• Radiation therapy is a common treatment for breast cancer, but it often causes a skin problem called radiation dermatitis. This condition can make the skin red, itchy, dry, or even peel and hurt. It affects most patients and can lower their quality of life and even cause delays in treatment (Sherman & Walsh, 2022). The problem is that there is no standard way for nurses or doctors to take care of the skin during radiation. Some places use creams, others use dressings, and some don’t use anything at all. Because there isn’t one clear solution, many patients still suffer from painful skin reactions (Liu et al., 2024). This project focuses on finding the best skin care routine to help prevent radiation dermatitis and keep patients more comfortable during their cancer treatment.

Problem:

• Radiation-related skin damage can range from mild irritation to severe blistering, leading to discomfort, treatment interruptions, and emotional distress.

Situation:

• Breast cancer patients receiving radiation therapy are directly affected. This condition can cause physical pain, emotional stress, and even delays in their cancer treatment if the skin gets too damaged (Liu et al., 2024).

Who is directly affected:

• How: Radiation damages healthy skin cells while killing cancer cells, which causes the skin reaction.

• Where: It happens in the area of the body being treated often the chest for breast cancer patients.

• When: It usually starts within the first few weeks of radiation treatment and can get worse over time.

• Why: There is no standard skin care routine used by all hospitals or clinics to prevent this condition, so patients are left with mixed or ineffective treatments (Liu et al., 2024).

• A study by Chen et al. (2024) found that when nurses use a structured skin care plan, patients are more likely to have fewer skin problems. The nurses gave patients helpful skin care tips and used special creams to protect the skin, which really made a difference.

• Sherman & Walsh (2022) reviewed many studies and found that moisturizing lotions, gentle skin cleaning, and early nurse intervention helped lower the chances of skin breakdown. They emphasized that nurses need proper training and supplies to do this well.

• Nurse Education and Role: Nurses are in a pivotal position to provide education and monitor patients throughout their treatment. Research by Forde (2025) demonstrates that when nurses educate patients on how to apply skin care products and recognize early signs of damage, patients report less severe reactions and higher satisfaction with their care.

The literature shows that when nurses are trained and involved, radiation skin damage can be greatly reduced. However, there are still gaps in education and practice, which is why it’s so important to improve nurse participation and support.

• Nurses monitor the patient's skin for signs of radiation dermatitis, such as redness, dryness, or irritation.

• Nurses educate patients on skin care techniques during radiation therapy like using moisturizers or avoiding certain fabrics.

• Nurses report skin changes to the healthcare team and adjust the care plan if necessary (Chen et al., 2024).

What nurses are not doing:

• Nurses may not always follow evidence-based practices due to lack of training or access to resources.

• There is no uniform standard for the skin care methods used by nurses, and this can lead to inconsistent care (Liu et al., 2024).

• Some nurses may not be aware of the latest research on the most effective skin care products.

How is this improving or exacerbating the issue:

• Lack of consistency in skin care is exacerbating the problem.

• Patients may not receive the best care or advice, leading to more severe skin reactions.

• Inconsistent care can delay cancer treatment or cause discomfort (Sherman & Walsh, 2022).

Nurse involvement is very important when it comes to preventing radiation dermatitis in breast cancer patients. Nurses are often the first to notice skin damage from radiation and play a key role in teaching patients how to care for their skin, such as using proper lotions and avoiding irritants (Forde et al., 2025).

When nurses provide this education, patients are more likely to follow the skin care routine, preventing further damage (Chen et al., 2024). Regular skin checks by nurses ensure early intervention, allowing for adjustments to the care plan if necessary.

Overall, nurses help patients stay comfortable, heal faster, and continue their cancer treatment without delays.

How would the nurse be able to help:

• Nurses can implement evidence-based skin care regimens to prevent or reduce radiation dermatitis.

• Recommend effective moisturizers and creams.

• Teach patients how to protect their skin at home.

• Monitor the skin regularly and report issues early to the healthcare team.

How will the nurse’s involvement help resolve or improve the issue?

• Improved skin care will reduce the severity of radiation dermatitis, making patients more comfortable.

• Nurses can help prevent delays in treatment by managing skin care more effectively.

• Better skin care can improve overall patient outcomes by making the treatment process smoother and less painful (Chen et al., 2024).

• Not Enough Time: Nurses are often very busy, taking care of many patients at once. This can make it hard for them to spend time teaching each patient how to care for their skin (Forde et al., 2025).

• Lack of Training: Some nurses may not have been taught the latest ways to prevent skin problems caused by radiation (Chen et al., 2024). Without training, they might not feel confident giving advice.

• Not Enough Supplies: Sometimes, hospitals don’t have the right creams, dressings, or resources nurses need to treat the skin properly (Sherman & Walsh, 2022).

Why Might Nurses Not Be Involved?

• Ethical Concerns: Nurses want to give the best care, but if they don’t feel confident or prepared, they may worry about giving the wrong advice (Forde et al., 2025).

• Legal Risks: If a nurse gives skin care instructions that aren’t approved or documented by the hospital, they could get in trouble legally if something goes wrong (Chen et al., 2024).

• Money Issues: Some hospitals may not invest in the best skin care supplies or extra training because of budget limits (Sherman & Walsh, 2022).

• Social Pressure: Nurses might not feel supported by their team or leadership, especially if others don’t see skin care as a priority (Forde et al., 2025).

• This means helping people stay healthy and stop problems before they start.

• I learned that nurses don’t just treat illness, we also work to prevent it from getting worse.

• In my project on radiation dermatitis, I saw how nurses can help protect a patient’s skin before it gets damaged from radiation.

• Using creams and teaching good skin care helps keep patients more comfortable and avoids treatment delays (Chen et al., 2024).

• This idea taught me to plan ahead and take action early, a skill that leaders use every day.

Patient-Centered Care

• This means putting the patient first in every decision.

• I learned how important it is to listen to the patient, respect their choices, and involve them in their care.

• In my project, this looked like helping each patient find the skin care routine that works best for them, not a one size fits all approach (Sherman & Walsh, 2022).

• When patients feel heard and supported, they’re more likely to follow the plan and have better results.

• This concept showed me how to be a kind, respectful, and thoughtful nurse, which is what strong leaders do.

• American Cancer Society. (2023, February 13). External Beam Radiation | Types of External Radiation Therapy. www.cancer.org. https://www.cancer.org/cancer/managing-cancer/treatment-types/radiation/external-beam-radiation-therapy.html

  
  

• Chen, X., Li, X., Wang, Z., Zheng, R., Zhang, F., Zhao, J., Liu, H., & Luo, H. (2024). Evidence-based summary of the prevention and management of radiodermatitis in patients with breast cancer. Asia-Pacific Journal of Oncology Nursing, 11(9), 100556–100556. https://doi.org/10.1016/j.apjon.2024.100556

  
  

• Forde, E., Van, Buijs, M., Cardone, A., Daly, J., Franco, P., Naman Julka-Anderson, Lechner, W., Marignol, L., Giulia Marvaso, Nisbet, H., O’Donovan, A., Russell, N. S., & Scherer, P. (2025). Practical recommendations for the management of radiodermatitis: on behalf of the ESTRO RTT committee. Radiation Oncology, 20(1). https://doi.org/10.1186/s13014-025-02624-9

  
  

• Liu, W., Wang, L., Meng, D., Hong, C., Zhang, Q., & Yang, J. (2024). Effectiveness of topical corticosteroids on the prevention of acute radiation dermatitis in patients with breast cancer: An updated systematic review and meta-analysis. Asia-Pacific Journal of Oncology Nursing, 11(9), 100553–100553. https://doi.org/10.1016/j.apjon.2024.100553

  
  

• Sherman, D. W., & Walsh, S. M. (2022). Promoting Comfort: A Clinician Guide and Evidence-Based Skin Care Plan in the Prevention and Management of Radiation Dermatitis for Patients with Breast Cancer. Healthcare, 10(8), 1496. https://doi.org/10.3390/healthcare10081496

• Why it’s important: Nurses can only provide the best care if they are educated about the latest research on radiation dermatitis and evidence-based skin care regimens.

• Recommendation: Hospitals should implement regular training programs or workshops focused on radiation dermatitis prevention and treatment. This will ensure nurses are up to date on the most effective skin care practices and products.

• How this helps: Nurses will feel more confident in their ability to educate patients, leading to better patient outcomes and less severe skin reactions (Sherman & Walsh, 2022).

2) Increase Access to Resources and Skin Care Products

• Why it’s important: Nurses can only provide the best care if they have access to the right tools and products.

• Recommendation: Ensure hospitals provide funding for the best skin care products and materials, such as high-quality moisturizers and special dressings for radiation dermatitis.

• How this helps: With access to better products, nurses can offer better prevention and treatment, which will reduce the severity of radiation dermatitis and improve patient quality of life (Liu et al., 2024).

3) Standardize Skin Care Plans for Nurses to Follow

• Why it matters: If every nurse does something different, patients might not get the best care.

• What to do: Create one clear plan that all nurses can follow with approved lotions, creams, and steps to take care of the skin.

• How it helps: When everyone follows the same routine, patients feel more comfortable, heal better, and get the same quality care no matter who helps them (Zhao et al., 2020).