated with radiotherapy.
No graded guideline sets out sun protection during anticancer treatment; the advice comes from national patient guidance and general sun-safety guidance. NCI's chemotherapy booklet (2023) says chemotherapy can cause sensitivity to the sun even in people with very dark skin, and advises avoiding direct sun from 10 a.m. to 4 p.m., sunscreen of SPF 15 or higher, lip balm with SPF, covering clothing and no tanning beds, and protecting skin previously treated with radiotherapy from the sun (radiation recall). NCI's radiotherapy booklet (2021) advises daily protection of the treated area, a broad-brimmed hat and long sleeves, sunscreen that the team may suggest at SPF 30 or higher, no tanning beds, protection continuing after treatment ends, and checking with the team before using sunscreen or other products on the treated skin. Macmillan (2023) says many targeted and immunotherapy drugs make skin sun-sensitive and that radiotherapy skin stays sensitive for many years, especially in the first year. The NHS (2026) recommends shade from 11 a.m. to 3 p.m. in the UK from March to October, at least SPF 30 and at least 4-star UVA protection, applied generously and reapplied. The MASCC EGFR inhibitor guideline (2011) includes sunscreen in its preventive rash regimen and recommends avoiding direct sun to prevent dry skin (level III, grade B). The sources differ on the SPF figure (15 in NCI's chemotherapy booklet, 30 in the others).
Why: Some chemotherapy and many targeted and immunotherapy drugs make the skin burn faster, and the team knows which ones.
“Many targeted therapy and immunotherapy drugs can make your skin sensitive to the sun. Your skin may burn more easily than normal. Ask your doctor or nurse whether you need to take special care to protect your skin.”
Macmillan Cancer Support 2023 · Not graded (patient information)
Why: Most of the burning ultraviolet light reaches the ground in the middle of the day.
“Spend time in the shade when the sun is strongest. In the UK, this is between 11am and 3pm from March to October.”
NHS 2026 · Not graded (public health guidance)
Why: Clothing protects more reliably than sunscreen, which is often applied too thinly.
“Wear a broad-brimmed hat, long-sleeved shirt, and long pants when you are outside.”
National Cancer Institute (US) 2021 · Not graded (patient booklet)
Why: Most people put on too little sunscreen, and it wears off with water, sweat and time.
“use at least factor 30 sunscreen – make sure to use enough and re-apply frequently”
NHS 2026 · Not graded (public health guidance)
Why: Some products on the treated area can increase the skin reaction or interfere with treatment.
“Check with your doctor or nurse before using any of the following skin products:”
National Cancer Institute (US) 2021 · Not graded (patient booklet)
Why: Treated skin stays sensitive for years and has a higher risk of burning and of later skin cancer.
“The skin in the area treated by radiotherapy stays sensitive for many years. You need to take extra care to protect it from the sun, especially for the first year.”
Macmillan Cancer Support 2023 · Not graded (patient information)
Why: Some drugs can bring back a skin reaction in an area treated before (radiation recall), and sun makes it worse.
“Protect the area of your skin that received radiation therapy from the sun.”
National Cancer Institute (US) 2023 · Not graded (patient booklet)
Why: Sunbeds give the same harmful ultraviolet light as the sun.
“Do not use tanning beds. Tanning beds expose you to the same harmful effects as the sun.”
National Cancer Institute (US) 2021 · Not graded (patient booklet)
How care is usually carried out, read from the guidelines and standards cited. Your own team's protocol and their judgement come first; this page is for understanding it, not for doing it yourself.
No graded guideline exists for sun protection during anticancer treatment. The best available version combines the NHS sun-safety guidance (2026: shade at midday, covering clothing, at least SPF 30 and 4-star UVA, generous application and reapplication) with the cancer-specific points that NCI (2021, 2023) and Macmillan (2023) agree on: ask whether the treatment is photosensitising, protect radiotherapy skin daily during and for years after treatment, check with the team before using products on skin under treatment, protect previously irradiated skin during chemotherapy, and avoid sunbeds. The sources disagree on the sunscreen figure: NCI's chemotherapy booklet says SPF 15 or higher; its radiotherapy booklet, the NHS and Macmillan say 30 or higher.
NHS 2026 · National Cancer Institute (US) 2021 · National Cancer Institute (US) 2023 · Macmillan Cancer Support 2023
Where it differs: Gives SPF 15 or higher, or a zinc oxide sunblock, and avoids direct sun from 10 a.m. to 4 p.m.
Evidence: Patient booklet, not graded: 'Use sunscreen lotion with an SPF (skin protection factor) of 15 or higher.' The NHS, Macmillan and NCI's own radiotherapy booklet give 30.
Where it differs: Sunscreen is applied twice daily with hydrocortisone 1% and moisturiser as part of preventive treatment in the first 6 weeks of an EGFR inhibitor; sunscreen alone is listed as not recommended for preventing the rash.
Evidence: MASCC 2011 Table 3: topical regimen level II, grade C; avoiding direct sun to prevent dry skin level III, grade B.
MASCC Skin Toxicity Study Group (Supportive Care in Cancer) 2011
Where it differs: Adds that some people's skin becomes sensitive to chlorine during chemotherapy and that hot tubs and saunas are best avoided.
Evidence: Patient information, not graded.
| Recommendation | Grade, as printed | Source |
|---|---|---|
| All sun protection steps | Not graded: patient booklets and public health guidance, without a grading scheme | NHS 2026 |
| Avoid extreme temperatures and direct sunlight to prevent dry skin on EGFR inhibitors | Level III, grade B (MASCC Table 8) | MASCC Skin Toxicity Study Group (Supportive Care in Cancer) 2011 |
| Chemotherapy can cause sun sensitivity even in very dark skin “This problem can happen even to people who have very dark skin color.” | Not graded (patient booklet) | National Cancer Institute (US) 2023 |
| Protection of radiotherapy skin continues after treatment ends “You will need to protect your skin from the sun even after radiation therapy is over.” | Not graded (patient booklet) | National Cancer Institute (US) 2021 |