Skin dose is often the quantity of interest for radiological protection, as the skin is the organ that receives maximum dose during kilovoltage X-ray irradiations. The purpose of this study was to simulate the energy response and the depth dose water equivalence of the MOSkin radiation detector (Centre for Medical Radiation Physics (CMRP), University of Wollongong, Australia), a MOSFET-based radiation sensor with a novel packaging design, at clinical kilovoltage photon energies typically used for superficial/orthovoltage therapy and X-ray CT imaging. Monte Carlo simulations by means of the Geant4 toolkit were employed to investigate the energy response of the CMRP MOSkin dosimeter on the surface of the phantom, and at various depths ranging from 0 to 6 cm in a 30 × 30 × 20 cm water phantom. By varying the thickness of the tissue-equivalent packaging, and by adding thin metallic foils to the existing design, the dose enhancement effect of the MOSkin dosimeter at low photon energies was successfully quantified. For a 5 mm diameter photon source, it was found that the MOSkin was water equivalent to within 3% at shallow depths less than 15 mm. It is recommended that for depths larger than 15 mm, the appropriate depth dose water equivalent correction factors be applied to the MOSkin at the relevant depths if this detector is to be used for depth dose assessments. This study has shown that the Geant4 Monte Carlo toolkit is useful for characterising the surface energy response and depth dose behaviour of the MOSkin.