Objective To systematically explore the needs and challenges experienced by patients with head and neck cancer in mana-ging their skin throughout the radiotherapy trajectory using patient journey mapping, and to provide a basis for the development of stage-specific nursing interventions. Methods A descriptive qualitative study was conducted.Semi-structured interviews were conducted with 15 patients with head and neck cancer undergoing radiotherapy.The interview data were coded and categorized into themes using directed content analysis, and a patient journey map of skin management was developed. Results Based on the radiotherapy process, the patients′ skin-management journey was divided into three stages:radiotherapy preparation, radiotherapy delivery, and post-radiotherapy recovery and follow-up.A total of 27 themes were identified across three dimensions (behaviors, challenges, and needs) and incorporated into a patient journey map of skin management for patients with head and neck cancer undergoing radiotherapy. Conclusion The skin-management needs of patients with head and neck cancer evolve dynamically across the different stages of radiotherapy and are context-dependent.Patient journey mapping can be used to develop a stage-specific and context-sensitive continuity-of-care model, thereby enhancing patients′ self-management capacity and improving skin health outcomes.