Radiation Dermatitis Explained: How X‑Rays Damage Skin and What to Do

This episode reviews radiation dermatitis — its history, how ionizing radiation creates free radicals and double‑strand DNA breaks, and which skin cells are damaged (basal stem cells, keratinocytes, endothelial cells, fibroblasts, lymphatics), leading to microvascular loss, fibrosis, and impaired healing. Learn how radiation wounds present (geometric borders, fibrosis, poor bleeding, delayed healing), the typical timelines from acute to chronic changes, and why patients with diabetes are at much higher risk for chronic ulcers and complications. Practical steps covered include gentle wound care and moisture balance, topical antimicrobials, hyperbaric oxygen for selected cases, avoiding aggressive early debridement, and when surgical reconstruction is indicated; plus prevention tips like skin moisturization, avoiding friction, and early wound surveillance.