Skin markings in external radiotherapy by temporary tattooing with henna: Improvement of accuracy and increased patient comfort

Purpose: To guarantee invariable skin markings in patients undergoing a cou rse of external radiotherapy, especially using conformal techniques. Cutane ous markings with henna also increase patient comfort, because washing and showering are allowed. Methods and Materials: Henna, a completely natural product, is a skin color ant with a history of 5,000 years. It is applied to the skin in the form of a paste, While drying, henna stains the superficial skin layers for severa l weeks, and the marked area can be exposed to water arbitrarily. In case o f fading of the stain before the end of radiotherapy, the marking procedure can be repeated. From November 1998 until March 2000, we performed skin ma rkings with henna in 158 patients with different tumor sites. The majority of patients received conformal radiotherapy techniques. All patients have b een evaluated concerning durability of the markings, the required number of marking procedures per treatment course, and possible related side effects . Results: The median durability of henna staining is 23 days (range 12-48 da ys). On average, two marking procedures (range 1-4) are necessary for a pat ient treated with curative intent. Although washing and showering are freel y permitted, no adverse cutaneous side effects (e.g., erythema, allergic re actions) have been observed. Conclusions: Skin marking by temporary tattooing with henna increases the a ccuracy of external radiotherapy. It yields stable and invariable markings for the entire course of radiotherapy and also increases the comfort of pat ients. (C) 2001 Elsevier Science Inc.