The trauma to the skin is a result of cellular damage caused by the ionizing radiation. Most patients will experience varying degrees of skin damage during the course of radiation treatment. The skin reactions that may occur will range from mild erythema, through dry, flaky, or scaly skin, to blistering, peeling, and sloughing of the skin. In severe cases, necrosis may be seen. Many patients will have a combination of the above. The skin reactions will usually begin to show within the first two or three weeks of treatment, increasing with the accumulation of the dosage. With some patients, skin reactions will occur immediately. Severe skin sensitivity can be a result of existing conditions such as prior skin damage from sunburns and overall health. If the patient is undergoing chemotherapy at the same time, the skin damage may be more severe.
Treatment of Skin Reactions
Cancer patients undergoing radiation therapy are advised to apply a skin care product to the radiation site to help limit the amount of skin damage that occurs during their treatment. Recommended treatments often suggested after the symptoms appear include:

• Gentle washing and avoidance of friction.
• Use of a emollients and moisturizer when the erythema develops.
• Wearing loose clothing. 
• Avoidance of perfumed products.

Evidence has shown that the first step in skin care during radiation therapy should be to try to prevent the skin breakdown, rather than treat the skin after it is damaged. This can occur by treating the radiation site from the first day of the treatment with standard first aid treatment for burns: cooling the burn to prevent further burn progression and relieving the pain that results from damage to nerve endings.
As an aesthetician treating your client with this condition, look for products developed specifically to cool a radiation burn. The systematic use of cooling the radiation site will help prevent skin damage, including erythema and dry or moist desquamation from occurring in the radiation area. Although this type of product may not be critical to the client’s successful treatment of the cancer, it does provide supportive care that will help the client through a difficult time.