Side effects from radiation therapy to the brain and skull

During radiation therapy to the brain and skull, you may experience different short-term side effects.

What are the possible short-term side effects?

Radiation therapy to the brain and skull may cause a number of short-term side effects. However, everyone is different and you’re unlikely to experience all of the same side effects as someone who is receiving the same treatment as you.

If you’re concerned about any side effects during your radiation therapy treatment to the brain and skull, we encourage you to speak with your care team who can help you with strategies to manage your side effects.

Types of short-term side effects

Skin reaction

Two to three weeks after your treatment begins, your skin and scalp may become red, dry and tender. This reaction can last the remainder of your treatment, and usually returns to normal four weeks after treatment finishes. It may become more intense towards the end of treatment and continue to increase for up to two weeks after treatment finishes.

Your nurses will show you how to care for your skin and manage any skin reactions. Tell your nurse if you’re worried about a skin reaction or are experiencing any skin changes.


You may feel tired or lack energy for daily activities during your treatment. You may feel increasingly tired as you reach the end of your treatment. This is a common reaction to radiation therapy and each person is usually affected to varying degrees. Fatigue usually eases a few weeks after treatment finishes. Finding a balance between rest and activity will help you manage daily life.

Pain flare

Radiation therapy to bone areas in the skull can cause a temporary increase in pain in the area being treated. It can occur after one dose of radiation and usually lasts for 12 to 36 hours. Let us know as soon as possible if you experience a pain flare, as we can control this with the use of additional pain medication.

Hair loss

Radiation therapy to the head may cause the hair in the treatment area to fall out, usually a few weeks after treatment begins. Hair will usually regrow within three to six months. The colour or texture may be different, and it may grow back thinner or patchy.

Occasionally, hair loss can be permanent if you have a high dose of radiation therapy. Your doctor will discuss this with you before you start your treatment.

We understand that hair loss can be upsetting. Please talk to us if you find losing your hair difficult to cope with. Our nursing team can discuss options to help you manage your hair loss, including headwear and wigs if required.

Please see your nursing team if you experience any of the below symptoms:


Headaches may occur during your radiation therapy treatment, or increase in intensity if you already experience them.

Nausea and vomiting

These are less common, but still may occur, especially if the treatment is directed at an area close to the back of the brain that controls nausea and vomiting.

Neurological disturbances

These are rare side effects and include limb weakness, walking/balance changes, seizures and visual disturbances.

How can I manage skin changes?

Washing and styling your hair

Avoid frequently shampooing your hair. You may wash your hair with warm water and a mild, non-perfumed shampoo. Let hair dry naturally. Avoid hair dryers, curling irons and straighteners.

Continue this for two weeks after completing treatment or until there are no signs of irritation. Avoid using hairsprays, gels or styling products.

Cosmetics and perfumes

Do not use cosmetics, perfumes or other lotions on your head once you begin radiation therapy. These products can increase the skin irritation caused by radiation.


Avoid wet shaving with a razor blade, as this may further irritate your skin in the area being treated. We recommend that you either avoid shaving or use an electric shaver instead.

Hair colours and perms

Do not colour or perm your hair until four weeks after your treatment is complete.

Protect your head in the sun

Wear a wide brimmed soft hat at all times when outdoors. Avoid applying sunscreen to the treatment area.

Moisturise twice a day

Your care team will recommend a cream to help manage any skin changes. At the start of your treatment, apply cream to the area being treated twice a day. As treatment progresses, you may need to apply the cream three to four times per day. Do not apply cream within the hour prior to your treatment, as cream needs to be well absorbed. Let your nursing team know if you continue to experience skin changes.

Avoid excessive temperatures

Avoid exposing the treatment area to excessive temperatures, such as direct sunlight, heat packs, ice packs, saunas or hot spas.


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