Mild soaps and radiotherapy: a survey of the UK public to identify brands of soap considered mild and analysis of these to ascertain suitability for recommendation in radiotherapy departments

Abstract

Cancer agencies recommend that patients use mild soap when undergoing external beam radiotherapy to minimise skin reactions. They define 'mild soap' as non-alkaline, lanolin free, unperfumed soap with a neutral pH. This study aimed to identify which soaps the UK public perceive as mild and ascertain if these were clinically mild and could potentially be recommended within radiotherapy departments. A survey of 237 participants identified eight top brands of mild soap, which were then tested for pH and analysed for potential irritants. All soaps were lanolin free and non-alkaline, with Simple and Johnson's the closest to pH 5.5. All contained fragrances except Simple and E45. Dove, Pears and Imperial Leather contained the highest concentration of fragrances. All soaps except E45 contained potential irritants. Only Simple and E45 fit the cancer agencies' definition of mild soap and could therefore be recommended for radiotherapy patients. Future research should identify current practices and recommendations in the UK as anecdotal evidence suggests large variations in skin care advice. Further scientific analysis could potentially identify cheaper brands that fit the definition of 'mild'. UK recommendations should be standardised and consistent with best practice to reduce skin reaction severity in radiotherapy patients.

A Canadian Survey of the Management of Radiation-Induced Skin Reactions

“…The idea that ''mild'' soap (pH-neutral or nonalkaline) is less irritating to irradiated skin would seem to be anecdotal, and there does not appear to be any evidence to indicate that patients should not carry on with whatever products they already use unless sensitivity or irritation develop [27]. In addition, there may be differences in patient and provider perceptions as to which brands that fit the definition of ''mild'' [28]. Dictating a particular brand or product ''has the potential to unnecessarily control the choices and preferences that an individual may have'' (p. 11) [20].…”

Prophylaxis and management of acute radiation-induced skin toxicity: a survey of practice across Europe and the USA

“…With respect to skin reactions, 'mild' soaps with an acceptable pH and no perfumed ingredients are recommended by many agencies (Cancer Research UK, Bolderston et al 2006, Society andCollege of Radiographers 2011). Interestingly, a 2011 UK study (Robertson & Brown 2011) reported that 50% of the general UK population (n = 130) considered Dove or Simple to be 'mild' soaps, whereas only Simple and E45 have an acceptable pH and do not contain perfume ingredients, and may be more appropriate for use by radiotherapy patients. The use of deodorants is generally contraindicated for patients receiving radiotherapy to the breast because of its potential boluslike effect (McGowan 1989) and potential interactions between metallic particles in the deodorant with radiation (Korinko & Yurick 1997).…”