Schreck, U., Pausen, F., Bamberg, M., & Budach, W. (2002). Intraindividual comparison of two different skin care conceptions in patients undergoing radiotherapy of the head-and-neck region: Creme or powder? Strahentherapie und Onkologie, 178, 321–329.

To assess differences between skin care with cream or powder formulations and protocols during radiation therapy

Twelve patients receiving radiation therapy to the head and neck region were randomly assigned to treat one side of the neck with cream and the contralateral side with powder. Highly detailed treatment regimens were defined, including cleaning and care for each type of skin problem that might be encountered. Care included a variety of topical treatments and dressings. All wound dressings and visible cream were removed before each radiation therapy session.

• The study sample (N = 12) was comprised of patients with cancer of the head and neck region.
• Eleven patients received adjuvant radiation therapy; eight patients received conventional fractionated radiation therapy up to  60 Gy, 2 up to 50, and all received 50–72 Gy.

The study took place at the University of Tuebingen in Germany.

The study used a quasi-experimental design.

• Objective and subjective assessment and photo documentation were performed at therapy onset and weekly during therapy.
• Skin dermatitis was scored weekly beginning with onset of therapy using a standard form based on skin toxicity scales.
• Patient questionnaires scored feeling of local warmth, tension, itch, pain, and general discomfort on a four-point scale
• Patient preference was considered.

Because of the small sample size, analysis was limited to description. No relevant differences were observed between the two treatment options according to the objective and subjective assessment criteria.

Onset and degree of acute skin reactions and differences in symptom relief between the two treatments could not be demonstrated.

• The sample size was small, with less than 30 participants.
• The trial was not strictly comparing cream and powder treatments (moist desquamation provided for dressings on the cream side and methyl violet solution and Bepanthen cream on the powder side). Complex protocol defined with use of many different treatments further complicates ability to draw any conclusions in the study.
• Validity and reliability of patient scoring was not noted.