Compounded Melatonin Cream for the Prevention and Treatment of Radiation Dermatitis: A Case Report

Radiation-induced dermatitis is a common complication of radiotherapy. In Spain, the manufactured products used to prevent and treat that condition consist of emollient creams (which are often ineffective) or corticosteroids (which can cause dermal atrophy and other adverse effects). However, we have found that topically applied melatonin, a product that to our knowledge is not commercially available in Spain, is safe and effective in the prevention and treatment of radiodermatitis and a viable substitute for corticosteroid therapy. In this report, we describe the use of compounded melatonin in Beeler cream (the formulation for which is provided) in a 46-year-old woman who underwent surgery and radiotherapy for early stage adenocarcinoma of the breast. The patient applied that cream as directed throughout the prescribed course of radiotherapy and continued its use for 3 weeks after she last underwent irradiation. She experienced no adverse effects from the use of the compounded formulation and tolerated that treatment well. Radiation dermatitis did not develop at the irradiated site until approximately 1 week after the final radiotherapy session, at which time mild erythema of the treated skin emerged. That condition, which was successfully treated by application of the melatonin-containing cream as previously prescribed, resolved after 3 weeks of its use. We suggest that when manufactured products designed to prevent or treat the adverse dermal effects of radiotherapy are unavailable, fail to be effective, or prove objectionable to patients, a melatonin-containing topical compound can provide a successful alternative.