Maiche, A.G., Grohn, P., & Maki-Hokkonen, H. (1991). Effect of chamomile cream and almond ointment on acute radiation skin reaction. Acta Oncologica (Stockholm, Sweden), 30(3), 395–396.

To evaluate the tolerability and activity of Kamillosan (chamomile cream) as compared to almond ointment in patients receiving radiation therapy

Patients were assigned to use one product above and the other product below their scar. The physician who evaluated the skin was blinded to which product was used on which side of the scar. The skin product was applied twice a day with the first 30 minutes before external beam radiation therapy and again at bed time. Reactions were noted after every 10 Gy and at two weeks and three months following completion.
 

• The study sample (N = 48) was comprised of female patients with breast cancer.
• Mean age of the sample was 56 years, with a range of 30–79 years.
• Patients received 2 Gy per fraction five times per week to 50 Gy (no break).

The study took place at Helsinki University Central Hospital in Helsinki, Finland.

The study used a quasi-experimental single-blinded design. Patients were used as their own controls

Adverse skin effects were graded on a four-point rating scale, with 0 being no change, 1 light erythema, 2 dark erythema, and 3 moist desquamation. Subjective evaluation was also performed, including symptoms such as pain and itching.
 

Skin changes seemed to appear later in the Kamillosan group; however, a higher proportion of the Kamillosan group developed grade 3 reactions. Overall, differences between groups were not significant. The subjective symptoms, such as itching and pain, were equally uncommon in the two groups. Most patients preferred Kamillosan because of convenience and hygienic preference.
 

Neither of the two agents prevented a skin reaction and every patient developed grade 1 erythema.

• Patients were able to decide which product went above or below the incision, leaving room for error.
• The skin grading scale is not one commonly used, and reliability or sensitivity is unknown.
• The sample size was small, with less than 50 patients.
• Since both products were used on all patients, there was no complete control and the effectiveness of either product could not be determined.