Radiation: Preventing and minimizing radiation skin damage

While it is a true statement that “not everyone burns” during or following radiation, skin burns and dermatitis occur in about 90% of persons treated with radiation for breast and throat cancers. This means that to minimize or avoid burns or dermatitis each patient must take the responsibility to actively treat and protect their skin on day one of radiation and continue these preventive treatments for two to three weeks following radiation.

Check my website on Quinary5.com. [1] I’ve posted a number of articles on burns and what I refer to as my “burn karma.” I’ve had several potentially dangerous burns in my life so I am keenly interested in both preventing and treating burns. I was burned over 25% of my body at age 6 and did not scar. I reviewed the burn literature from 1928 to learn why tannic acid, made from green tea was used to treat extensive burns in that era. [2] Tannic acid is no longer used in burn recovery centers, but when I needed radiation for throat cancer, I turned to green tea and calendula gel. I did not burn though most of the other patients in my cohort who began radiation treatment at the same time in 2001 did suffer from burns or severe dermatitis.

A radiation burn is not just a sunburn

There are several problems that may occur from radiation skin damage. First and foremost is that with a severe burn people are less likely to continue their radiation treatment. Secondly, studies have shown that preventing serious skin reactions can also prevent long-term effects such as fibrosis. [3]

Many Radiation Treatment Centers tend to downplay burns or dermatitis. It is often referred to as “sunburn” or a minor problem that if it occurs, can be easily treated. Often patients are told “not everyone burns.” While it is a true statement that “not everyone burns,” more patients burn than those who get through the entire process without skin damage. Do Radiologists believe that by minimizing burn risk they are helping people accept the treatment? I think this is a psychological error that does not encourage the doctor-patient partnership that is needed for a successful treatment series that lasts 6–7 weeks.

As a nurse and psychologist my approach is very different. I tell people exactly what to expect and encourage them to enter into a partnership. While it is true that radiologists tell people that burning is a possibility, almost immediately they are told “it is like sunburn” or “if you burn we can treat it.” By contrast I tell people that by following a protocol and using specific products radiation burns can be minimized or prevented. The protocol is described in detail in previous articles posted on Quinary5.com. How I avoided a radiation skin burn (and) Minimizing the Risk of Radiation Skin Burns: Act II. [4; 5]

Salvo and others report that skin damage begins with the first radiation treatment; therefore, it is important to begin any burn preventive regime the first day of radiation. Do not wait until skin damage has occurred.

My protocol stresses that the skin must be treated at least 3 times a day. The initial treatment begins immediately after radiation is completed for each day. Since many people must return to work the second skin protective treatment often occurs at the workplace. The final treatment of the day is done after the evening shower. Finally the skin is clean and dry prior to radiation. Nothing must be on the skin prior to the radiation treatment.

The Salvo, et al. (2010) review of 33 prophylactic (prevention) trials reported that topical corticosteroids were the most common agents used, and that Biafine Cream was not found to be superior to standard regimes in the prevention and management of acute radiation-induced skin reactions. [6] Biafine Cream is an expensive prescription medicine.

According to the research literature, the most common methods for preventing and minimizing skin reactions to the irradiated area are the use of corticosteroid creams and Aloe vera or other lanolin-free products. But are corticosteroid creams, Aloe Vera creams and other prescription formulations the best remedies to use? The research literature does not answer those questions.

If standard remedies and prescription drugs are not particularly effective or are prohibitively expensive, then should we look for alternative therapies?

What did a search of the alternative literature reveal?

My initial search revealed that tannic acid made from green tea is a potent burn treatment remedy. This was initially reported by two Cleveland Ohio surgeons in 1926. [2] It was because of their work that the extensive burns I experienced at age 6 were successfully treated with tannic acid solution. (See Burning Karma: http://quinary5.com).

The alternative literature search also revealed that in 1910 Rene-Maurice Gattefosse, a French chemist was severely burned on both hands. In his book Aromatherapy, he wrote just one rinse with lavender essential oil stopped the gasification of the tissue. He later began using and studying the effects of lavender essential oil on burned soldiers in military hospitals during World War I. [7]

Calendula Gel: Calendula has been used for medicinal purposes since the 12^th Century. [8]. The University of Maryland recently reported that Calendula has been shown to help prevent dermatitis or skin inflammation in breast cancer patients during radiation therapy. Calendula gel is generally considered safe to use on the skin except for people who are allergic to plants in the daisy or aster family including chrysanthemums and ragweed; these people may have an allergic reaction to calendula (usually a skin rash).

Several Radiation Treatment Centers recommend Calendula but do not specify the type of formulation. Nor, as a rule do these centers specify how soon to begin a prophylactic or preventative regime. My clinical observations led me to recommend Calendula Gel by Boiron. (Please note that I do not have a professional affiliation with the Boiron Company).

I am very willing to consult with people prior to and during their radiation treatment. I do not charge a fee for e-mail consultation though I will encourage you to purchase products from safe sources and use three products: Lavender Healing Mist, Green tea solution and Boiron Calendula Gel.

How much Lavender Healing Mist (LHM) will you need?

I used between 14–16 ounces of LHM for the entire course of radiation following my mastectomy. During the “boost” portion of the treatment I used LHM frequently because of its cooling and healing effect. During the final week or so of the 5- to 7-week radiation regimen, I received a supplemental dose of radiation targeted directly to the area around my surgery incision. This dose is called the “boost” and it is an area that is prone to burns so I used special precautions.

http://www.pelindabalavender.com/Organic-Lavender-Healing-Mist-p/179.htm?Click=5342

Pelindaba Lavender Farm crafts an organic lavender hydrosol that incorporates Lavender essential oil into the formula to create Lavender Healing Mist (LHM) that is an effective product to minimize radiation burns. This product is also effective to treat minor kitchen burns. Pelindaba uses my formula to craft their Lavender Healing Mist (LHM) so I get a small rebate if you order it from there using the above link.

I also recommend Boiron Calendula Gel. I do not have a professional affiliation with the Boiron Company, but their Calendula Gel is a stable product that works reliably. Boiron Calendula Gel is available through Amazon.com and health store outlets. (Note: I do not have a professional affiliation with Amazon.com.)

Green tea solution is made by steeping an organic green tea bag in hot water. (Traditional Medicinals Teas is an excellent brand though other green teas will also work). This solution must be refrigerated and made fresh every other day. Tea will become moldy if not refrigerated. It is safe to use a refrigerated tea solution for 48 hours.

I keep a bottle of Lavender Healing Mist in my refrigerator at all times. It is a fast and effective way to treat kitchen burns. If it is applied immediately after a kitchen burn, a blister can often be avoided. See DeHart, S. and Whalen, K.M. (2014) The Essential Burn Book for Baristas and Cooks: A nurse’s fast action secrets to stop pain and minimize blisters. Amazon.com. [9]

Discuss my protocol with your Radiologist. The protocol is provided for information only and should not be construed as medical advice.

Patient comments

Remember that radiation is not a “walk in the garden,” but it is manageable.

The following comment is from the wife of a man who recently completed radiation of the neck for inoperatable throat cancer.

“Your treatment for his neck has been a miracle. He has some redness and a little roughness, but nothing like what they were preparing him for. One of the nurses was so excited about this treatment that she wrote everything down and was holding a ‘clinic’ with the other nurses.”

References

[1] http://quinary5.com

[2] Beck, CS, and Powers JH, Burns treated by Tannic Acid. Ann Surg 1926: 84 p. 19–36.

[3] http://www.mayoclinic.org/diseases-conditions/cancer/expert-blog/radiation-therapy-and-skin/bgp-20056321

[4] http://quinary5.com: DeHart, S. (2015) Radiation skin Care: How I avoided a radiation skin burn

[5] http://quinary5.com: DeHart, S. (2016) Minimizing the risk of radiation skin burns: Act II.

[6] Salvo, N, Barnes, E, Van Draanen, J. et al. Prophylaxis and management of acute radiation-induced skin reactions: A systematic review of the literature. Curr Oncol. 2010: 17(4) p. 94–112.

[7] Rene-Maurice Gattefosse (1910). Aromatherapy
[8] Calendula (2013. University of Maryland. http://umm.edu/health/medical/altmed/herb/calendula

[9] DeHart, S. and Whalen, K.M. (2014) The Essential Burn Book for Baristas and Cooks: A nurse’s fast action secrets to stop pain and minimize blisters. Amazon.com Kindle book.

Sara DeHart, MSN, Ph.D., has studied burn injuries since 2000 as she sought natural solutions to avoid a radiation burn. She has focused on self-care solutions for some of the acute and chronic medical problems that many people encounter over a lifetime. She may be contacted at sdehart@dehartresearch.com or dehart.ss@frontier.com.