Randomized, prospective assessment of moisturizer efficacy for the treatment of radiation dermatitis following radiotherapy after breast-conserving surgery

Abstract

ObjectiveThe effect of heparinoid moisturizer use after acute skin damage for patients receiving whole-breast radiotherapy after lumpectomy is understudied.MethodsA total of 30 patients were randomly assigned to receive heparinoid moisturizer (Group M), and 32 patients comprised the control group (Group C). Patients in Group M were instructed to apply heparinoid moisturizer from 2 weeks following whole-breast radiotherapy, and to continue to use the moisturizer until 3 months after completion of whole-breast radiotherapy. Group C patients were instructed to not apply any topical moisturizer during the study period. The relative ratio of skin water content ratio (RWCR(t) = (It /Nt)/(I0/N0)) between irradiated and non-irradiated field was calculated. Signs and symptoms were also assessed. The primary endpoint was the difference in relative ratio of skin water content ratio between 2 and 4 weeks following whole-breast radiotherapy.ResultsIn Group C, relative ratio of skin water content ratio dropped to 0.80 ± 0.15 at 2 weeks and maintained the low level at 4 weeks following whole-breast radiotherapy. Similarly, in Group M, relative ratio of skin water content ratio dropped to 0.81 ± 0.19 at 2 weeks (prior to application), however, it returned to baseline level (1.05 ± 0.23) at 4 weeks (2 weeks after application). The arithmetic difference of relative ratio of skin water content ratio in Group M was 0.24 ± 0.23 and was significantly larger than in Group C (0.06 ± 0.15; P < 0.01). Skin dryness and desquamation were less severe in Group M.ConclusionsThe application of heparinoid moisturizer for 2 weeks following whole-breast radiotherapy significantly increased water content and helped improve skin dryness and desquamation compared with no use of moisturizer.

A topical heparinoid‐containing product improves epidermal permeability barrier homeostasis in mice

“…Because clinical studies showed that topical heparinoid improved stratum corneum hydration in humans, we first assessed whether topical heparinoid‐containing product, Hirudoid ® cream, produces comparable benefits in mice. Indeed, twice‐daily applications of Hirudoid ® cream significantly elevated the levels of stratum corneum hydration, while neither baseline transepidermal water loss rates (TEWL) nor skin surface pH differed in Hirudoid ® cream‐treated versus Hirudoid ® cream‐untreated controls (Figure A).…”

“…Moreover, topical heparinoid‐containing cream not only reduces postoperative ecchymosis and oedema, but also prevents the development of pressure ulcers . Furthermore, topical applications of a heparinoid‐containing product significantly increased stratum corneum hydration in both young and aged humans, as well as both epidermal growth factor receptor inhibitor‐ and radiotherapy‐induced skin dryness . Additionally, a questionnaire survey found that twice‐daily applications of a heparinoid cream or lotion for 1 month markedly improved skin dryness, pruritus and inflammation in subjects with atopic dermatitis, particularly in older patients .…”

Quantitative assessment of radiodermatitis through a non‑invasive objective procedure in patients with breast cancer

“…In this study, the subjects did not use moisturizer until after radiodermatitis occurred. Sekiguchi et al reported that the application of a heparinoid moisturizer for 2 weeks resulted in lower skin dryness and desquamation compared to the non-application thereof (17). Therefore, medical staff should advice their patients regarding the appropriate timing of moisturizer usage.…”

Efficacy of heparinoid moisturizer as a prophylactic agent for radiation dermatitis following radiotherapy after breast-conserving surgery: a randomized controlled trial

“…In our previous report, the application of heparinoid moisturizer for 2 weeks following whole-breast radiotherapy (WBRT) significantly increased skin water content (WC) and helped improve skin dryness and desquamation compared with no use of moisturizer ( 6 ). The aim of this study is to assess the efficacy of heparinoid moisturizer as a prophylactic agent for ARD in patients with breast cancer receiving WBRT.…”