What is a Radiation "Burn"?
Radiation "burns" are not actually burns! They are a type of dermatitis or skin irritation caused by high levels of radiation exposure on the skin. Radiation exposure can originate from various sources including: prolonged UV light exposure, high levels of X-ray exposure from medical imaging procedures, and radiation therapy used in cancer treatment.
Why does it happen?
Radiation therapy used in cancer treatment not only kills the targeted cancer cells, but it also harms the surrounding skin and tissue. Frequent treatment regimens of radiation therapy prevent the proper and timely regeneration of skin cells, ultimately causing skin damage. Studies show that over 85% of patients undergoing radiation therapy experience skin irritations or radiation “burn” of varying degrees. The severity of the skin damage caused by radiation may differ based on patient-specific factors or the location, dose, and frequency of the radiation. Radiation "burns" may manifest within 1-4 weeks of starting radiation therapy and may persist for weeks to months after its completion.
Symptoms of Radiation "burn"
- Itchiness and redness
- Pigmentation changes
- Flaking, peeling skin
- Ulcerated, blistered skin
The general management of Radiation "burns" is to protect the moisture barrier of the skin and to alleviate symptoms of itchiness, pain, blistering and flaking skin.
- Avoid harmful perfumes, deodorants, and strong chemicals on the affected area
- Protect skin from UV light and avoid tanning beds
- Wear loose fitting clothing, preferably cotton
- Avoid shaving in the affected area
- Provide gentle washing with warm water
- Medicated creams and ointments may be applied topically to alleviate symptoms
|Aloe Vera||Topical application may inhibit infection and promote healing of minor burns or wounds. Has shown efficacy in preventing radiation dermatitis.|
|Vitamin A & D Ointment||Helps to protect chafed skin and seals in the skin’s moisture. May provide temporary protection of the skin due to minor cuts, burns, scrapes or cracked skin.|
|Miconazole *or other alternative||Antifungal cream or ointment used to treat skin infections (yeast) commonly found in skin folds or other areas of the skin.|
|Betamethasone *alternative: hydrocortisone cream||Topical application may inhibit infection and promote healing of minor burns or wounds. Has shown efficacy in preventing radiation dermatitis.|
|Ketoprofen||Pain-reliever (NSAID) that may be used to treat local pain associated with radiation therapy.|
|Lidocaine||Pain-reliever that may be used to treat local pain associated with radiation therapy.|
|Phenytoin||Used in the treatment of pressure ulcers ("bed sores") to potentially heal and reduce pain and swelling of wounds.|
|Pracasil-Plus||Base ingredient commonly used in topical formulations. Composed of lipids and silicones which alleviates scarring.|
|Misoprostol||Anti-inflammatory agent used to potentially aid in wound healing. Currently orally used to treat NSAID-induced ulcers. Topical use has been shown to be effective in pre-clinical, animal studies for the treatment of various types of wounds.|
Note: Metallic-based topical products (zinc oxide, aluminum) should be avoided due to the possibility of increasing the surface dose and severity of radiation to the skin.
*Contact your physician before initiating any new medications or for additional options to alleviate symptoms caused by radiation exposure
Where can I find these creams/ointments?
Some of these individual ingredients may be found over the counter at your local pharmacy or may require a prescription from your healthcare provider.
However, formulations requiring multiple ingredients require patient-specific compounding at a compounding pharmacy. Contact your health care provider and local compounding pharmacy to see how you can get the medications you need, specifically made for you.
- American Academy of Dermatology Association. How to care for your skin during and after radiation therapy. (https://www.aad.org/public/diseases/skin-cancer/types/common/melanoma/radiation-care). (Accessed 2020 May 30).
- Haddad, P., Amouzgar-Hashemi, F., Samsami, S., Chinichian, S., & Oghabian, M. A. (2013). Aloe vera for prevention of radiation-induced dermatitis: a self-controlled clinical trial. Current oncology (Toronto, Ont.) , 20 (4), e345–e348. https://doi.org/10.3747/co.20.1356
- Hao X, Li H, Su H, Cai H, Guo T, Liu R, Jiang L, Shen Y. Topical phenytoin for treating pressure ulcers. Cochrane Database of Systematic Reviews 2017, Issue 2. Art. No.: CD008251. DOI: 10.1002/14651858.CD008251.pub2 https://www.cochrane.org/CD008251/WOUNDS_topical-applied-skin-phenytoin-treating-pressure-ulcers
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- Lidocaine [monograph]. In: Lexicomp online [online database]. Hudson, OH: Lexicomp (accessed 2020 May 29). https://online-lexi-com.proxy.libraries.rutgers.edu/lco/action/doc/retrieve/docid/patch_f/1797833?cesid=94Lnstz8qa1&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dlidocaine%26t%3Dname%26va%3Dlidocaine
- Ulff E, Maroti M, Serup J, Falkmer U. A potent steroid cream is superior to emollients in reducing acute radiation dermatitis in breast cancer patients treated with adjuvant radiotherapy. A randomised study of betamethasone versus two moisturizing creams. Radiother Oncol . 2013;108(2):287‐292. doi:10.1016/j.radonc.2013.05.033 https://www.sciencedirect.com/science/article/pii/S0167814013002740
- Mahoney J., Ponticello M., Nelson E. Topical misoprostol and wound healing in rats. Wounds . 2007; 19 (12). https://www.woundsresearch.com/index.php/article/8076
- Waghmare CM. Radiation burn—From mechanism to management. Burns . 2013; 39(2), 212-219. doi:10.1016 http://www.sciencedirect.com/science/article/pii/S0305417912003014
- Vitamin A and Vitamin D (topical) [monograph]. In: Lexicomp online [online database]. Hudson, OH: Lexicomp (accessed 2020 May 29). https://online-lexi-com.proxy.libraries.rutgers.edu/lco/action/doc/retrieve/docid/patch_f/3776522?cesid=7xPoT5uRjVQ&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dvitamin%2520a%2520%2526%2520d%26t%3Dname%26va%3Dvitamin%2520a%2520%2526%2520d#use