As radiotherapy continues, the stem cells in the basal layer are affected, impairing their ability to produce enough new cells to replace those that have been damaged . This results in sloughing of the epidermis and leakage of serous fluid and a skin reaction that appears blistered, moist and oedematous . The area affected can be partial or widespread and can
feel painful, tender and sensitive . Trueman (2013) describes how the exudate produced in moist desquamation can have beneficial properties as it helps towards a moist wound-healing environment and bathes nerve endings in the area affected, decreasing discomfort. As a consequence, Trueman (2013) proposes that routine cleansing of the skin reaction to remove exudate is not advised unless excessive and there is risk of maceration of the surrounding skin. Moist desquamation can appear at doses above 4000cGy.