In patients with head and neck cancer (HNC) receiving concurrent chemoradiation (CCRT), application of topical aloe vera gel significantly reduced moist desquamation and moderate to severe skin erythematous, according to study results published in the European Journal of Oncology Nursing. No difference in prophylactic efficacy for radiation induced dermatitis (RID) was noted between patients treated with aloe vera gel or placebo.

An overwhelming majority of patients receiving radiotherapy develop radiation-induced dermatitis (RID), a common cause of radiation related toxicity, often developing an erythematous skin reaction with possible desquamation. Concurrent chemotherapy increases the frequency of such reactions. Researchers sought to investigate the efficacy of aloe vera gel in reducing the severity or preventing RID in patients with HNC receiving high-dose CCRT.

To accomplish this, they conducted a randomized, double-blind placebo-controlled study in Udon Thani Cancer Hospital, Lampang Cancer Hospital, and Chiang Mai University Hospital in Thailand that included 120 adult patients with HNC (older than 18 years of age) treated with CCRT and randomly assigned into the aloe vera cohort (58 of 60 patients completed CCRT) or the placebo cohort (54 of 60 patients completed CCRT) all with similar baseline demographics.

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Moderate to severe skin erythematous was observed in 13.6% of the aloe cohort vs 27.8% of the placebo cohort (P =.050) in the 5th week of treatment, and in 24.1% of the aloe cohort vs 42.6% of the placebo cohort (P =.038) in the 6th week of treatment. Moderate to severe moist desquamation was observed in 19% of the placebo cohort and in .0% of the aloe cohort (P =.001) in the 7th week of treatment.

The radiation-induced skin reaction assessment scale (RISRAS) was used to assess adverse skin toxicity levels and median values from the 1st week of CCRT treatment through the 8th week of treatment and showed no statistical difference between study cohorts.

Study limitations include variations in radiotherapy techniques and a wide range of doses, there were no instances of acute dermatitis revealing differences among patients, unaccounted for patient confounding factors, and unblinding.

Researchers concluded that, “Topical applications of aloe vera gel significantly reduced moderate to severe grades of skin erythematous and instances of moist desquamation in HNC patients receiving CCRT.” Comparing the aloe vera gel cohort with the placebo cohort, researchers found, “no prophylactic efficacy for RID.”


Tungkasamit T, Chakrabandhu S, Samakkarn V, et al. Reduction in severity of radiation-induced dermatitis in head and neck cancer patients treated with topical aloe vera gel: A randomized multicenter double-blind placebo controlled trial. Eur J Oncol Nurs. Published online June 16, 2022. doi:10.1016/j.ejon.2022.102164