Many women who have breast-conserving surgery for breast cancer go on to have radiation treatment. One of the most common side effects of this radiation is dermatitis, causing pain, itchiness, discomfort, and blisters. A study has found that topical melatonin may prevent and reduce the severity of this dermatitis.

The goal of radiation after breast cancer surgery is to reduce the rate of local recurrence, as well as reducing the risk of death from breast cancer. But radiation dermatitis can have serious effects on quality of life and treatment compliance. Thus finding an effective treatment is important in cancer care.

One such treatment being investigated is the use of melatonin as an emulsion in a topical cream. I’ve written several blog posts about melatonin before and it’s impact on circadian rhythm, anti-cancer effects, digestive effects and more. But using it topically applied to the skin is a more recent development.

Animal and in vitro studies have shown that melatonin reduces the oxidative damage caused by radiation. And now we have a study that shows its impact in women.

Study Design

The study looked at 47 female breast cancer patients with a median age of 55 who had early stage breast cancer, stages 0-2.

The women were randomized into two groups. The melatonin group received melatonin as an emulsion in a cream, applied to the breast. The other group received a placebo cream with the same constituents as the test group, just no melatonin. 

For all women, the cream was applied twice daily over the treated breast, but not within 2 hours prior to radiation.

 Both groups received whole breast radiation, 5 days a week for 5 weeks. 

Statistically significant results

image of skin cream from CALMERme.com

Those who were treated with melatonin had less dermatitis than the placebo group – 59% occurrence in the melatonin group compared to 90% in the placebo group

image of skin cream from CALMERme.com

The severity of dermatitis was less in the melatonin group compared to the placebo group

 Conclusions

While the study is relatively small, the results tie in with the in vitro and animal studies and show promise for a hard-to-treat side effect that can have a considerable impact on women.

Further applications 

Other studies have investigated the protective effects of melatonin on the inflammatory effects of radiation. They have shown positive effects using melatonin in REDUCING:

  • mucositis after gastrointestinal radiation;
  • radiation associated pneumonitis after chest area radiation;
  • enteritis associated with abdominal and pelvic radiation; and
  • radiation myelopathy after spinal cord radiotherapy. 

Take home message

Yes, the study summarized here was only small. But along with the evidence for other protective effects against radiation side effects, this use of melatonin warrants further examination. Indeed, melatonin creams are currently readily available and are being used successfully by practitioners. However, caution is necessary regarding the timing of application in relation to radiation treatment. Talk to your healthcare practitioner if you are want to explore this further. 

Melatonin for prevention of Breast Radiation Dermatitis: A Phase II, Prospective, Double-Blind Randomized Trial. Ben-David MA, et al. IMAJ.2016;18:188-192

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