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Acute Radiation Dermatitis

Acute radiation dermatitis (ARD) frequently occurs in cancer patients receiving radiotherapy and is typically characterized by redness (erythema), skin peeling (desquamation), and pain.

The development of radiation dermatitis is a complex process involving damage to the skin layers caused by radiation, which affects the cells responsible for skin regeneration.

This damage can impair the skin’s protective barrier and lead to increased inflammation, resulting in symptoms such as redness, pain, and various skin changes.​

​Common signs include:

  • Changes in skin pigmentation

  • Pain

  • Burning

  • Tenderness

  • Pruritus (persistent intense itching)

  • Edema (swelling caused by excessive fluid)

  • Desquamation (skin shedding/peeling) either dry and/or moist, with ulceration in severe cases

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Risk factors:

  1. ​Treatment-related factors

    • Radiation dose

    • Irradiated volume

    • Bolus

    • Concurrent chemotherapy

    • Treatment positioning​

  2. Intrinsic factors

    • BMI

    • Irradiation site

    • Smoking status

    • Skin pigmentation

Treatment Options

 Topical non-steroidal agents and corticosteroids

  • Non-steroidal and steroidal agents have been studied for managing radiation dermatitis, with some research showing conflicting results

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  • Biafine has been found to significantly reduce the risk of severe radiation dermatitis

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  • Other agents, such as doxepin and sucralfate, have limited supporting evidence or have demonstrated only minimal benefit 

Barrier films and dressings

  • Barrier films or dressings were found to be effective in preventing radiation dermatitis

  • There is some insufficient evidence on certain barrier films such as Hydrofilm, Mepilex Film, No-Sting Barrier Film, and SLND ​

Natural, miscellaneous, and alternative therapies

  • Natural products such as aloe vera, oral enzymes, olive oil, calendula, and curcumin have been studied with oral enzymes and olive oil show significant reduction in radiation dermatitis 

  • Other products such as honey-based products, vitamins, chamomile-based creams have shown minimal or no benefit

Laser Therapy

  • Photobiomodulation (low-level laser therapy) has been studied in multiple research efforts, with most findings indicating that it may help prevent or lessen the severity of acute radiation dermatitis 

Systemic and other treatments

  • Some studies have examined systemic agents such as oral enzyme mixtures, which showed potential in preventing acute radiation dermatitis

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  • However, evidence supporting the use of other systemic medications and multi-component therapies remains limited 
     

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