What Are the Effects of Radiation Therapy on Skin?

Skin radiation damage caused by direct ionizing radiation is called skin radiation damage
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Skin radiation damage caused by direct ionizing radiation is called skin radiation damage

Chinese name

Skin radiation damage

Foreign name

radiation injury of skin

Skin radioactive injuries are the most common in radiological accidents and radiotherapy. Radiation falling on the surface of gray body can also cause skin burns. The degree of skin damage is closely related to the energy and penetration of the rays. Alpha particles are almost completely absorbed by the epidermis, so it is easy to protect, except for certain occasions in medical applications, it is not easy to cause skin damage; particles can reach the dermis to cause damage; low-energy X-rays (<20kVp) only damage the epidermis; harder X Radiation can injure the subcutaneous skin, and the performance is slightly heavier; -ray damage often causes deep tissue damage and is prone to severe sequelae.

Divided into two categories according to radiation dose (low LET radiation) and clinical manifestations.

1. Acute skin radiation injury

   It is caused by a large dose or multiple exposures in a short period of time.

   (1) once

   Epilation reaction occurs when the skin absorbs more than 3Gy (300rad). It usually starts 2 weeks after the photo and regenerates in about two months. When exposed to 6-8Gy (600-800rad), the hair follicles completely shrink and never regenerate.

   (2) Second degree

   The erythema reaction occurs when the average absorbed dose reaches 5.5Gy (550rad). The initial erythema appeared a few minutes after exposure and subsided after several hours to several days. Real erythema occurred after 8-10 days: the skin was tan, local edema, and itching, burning and pigmentation.

   (3) Third degree

   Vesicular reaction occurs at a dose of 8.5 Gy (850 rad). Blisters appear in the erythema and the surrounding pigmentation occurs. Erosive surfaces are formed after the blister breaks, with systemic symptoms such as elevated body temperature.

2. Chronic skin radiation damage

   Most of them occur in people who have been exposed to radioactive sources for a long time and do not pay attention to protection; or acute skin radiation injuries have become chronic over time.

   (1) Chronic radiation dermatitis: Early rise of the skin is dry, rough, chapped, nail crusts, thickened deck, late formation of warts or superficial capillary dilatation of the skin, hypopigmentation, etc.

   (2) Late radiation ulcer usually occurs on the skin with hyperpigmentation, scarring, or atrophy. Once the ulcer is broken, the wound is difficult to heal, often accompanied by dysfunction.

   (3) Radiation cancer of skin Some long-term unhealed skin radiation damage can be secondary to skin cancer. The incubation period is 20-25a, which is not easy to transfer. Mostly squamous cell carcinoma or basal cell carcinoma.

   The treatment principle of skin radiation injury is basically similar to general burn or corresponding injury. ^[1]