Radiation Burn

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"

• Rash
• Inflammation
• Itchiness and redness
• Pain
• Pigmentation changes
• Flaking, peeling skin
• Ulcerated, blistered skin

Recommended Management

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.

Non-pharmacological management:

• 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

Pharmacological management:

• Medicated creams and ointments may be applied topically to alleviate symptoms

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.

References:

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• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3728063/
• 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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• 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
• https://www.pccarx.com/Products/ProductCatalog?pid=30-4655
• https://www.cancercenter.com/integrative-care/radiation-burns
• https://www.sor.org/system/files/news_story/201204/ltht-managingradiotherapyinducedskinreactions-oct2011.pdf