Two weeks after radiation treatment starts, you might notice changes in your skin. Most of these symptoms go away after your treatments have stopped. These changes can be made worse by certain chemotherapies.

• Your skin and mouth may turn red.
• Your skin might start to peel or get dark.
• Your skin may itch.

The hair on your head and possibly your eyebrows may begin to fall out about 2 weeks after radiation treatment starts. It may not grow back. Sometimes if your hair does regrow, it may be different than before.

When you have radiation treatment, color markings are drawn on your skin. Do not remove them. These show where to aim the radiation. If they come off, do not redraw them. Tell your provider instead.

To care for your hair:

• For the first 2 weeks of treatment, wash your hair once a week with a gentle shampoo, such as a baby shampoo.
• After 2 weeks, use only warm water on your hair and scalp, without shampoo.
• Dry gently with a towel.
• Do not use a hair dryer.

If you wear a wig or toupee:

• Be sure the lining does not bother your scalp.
• Wear it only a few hours a day during the time you are getting radiation treatments and right after treatment has ended.
• Ask your provider when you can start to wear it more.

To care for your skin in the treatment area:

• Wash the treatment area gently with lukewarm water only. Don't scrub your skin.
• Don't use strong scented soaps.
• Pat dry instead of rubbing dry.
• Don't use lotions, ointments, makeup, perfumed powders, or other perfumed products on this area. Ask your provider what is OK to use.
• Keep the area being treated out of direct sunlight. Wear a hat or scarf. Ask your provider if you should use sunscreen.
• Don't scratch or rub your skin.
• Ask your provider for medicine if your scalp gets very dry and flaky, or if it gets red or tanned.
• Tell your provider if you have any breaks or openings in your skin.
• Don't put heating pads or ice bags on the treatment area.

Keep the treatment area in the open air as much as possible. But stay away from very hot or cold temperatures.

Don't swim during treatment. Ask your provider when you can start swimming after treatment.

You need to eat enough protein and calories to keep your weight and strength up. Ask your provider about liquid food supplements that may help you get enough calories.

Avoid sugary snacks and drinks that may cause tooth decay.

You will likely feel tired after a few days. If so:

• Don't try to do too much. You probably will not be able to do everything you are used to.
• Get more sleep at night. Rest during the day when you can.
• Take a few weeks off work, or work less.

You may be taking a medicine called dexamethasone (Decadron) while you are getting radiation to the brain.

• It may make you hungrier, cause leg swelling or cramps, cause problems sleeping (insomnia), or cause changes in your mood.
• These side effects will go away after you start taking less of the medicine, or when you stop taking it.

Your provider may check your blood counts regularly.

Radiation - brain - discharge; Cancer - brain radiation; Lymphoma - brain radiation; Leukemia - brain radiation; CNS radiation; Cranial radiation

American Cancer Society website. Radiation therapy side effects. www.cancer.org/cancer/managing-cancer/treatment-types/radiation/effects-on-different-parts-of-body.html. Updated December 10, 2020. Accessed June 3, 2024.

Doroshow JH. Approach to the patient with cancer. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 164.

National Cancer Institute website. Adult central nervous system tumors treatment (PDQ) health professional version. www.cancer.gov/types/brain/hp/adult-brain-treatment-pdq. Updated January 5, 2024. Accessed June 3, 2024.

National Cancer Institute website. Radiation therapy and you: support for people with cancer. www.cancer.gov/publications/patient-education/radiation-therapy-and-you.pdf. Updated April 2021. Accessed June 3, 2024.

Updated by: David Herold, MD, Radiation Oncologist in Jupiter, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.