Prevention and Treatment of Acute Radiation Dermatitis: A Literature Review

Mihkaila Maurine Wickline

ONF 2004, 31(2), 237-247. DOI: 10.1188/04.ONF.237-247

Purpose/Objectives: To review historical and current research data on prevention and treatment of acute radiation dermatitis.

Data Sources: 18 research trials and 1 case report published from 1967-2001 and 1 unpublished research trial from 1972.

Data Synthesis: Washing the skin with mild soap and water and the hair with mild shampoo is safe during radiation therapy. Biafine® (Medix Pharmaceuticals, Inc., Largo, FL), chamomile cream, almond ointment, topical vitamin C, and gentian violet have not been proven effective and should not be used. Transparent, hydrocolloid, and hydrogel dressings have been beneficial, as have sucralfate cream and corticosteroid cream. Aloe vera may be beneficial and is not harmful.

Conclusions: The existing scientific data are lacking in quantity and quality. The current body of evidence is unable to provide clinicians with comprehensive guidelines for prevention and management of acute radiation dermatitis.

Implications for Nursing: Nurse clinicians and nurse scientists must partner to conduct further research to add to the limited resources about the prevention and management of acute radiation dermatitis and develop comprehensive evidence-based clinical practice guidelines.

Jump to a section


    Banati, A., Chowdhury, S., & Mazumder, S. (2001). Topical use of sucralfate cream in second and third degree burns. Burns, 27, 465-469.

    Bjornberg, A., Hellgren, L., Magnusson, B., Mattsson, I., & Rosengren, B. (1967). Topical treatment of radiation dermatitis with bethamethasone-17-valerate, Vaseline and Eucerine—A double-blind comparison. Clinical Radiology, 18, 463-464.

    Blackmar, A. (1997). Radiation-induced skin alterations. Medsurg Nursing, 6, 172-175.

    Boot-Vickers, M., & Eaton, K. (1999). Skin care for patients receiving radiotherapy. Professional Nurse, 14, 706-708.

    Bostrom, A., Lindman, H., Swartling, C., Berne, B., & Bergh, J. (2001). Potent corticosteroid cream (mometasone furoate) significantly reduces acute radiation dermatitis: Results from a double-blind, randomized study. Radiotherapy and Oncology, 59, 257-265.

    Bruner, D.W., Bucholtz, J.D., Iwamoto, R., & Strohl, R. (Eds.). (1998). Manual for radiation oncology nursing practice and education. Pittsburgh, PA: Oncology Nursing Society.

    Delaney, G., Fisher, R., Hook, C., & Barton, M. (1997). Sucralfate cream in the management of moist desquamation during radiotherapy. Australasian Radiology, 41, 270-275.

    Fenig, E., Brenner, B., Katz, A., Sulkes, J., Lapidot, M., Schachter, J., et al. (2001). Topical Biafine and lipiderm for the prevention of radiation dermatitis: A randomized prospective trial. Oncology Reports, 8, 305-309.

    Fisher, J., Scott, C., Stevens, R., Marconi, B., Champion, L., Freedman, G., et al. (2000). Randomized phase III study comparing best supportive care to Biafine as a prophylactic agent for radiation-induced skin toxicity for women undergoing breast irradiation: Radiation Therapy Oncology Group (RTOG) 97-13. International Journal of Radiation Oncology, Biology, Physics, 48, 1307-1310.

    Glees, J., Mameghan-Zadeh, H., & Sparkes, C. (1979). Effectiveness of topical steroids in the control of radiation dermatitis: A randomized trial using 1% hydrocortisone cream and 0.05% clobetasone butyrate (Eumovate). Clinical Radiology, 30, 397-403.

    Goldberg, M.T., & McGynn-Byer, P. (2000). Oncology-related skin damage. In R.A. Bryant (Ed.), Acute and chronic wounds: Nursing management (2nd ed., pp. 367-386). St. Louis, MO: Mosby.

    Halperin, E., Gaspar, L., George, S., Darr, D., & Pinnell, S. (1993). A doubleblind, randomized, prospective trial to evaluate topical vitamin C solution for the prevention of radiation dermatitis. CNS Cancer Consortium. International Journal of Radiation Oncology, Biology, Physics, 26, 413-416.

    Hazuka, M.B., Goebel, R.H., McCutcham, S., Sousa, K., & Greff, R.F. (1997). A new approach to the prevention of radiation-induced skin desquamation using a polymer adhesive skin sealant (PASS): Final results of a prospective study [Abstract 239]. Retrieved January 20, 2004, from,1003,_12-002490-00_18-001997-00_19-0011064,00.asp

    Hom, D., Adams, G., Koreis, M., & Maisel, R. (1999). Choosing the optimal wound dressing for irradiated soft tissue wounds. Otolaryngology and Head and Neck Surgery, 121, 591-598.

    Maiche, A., Grohn, P., & Maki-Hokkonen, H. (1991). Effect of chamomile cream and almond ointment on acute radiation skin reaction. Acta Oncologica, 30, 395-396.

    Maiche, A., Isokangas, O., & Grohn, P. (1994). Skin protection by sucralfate cream during electron beam therapy. Acta Oncologica, 33, 201-203.

    Mak, S., Molassiotis, A., Wan, W., Lee, I., & Chan, E. (2000). The effects of hydrocolloid dressing and gentian violet on radiation-induced moist desquamation wound healing. Cancer Nursing, 23, 220-229.

    Margolin, S., Breneman, J., Denman, D., LaChapelle, P., Weckbach, L., & Aron, B. (1990). Management of radiation-induced moist skin desquamation using hydrocolloid dressing. Cancer Nursing, 13, 71-80.

    Murakami, R., Baba, Y., Nishimura, R., Furusawa, M., Yokoyama, T., Yamashita, Y., et al. (1997). The effect of azelastine on acute radiation dermatitis in mice models. International Journal of Radiation Oncology, Biology, Physics, 37, 907-911.

    Olsen, D., Raub, W., Jr., Bradley, C., Johnson, M., Macias, J., Love, V., et al. (2001). The effect of aloe vera gel/mild soap versus mild soap alone in preventing skin reactions in patients undergoing radiation therapy. Oncology Nursing Forum, 28, 543-547.

    Roof, L. (1991). The use of Vigilon primary wound dressing in the treatment of radiation dermatitis. Oncology Nursing Forum, 18, 133-134.

    Roy, I., Fortin, A., & Larochelle, M. (2001). The impact of skin washing with water and soap during breast irradiation: A randomized study. Radiotherapy and Oncology, 58, 333-339.

    Shell, J., Stanutz, F., & Grimm, J. (1986). Comparison of moisture vapor permeable (MVP) dressings to conventional dressings for management of radiation skin reactions. Oncology Nursing Forum, 13(1), 11-16.

    Sitton, E. (1992). Early and late radiation-induced skin alterations. Part I: Mechanisms of skin changes. Oncology Nursing Forum, 19, 801-807.

    Spitalier, J.M., & Amalric, R. (1973). Value of Biafine in the prevention and treatment of immediate skin reactions following radiotherapy: Comparative study. Unpublished manuscript.

    Strunk, B., & Maher, K. (1993). Collaborative nurse management of multifactorial moist desquamation in a patient undergoing radiotherapy. Journal of ET Nursing, 20, 152-157.

    Szumacher, E., Wighton, A., Franssen, E., Chow, E., Tsao, M., Ackerman, I., et al. (2001). Phase II study assessing the effectiveness of Biafine cream as a prophylactic agent for radiation-induced acute skin toxicity to the breast in women undergoing radiotherapy with concomitant CMF chemotherapy. International Journal of Radiation Oncology, Biology, Physics, 51, 81-86.

    Trotti, A., Byhardt, R., Stetz, J., Gwede, C., Corn, B., Fu, K., et al. (2000). Common toxicity criteria: Version 2.0. An improved reference for grading the acute effects of cancer treatment: Impact on radiotherapy. International Journal of Radiation Oncology, Biology, Physics, 47, 13-47.

    Vogler, B., & Ernst, E. (1999). Aloe vera: A systematic review of its clinical effectiveness. British Journal of General Practice, 49, 823-828.

    Westbury, C., Hines, F., Hawkes, E., Ashley, S., & Brada, M. (2000). Advice on hair and scalp care during cranial radiotherapy: A prospective randomized trial. Radiotherapy and Oncology, 54, 109-116.

    Williams, M., Burk, M., Loprinzi, C., Hill, M., Schomberg, P., Nearhood, K., et al. (1996). Phase III double-blind evaluation of an aloe vera gel as a prophylactic agent for radiation-induced skin toxicity. International Journal of Radiation Oncology, Biology, Physics, 36, 345-349.