Modern Dressings in the Prophylaxis and Management of Acute Radiation Dermatitis: A Narrative Review

Radiation-induced skin injury is the most common side effect of radiotherapy (RT), affecting up to 95% of patients. Severe skin reactions may restrict radiation delivery or limit further treatment. Acute radiation dermatitis (ARD) arises within three months of the initiation of RT and is characterized by erythema, desquamation, ulceration, and even necrosis. To prevent or manage ARD, multiple systemic and topical medications have been employed, including topical vitamins, metallic ointments, and dressings. Among them, dressings are widely used and competitive, as they provide an intact, moist environment to facilitate the re-epithelialization of impaired skin. Polyurethane film dressings (such as Mepitel film and Hydrofilm dressings) are guaranteed in preventing ARD, whereas foam dressings (such as Mepilex® Lite dressings) can effectively manage ARD. Hydrogels are the most promising material for radiation-induced wound dressings due to their biodegradability, porous structure, and delivery features. However, due to the complexity of the skin repair process and the uncertainty surrounding its underlying mechanisms, the wide clinical application of hydrogels in ARD still requires further investigation. This review discusses the classification and pathological processes of ARD, the types of dressings available for clinical use, and modern dressings used to prevent and treat ARD. The aim is to provide valuable insights for optimizing ARD prevention and management.