bras (for women receiving breast RT) is recommended during RT.7,25 The use of electric shavers for hair removal, waxing, or other depilatory pre-shave and after-shave products are generally not recommended during RT if these regions are within the treatment field.7,25 Breast cancer patients are asked to avoid shaving the axilla with straight-edge razors and are reassured that they may continue to use aluminum-based antiperspirants or deodorants during RT7,11,31,32 Printed or online information sources may be provided to supplement these teaching points (Appendix 1).7,25
Cleansing and Skincare
Recommendations on OTC cleansers and moisturizers collated from various cancer treatment guidelines and consensus papers are outlined, although OTC skincare products used during RT are not supported by evidence (Appendix 2).7-14,19,23,26-30,34-40 Rosenthal and colleagues recommended a treatment algorithm for RD that included basic hygiene measures using a mild cleanser and lukewarm water.8 The USCOM I algorithm recommended a daily skincare regime focusing on hygiene, moisturization, sun protection, and if desired, camouflage products.7 The panelists recommended keeping skin moisturized during RT to minimize pruritus and xerosis.7 The OTC skincare should be safe, effective, free of additives, fragrances, perfumes, and sensitizing agents, and should have a near physiologic (4-6.5) skin surface pH.7 To support adherence to skin care, healthcare providers should encourage products that patients find affordable, cosmetically pleasing, and easy to use.7
Studies have analyzed the benefits of skincare products for the prevention and treatment of RD (Table 2).8,14,33-64 A systematic review8 of topical agents for the treatment of RD reported benefits or potential benefits when using formulations containing hyaluronic acid,30,35,41,55 epidermal growth factor (EGF),8,46,52 granulocyte-macrophage colony-stimulating factor (GM-CSF), topical corticosteroids (TCS),58-63 or statins.65
