Radiotherapy is a widely used cancer treatment that can be used for curative and palliative intent. While it is effective, it can also result in side effects, including skin reactions. The type and severity of skin reaction experienced are influenced by intrinsic and extrinsic factors, and include erythema, dry desquamation and moist desquamation. These can make a significant impact on patients’ wellbeing as they have physical, psychological and social consequences. Accurate and structured skin assessment throughout treatment is needed to monitor reactions, evaluate interventions and plan care. Many patients have fears about the use of radiation as a treatment along with concerns about its potential side effects, including skin reactions. The provision of accurate patient information can help allay anxiety and improve their ability to cope with the challenges of treatment.