The Things They Put on Their Skin

When patients start their radiation therapy, one of the side effects that we tell them to look for is a skin reaction.  Depending on the area of the body treated, and the dose given, the skin reaction at the end of treatment ranges anywhere from a mild sunburned look all the way to what we call moist desquamation, where the skin literally sloughs off, yet ultimately heals without even a scar. My nurse spends a great deal of time educating patients about taking care of their skin.  The instructions are simple—do not get a sunburn on irradiated skin (breast and prostate cancer patients take note:  NO NUDE SUNBATHING!), do not use perfumes or deodorants on irradiated skin, do not use harsh soaps or detergents, and DO use a fragrance free product that helps the skin retain moisture.  The two tried and true products which have been on the market for over thirty years are Aquaphor ointment, and Eucerin cream (which, for the record, is just Aquaphor whipped like egg whites turning into meringue!)  When I was a resident, we had giant vats of the stuff stored in a back room and when a patient would start his treatment, my job was to go and get a sterile urine cup, and a sterile tongue depressor and scoop the ointment or cream out with the tongue depressor, fill the cup, put the top on and voila,  hand it to the patient. Simple, and very cheap.

It seems that there is now a cottage industry which provides skin care products for radiation therapy patients.  Many of the concoctions are “all natural” and as a result, some are very expensive.   A few are made by the big pharmaceutical companies and tout ingredients with chemical names that only a terrorist would recognize. One of the “natural” creams made locally contains aloe, lavender and calendula—it was light, smoothed on well, and was very popular with me and my patients until it came to my attention that it was made and marketed by a competing radiation oncology group. This seemed a bit devious and self-serving to me—make money off treating the cancer, then make more money off of selling skin care products.  I dropped it from our “line up” and went back to the old tried and true.

Despite getting very explicit written instructions at the beginning of treatment along with a few samples, I am always completely astounded by the variety of unprescribed substances that patients find themselves compelled to put on their skin.  Just in the last few months, I’ve had grown men who fought in wars extolling the virtues of jojoba oil, coconut oil, crisco and almond butter.  It makes me wonder if the discovery of the healing properties of these substances was actually a by-product of a different sort of usage!  And the women too get into the act—women who think nothing of spending four hundred dollars for a small vial of a wrinkle cream waltz in and tell me that they used rubbing alcohol on their skin reaction, or betadine, not to mention products from their spice rack including turmeric and cayenne pepper.  And these are the things they will admit to!

Let me tell you two little secrets.  First, there is NOTHING that will prevent a radiation skin reaction.  So don’t waste a lot of money trying.  And second, no matter how bad it gets, it will heal quickly.  Without a scar.  So use your Aquaphor, and please, try not to scratch!