Non-melanoma skin cancer (NMSC), which includes basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), is the most frequently diagnosed cancer, especially among the Caucasian population. About 5.4 million cases of this type of cancer are diagnosed in the United States annually, and 80% of these cases are basal cell carcinoma. These high records are attributed to early detection of the disease, increased sun exposure, and high survival rates.

In terms of death rates, skin cancer deaths from BCC and SCC have been declining in recent years. Only about 2,000 deaths, mostly involving older adults and people with suppressed immune systems, are recorded each year. These low death rates may be explained by the many treatment options available and their effectiveness.

The available treatment options for NMSC include superficial radiation therapy (SRT), a non-surgical form of skin cancer treatment developed more than 100 years ago. It utilizes low-energy photons or X-rays, in the range of 50-150kVp, which are strong enough to stop mitosis of the rapidly dividing skin cells and avoid the spreading of cancer. This means that superficial radiation therapy machines target only the skin and spare the deeper structures like tissues and organs, hence the name superficial radiation therapy.

Many patients prefer SRT because it can be used on cosmetically sensitive areas like the nose, ears, and eyelids and causes minimal or no scarring, unlike in surgical methods. The procedure is painless, and each treatment session takes about 15 minutes only. Depending on the severity of skin cancer, many sessions might be required for better results. For more information on SRT, check out Skin Cancer Treatment: Superficial Radiation Therapy.

After undergoing superficial radiation therapy, the radiation may leave some acute side effects because, unfortunately, some healthy cells in the treated area may also be affected. Some of the common side effects are:

  • Sore skin on the treated area, which is usually experienced a week after the first treatment session
  • If the treatment is focused on the skin of the nose, mild nosebleeds may occur when you blow your nose. This is because the radiation may affect the nose’s lining. Nosebleed may occur until two weeks after completing all the treatment sessions.
  • If your treatment is close to the lips, the lining of the mouth may become sore or have blisters. This may also be experienced until a couple of weeks after completing the treatment.
  • Hair loss on the treated area (ex. beard, chest hair, eyebrow)

To manage the side effects, the following are some tips you can do during the course of your treatment and after completing it.

Skin care tips during the course of SRT treatment

The skin may react to SRT any time, but usually begins ten days after the first session. Some of the most common skin reactions include skin becoming pinker or darker, skin may feel itchy or sore, and blister and scab formation. From the moment you started SRT until you’ve finished the treatment and your skin starts feeling normal again, you may want to start doing the following:

  • Ignore the lines or pen marks drawn on your skin during the treatment. Trying to remove them by scrubbing will only irritate your skin.
  • Wash the treated skin gently with warm water to remove bacteria from your skin and avoid infection. Don’t use sponges or washcloths but rather your hands to just splash the water on the treated skin.
  • Avoid rubbing or shaving the treated area to avoid irritation.
  • Use a low-pH cleanser if you need to clean the treated area. Again, use your hands instead of washcloths or sponges to avoid skin irritation.
  • Apply moisturizer daily as recommended by your specialist. Doing this helps your skin recover from the treatment more quickly by avoiding dryness.
  • Avoid applying products that contain alcohol on the area being treated (Examples of products include make-up, perfume, hair dye, deodorant, and aftershave.)
  • Avoid applying anything sticky to your skin. This may include medical tapes and bandages. If you need to care for a wound, ask directions from your specialist.
  • Avoid swimming during the course of treatment as it may cause irritation.
  • Avoid getting exposed to direct sunlight as the treated area becomes more sensitive to the sun. If you need to go out, apply sunscreen with a minimum UVB protection or wear a brimmed hat and clothing that covers the treated area. Other devices that emit UV rays like tanning beds and devices must also be avoided.

Aside from these tips, your doctor or radiographer may talk to you about other daily skin care routines. Take note of them and follow them as strictly as you can.

Skin care tips after completing the SRT treatment

After finishing the treatment, some of the side effects may persist for a few weeks. Even months or years later, you may experience long-term side effects, including a paler appearance of the treated area than the surrounding skin, more visible small veins in the treated area, permanent hair loss on the treated area, and increased sun sensitivity.

Continue following the skin care advice during the course of your treatment until the side effects vanish. Post-superficial radiation therapy patients are often advised to continue avoiding sun exposure by applying sunblock on a regular basis. Other useful tips are:

  • Watch out for signs of damage on the treated skin. If you see any rash, redness, or changes, reach out to your oncologist or dermatologist. 
  • Follow up with your dermatologist four weeks after you receive your last treatment. This will help you ensure that the treatment is effective and that there is no evidence of skin cancer anymore. Your dermatologist may also advise you of the specific skin care routines to follow at this point.

While there is a low chance for skin cancer to return following a superficial radiation therapy, its recurrence is more likely if skin care advice is not followed. Therefore, it is important for former skin cancer patients to listen carefully to the recommendations of their oncologists and dermatologists and keep in touch with them.