Topical corticosteroid therapy for acute radiation dermatitis: a prospective, randomized, double-blind study

Br J Dermatol. 2002 Jun;146(6):983-91. doi: 10.1046/j.1365-2133.2002.04751.x.


Background: Radiation dermatitis is a common side-effect of radiation therapy, but there is no current consensus about its appropriate therapy.

Objectives: To compare treatment with topical 0.1% methylprednisolone vs. 0.5% dexpanthenol in a cohort of patients undergoing fractionated radiation therapy for breast cancer.

Methods: In a randomized, double-blind design, treatment was initiated at the beginning of radiation therapy and continued for 2 weeks after termination of radiation. Outcomes were compared by three different measures: clinical (symptom score), functional (transepidermal water loss, TEWL) and subjective (quality of life, QOL).

Results: In a preliminary cohort of untreated patients undergoing radiation therapy, clinical signs and TEWL levels increased progressively during radiation therapy, reaching highest values at 5 and 4 weeks, respectively. Although neither topical treatment reduced the incidence of radiation dermatitis, both delayed the emergence of greatest clinical and TEWL scores until approximately 6 and 5 weeks, respectively. With topical corticosteroids, clinical symptoms and TEWL were less pronounced than with dexpanthenol. Whereas general QOL improved after completion of radiation therapy, skin-related QOL declined. However, the skin-related QOL decline could be at least in part reversed by use of topical corticosteroid vs. dexpanthenol-containing emollient.

Conclusions: We provide evidence that prophylactic and ongoing use of topical therapy with either topical corticosteroid or a dexpanthenol-containing emollient ameliorates, but does not prevent radiation dermatitis. Our data suggest, but do not prove, a benefit of a topical corticosteroid vs. a dexpanthenol-containing emollient. Further controlled studies with larger cohorts will be needed to determine optimal forms of topical therapy for radiation dermatitis.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Acute Disease
  • Administration, Topical
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents / administration & dosage*
  • Breast Neoplasms / radiotherapy
  • Cohort Studies
  • Double-Blind Method
  • Female
  • Glucocorticoids
  • Humans
  • Methylprednisolone / administration & dosage*
  • Methylprednisolone / analogs & derivatives*
  • Middle Aged
  • Ointments
  • Pantothenic Acid / administration & dosage*
  • Pantothenic Acid / analogs & derivatives
  • Prospective Studies
  • Radiodermatitis / drug therapy*
  • Radiodermatitis / etiology


  • Anti-Inflammatory Agents
  • Glucocorticoids
  • Ointments
  • Pantothenic Acid
  • dexpanthenol
  • methylprednisolone aceponate
  • Methylprednisolone