Meegan, M.A., & Haycocks, T.R. (1997). An investigation into the management of acute skin reactions from tangential breast irradiation. Canadian Journal of Medical Radiation, 28, 169–173.

To determine if there is an adverse effect to irradiated skin when patients use their normal skin care regimens

Two consecutive groups of patients received tangential breast irradiation. The first group (group A) used the traditional skin care advice of using warm water only, avoiding the use of all lotion, soaps, and deodorants in the treatment field. The second group (group B) continued with their normal skin care regimen with no product restriction. Patients and therapists scored the skin reaction weekly and three weeks after treatment.

• The study sample was comprised of 156 patients with breast cancer who received treatment in group A (n = 94) or group B (n = 64).
• Twenty-two percent of patients were also receiving tamoxifen.
• Patients were treated on cobalt units or a 6 MV linear accelerator.

The study used a prospective trial design.

• Erythema, dry desquamation, patchy desquamation, and moist desquamation were scored weekly using a numerical scale from the researchers' institution.
• Level of discomfort, interference with normal activities, and use of analgesics for skin reactions was self-scored by patients weekly using a numerical scale.
• Treatment parameters, breast size, medical history, concurrent medications, nursing or medical interventions, and skin products used were documented.
• T-test statistical analysis method was used to establish if there was a significant difference in the mean score for the reactions in each group.

There were no significant differences found in skin assessment scores between groups. Reactions peaked at 7–10 days from completion of radiation. There was no difference in the skin scores between the two groups at that point. Patient self-scoring of the severity of the skin reaction revealed that group A consistently scored higher than group B, indicating greater level of problems.

There is no difference between the severity of skin reactions of patients using no products and those using their usual skin care products.

• The study had a risk of bias due to no random assignment.
• Skin scoring and patient self-report did not use standard scales.
• No testing was completed for validity and reliability of rating scale.
• No data were provided on the specific products patients used.