Promoting tissue viability and caring for skin damaged as a result of radiotherapy are critical to the quality of care patients receive. However, few nurses recognise fully the effect of radiotherapy on tissue viability and wound healing. This article considers the causes and types of skin damage resulting from radiotherapy treatment that nurses may encounter, and how this damage can be graded. Based on the extent of skin reaction to radiotherapy, management options are explored, illustrated by a case study. A guide to product selection, derived from the authors’ experience, is presented.