Back in the 1950s at the height of the cold war, there was a great deal of talk about fallout shelters. When people were very serious about the prospect of nuclear war with the Russians and the Chinese, shelters were built that were intended to allow people to survive if their city was hit by a nuclear blast and they were outside the radius of immediate destruction. As international relations changed with détente and the fall of the Soviet Union as well as talk about nuclear winter following a nuclear war, interest in fallout shelters faded. Now with the Fukushima disaster and the continuing threat of the collapse of Fukushima Unit 4 spent fuel pool threatening the entire northern hemisphere, fallout shelters are a topic of interest once more.

            The first consideration for a fallout shelter is to put it underground. This provides additional protection against radiation as well as protecting against the effects of a nearby blast. The walls, ceiling and floor should be as thick and dense as possible and should be sealed against ground water and atmosphere. Including lead shielding in the shell of the shelter would increase radiation protection. The shelter should have a thick shielded door that is air tight and can be barred. Electromagnetic shielding in the form of a copper mesh would be a good addition to protect your electronics against the electromagnetic pulse the will accompany any nuclear blast.

            The first thing that the people in the shelter will need is a supply of air. It would be possible to store some oxygen and to have a way to remove carbon dioxide for a short period but impractical for more than a few days. For long term occupation, it will be necessary to have an air intake with a filtration system that can remove any radioactive particles in the incoming air. A heat exchanger would be a good addition to the system so that if the climate is cold, heat will not be lost when the air in the shelter is exhausted to the outside.

            Water will be the next concern. The municipal water supply may be shut off so the shelter should contain as much bottled water as possible. To provide for the possibility that piped water is still flowing, the shelter should also have a high level water filter that can remove particles down to 1 micron. Disposing of waste water and sewage is another issue. Chemical toilets or composting toilets will need to be installed with sufficient supplies and ventilation as required.

            After air and water comes food. Freeze dried foods store well and take up much less space than canned goods. Care must be taken to provide for a balanced diet for everyone who may take refuge in the shelter. Food that can be eater cold is preferable to food that must be cooked and will require some sort of heat source.

            The shelter will require energy to operate. Being underground will reduce the need for heat but you will still need to have some heating. You will need to have a radio that receives AM, FM and shortwave frequencies and that can transmit on shortwave bands. Antennas will be a problem if the destruction above ground is serious but you could have a buried extendable antenna to deal with this possibility.

            Boredom will be a real danger so the shelter should include reading material. If you have functioning electronics,  you will be able to store hundreds of books, movies and hours of music on compact electronic media. Multiplayer board and card games should be available as well.

            Basic furniture such as tables, chairs, beds, etc. will be required as well as changes of comfortable and easy to care for clothing. Computers would be useful for a number of purposes. Back-ups such as flashlights, radios, lamps, etc. should have a supply of rechargeable batteries. Some sort of exercise equipment such as a stationary bike should be included for exercise and could be hooked to a charge to recharge batteries.

            Studies have shown that colors of rooms and accessories can have positive or adverse psychological effects so attention should be paid to what colors you use to paint the interior of the shelter. Lighting should be natural solar spectrum LED or incandescent. You should include HEPA air filters for the air inside the shelter to remove any air particles that might carry disease or trigger allergies.

            Although there is a danger of rogue states and terrorists exploding a nuclear device in an American city, the old danger of an all out nuclear war seems remote. Such a war would probably render the earth uninhabitable so a fallout shelter would temporary protection at best. As must be obvious, all of these preparations will cost a great deal of time and effort. It is a matter of personal concern and resources as to whether or not you should build a fallout shelter.

 

            If there is a nuclear accident or explosion and radioactive fallout may reach your area, there are preparations that you can make to protect yourself and your family from the fallout. Time being one of the factors that reduces the danger of fall out, here are some temporary measures that will protect your home and family for a few days. These actions will take time to prepare so in order to be effective, they must be done well before any accident or explosion occurs. Since it is impossible to predict exactly when an accident or explosion will happen, it would be best to start working on them as soon as possible.

            Purchase a Geiger counter. You need to be able to monitor the radiation in your home in order to know if there is a problem and if your precautions are working. Inexpensive handheld Geiger counters are widely available for under five hundred dollars.

            The main concern is to prevent the radiation from getting into your home. Alpha particles are dangerous if inhale, eaten or they contact your skin but they can be blocked by as little as a sheet of paper or regular clothing. Beta particles require more shielding but they are not as damaging as alpha particles. The walls of your home and heavy drapes or curtains over the windows will stop beta particles. Unfortunately, gamma radiation requires thick shielding with dense materials such as lead.

            The main way to protect yourself and your family against radioactive fallout is to prevent it from entering your home. Purchase enough plastic sheeting used by painters to cover every entrance into your home. Get a lot of the blue painters masking tape as well. Measure and cut pieces of the plastic to fit over every single opening in the walls of your home including doors, windows, heater vents, air conditioning vents, wall outlets, etc. Label each piece by room and location in room. Store the plastic pieces until they are needed. Figure on sealing as much of the house as possible to give you and your family as much oxygen as possible.

            Purchase potassium iodine tablets. These will only protect against thyroid cancer caused by radioactive iodine-131 but that is a real danger from some types of fallout and it is one concern that can be eliminated.

            You should plan on having enough bottled water for everyone for at least 3 days. Remember that you will need water for cooking and washing. The municipal water supply may be shut off or it may be contaminated so you can’t count on using tap water unless you have a filter than can take out any radioactive particles.

            You need enough food for everyone for at least 3 days. Food that is sealed and preserved for long storage is best. Also remember that electricity may be off so food that does not need to be cooked is best.

            You should rig some sort of area where people can put on and take off their outer garments if it is necessary to go outside. This will prevent any particles that have accumulated on their clothing and footwear while outside from being brought into the house.

            These preparations will protect you and your family through a short period of radioactive fallout. A future post will provide details of longer term protection.

 

 

            Radioresistance is defined as the ability of some organisms to survive in environments where there is a high level of radioactivity. There may be naturally occurring radiation from uranium ores or man-made radiation from nuclear bombs or nuclear accidents. After the Chernobyl accident in Ukraine, scientists were surprised to find that many species survived when the assumption was that the high level of radiation should have killed most of them.

            Research has shown that repeated exposure to small doses of radiation may stimulate biological changes that confer some resistance to larger doses of radiation. Biological self-repair mechanisms have time to repair damage if the doses of radiation are small and spread out over time. If a culture of cells is irradiated, set aside for a time and then exposed to another dose of radiation, fewer cells will die from the second exposure. Studies have shown this response in yeast, bacteria, protozoa, algae, plants and insects. Tests of cultures of mammal cells and human cells have also shown this effect. Suggested mechanisms are enhanced DNA repair, increased expression of some genes and increased levels of certain proteins in the nucleus and in the rest of the cell.

            It has been suggested that radioresistance can be inherited genetically from parent organisms. Experiments with the common fruit fly confirmed this possibility. Some cancers are resistant to radiation treatment.  It is unclear whether this resistance is an original property of the cancer cells themselves or may be induced by repeated exposures to radiation. When a cancer is irradiated, some of the cells will be killed. When those which survive reproduce, they may pass along any enhanced radiation resistance that they have to their offspring. The next time the cancer is exposed to radiation, more of the cells will survive and so on.

            One way to compare the radioresistance of different organisms is with a comparison of what is called the median lethal dose. The median lethal dose is similar to the half-life of a radioactive material. When applied to radiation damage, It is the amount of radiation measured in Grays that will kill half of the organisms in a group in a specified period of time.  Here is a list of the amount radiation that will kill half of the corresponding group in thirty days.

Dog –                                         3.5 Grays

Human –                       4.5 Grays

Rat –                               7.5 Grays

Rabbit –                         8    Grays

Goldfish –                    20    Grays

German cockroach-   64    Grays

Shellfish-                   200    Grays

 

            As the chart indicates, generally, the higher up the evolutionary ladder, the more susceptible to radiation the organisms are. Greater complexity involves greater vulnerability to radiation damage.

            There is a theory called radiation hormesis that suggests that small doses of radiation just above the background level of radiation can stimulate the activation of biological protective biological mechanisms that could protect against some diseases. This theory is rejected by the U.S. National Council on Radiation Protection and Measurements and the United Nations Scientific Committee on the Effects of Atomic Radiation. These organizations hold to the linear no-threshold model which states that any exposure to any level of radiation can cause biological damage.

 

Ionizing radiation damages DNA in living cells. All cells have DNA repair machinery. If there is a way to accelerate the repair of DNA, it would confer some protection against the damage caused by ionizing radiation.

Some of the DNA in the nucleus of human cells contains the instructions for creating proteins which are the working machinery of all living cells. Some of these proteins carry out the repair of DNA. There is a human gene called RAD52 which carries the code for a protein also called RAD52. This protein binds the ends of single strand DNA and also facilitates the coming together of complimentary DNA strands to create the famous double helix of DNA. It also interacts with the RAD51 protein which is involved in DNA recombination and repair.

Dealing with breaks in double stranded DNA is carried out by multiple repair mechanisms including a process called homologous recombination. Homologous recombination cuts out the damaged sections and inserts new sections created by copying the corresponding sections of undamaged DNA strands.

RAD52 had previously been shown to be involved in homologous recombination processes in yeast cells to repair radiation damage. Research in 1995 showed that causing the overexpression of the RAD52 gene in cultured monkey cells accelerated the homologous recombinant repair of DNA damaged by gamma rays. The RAD52 protein does not initiate the repair process but is involved in intermediate stages of repair through interaction with other mechanisms such as the RAD51 protein. When there is damage to the DNA of a cell, the RAD52 protein gathers at the site of the breaks in the strands. RAD52 fused with a fluorescent protein has been used as a marker of DNA damage and repair.

Multiplying copies of a gene will cause can be used to cause overexpression of that gene but such multiplying may also cause genetic instability and problems when copies are integrated into the chromosomes. Gene expression is normally regulated by special “promoter” enzymes. When the promoter is present the gene will be transcribed and proteins based on the gene sequence will be created by the ribosomes in outside the nucleus of the cell. So another way to get overexpression of a gene is to increase the quantity of the promoters. Promoter clusters with up to five copies of the promoter can be created which cause significant overexpression of the targeted gene.

It may be possible in the future to create enhanced promoter clusters for the RAD52 gene which in turn would increase the production of the RAD52 protein. The increased RAD52 protein would, in turn, increase the repair activity for double stranded DNA caused by exposure to gamma radiation. This treatment could be developed as an injectable drug that would temporarily increase RAD52 production to treat a single exposure incident. It may also be possible to use gene therapy to permanently increase production of RAD52 to confer ongoing protection against radiation. This might be useful in astronauts to protect them from radiation in space.

RAD52 protein:

          There is a type of bacteria named Deinococcus radiodurans (Latin for “terrific berry that withstands radiation”) that is very resistant to damage by ionizing radiation. It is known as an extremophilic bacterium meaning that it is very tough. In addition to being able to withstand radiation it can also survive dehydration, extremely low temperatures, some acids and even vacuum. This classifies it as a polyextrmophile or a bacterium that can survive a number of different things that kill most other bacteria.. Radiodurans is a specific species within the genus Deinococcus which also contains other radiation resistant species of bacteria.

            ”Grays” are units of measurement for the absorption of energy associated with radiation. One Gray is equivalent to the absorption of one joule of energy by one kilogram of matter. One joule is the amount of work necessary to generate one watt of electrical energy for one second. The Gray is often used to measure energy absorption by human tissue. Five to ten Grays can kill a human being. Two thousand Grays can sterilize a culture of Escherichia coli also known as E. coli which is found in human intestines and can sometimes cause food poisoning. Ten thousand Grays can kill any bacteria other than Deinococcus radiodurans.

             Scientists have been studying Deinococcus radiodurans since its discovery in 1956 trying to find out how it survives huge doses of radiation. At first it was thought that they had special repair enzymes that were much more resistant to the damage that radiation causes to DNA in all living creatures. They were thought to have special repair processes that could rapidly repair radiation damage to segments of both single strand and double stranded DNA. Ongoing research has come to question this DNA repair hypothesis.

             It now appears that the unique ability of radiodurans to resist radiation damage may lie in its ability minimize protein damage by radiation. While DNA damage caused by radiation seems to be very similar in all living organisms, protein damage is much more variable. The key feature of radiation resistance seems to be high concentrations of an orthophosphate complex of manganese. Cells susceptible to radiation damage suffer oxidation of their proteins which causes cell death. Radiodurans utilizes the high levels of the manganese compound to protect cellular protein against oxidation.

             Researchers have been able to prepare extracts of the manganese peptide complexes from radiodurans as a vaccine. Tests have shown that cells treated with the radiodurans compound have been able to withstand doses of radiation which would kill their untreated counterparts. This vaccine approach has been used to protect mice from radiation exposure by boosting immune system functioning and defend cellular proteins. This treatment can also protect the mice against infectious bacteria and viruses. The vaccine can be easily and rapidly prepared in large batches.

             Given the current concern with radiation exposure from nuclear accidents and bombs as well as the threat of bioterrorism, the development of a human vaccine from radiodurans in seen a very promising possibility.

 

          There are no drugs licensed to treat any acute radiation damage to internal tissues. Sometimes, iodine tablets are taken with the intent of flooding the system with non-radioactive iodine so that the radioactive isotope iodine-131 will not be taken up by the thyroid and cause cancer.

           “Acute radiation syndrome is caused by exposure to high doses of damaging (ionizing) radiation. ARS includes injuries to multiple organs, hemorrhaging, infection, and suppression of the immune system’s ability to fight organisms that cause infection.”

            The U.S. Department of Health and Human Services has a division named Biomedical Advanced Research and Development Authority (BARDA) devoted to supporting. There are a number of drugs currently under development with support BARDA to either prevent radiation damage or to repair radiation damage to human tissues.

            Neumedicines Inc has received 17 million dollars grant to evaluate the effectiveness and safety of a drug called HermaMax which is recombinant human interleukin-12 (fhuIL-12). Nuemedicine has already proved that HemaMax can mitigate radiation damage to bone marrow under a previous contract with BARDA. They are also working on manufacturing processes for HemaMax.

            RxBio Inc is receiving 15 million to study the efficacy of its drug Rx100 for protection against radiation-induced gastrointestinal injury. Rx100 may protect or heal if administered within 72 hours of major radiation exposure.  They are also working on development of manufacturing processes for the drug.

           UAMS is receiving 4.5 million dollars to evaluate SOM230 and generate data so that Norartis which originally developed the drug for another purpose will be able to apply to the FDA for permission to use the drug to treat gastrointestinal radiation damage. The drug will reduce secretion of hormones by the pancreas which can aggravate intestinal inflammation accompanying radiation damage.

           Araim Pharmaceuticals is receiving $3.1 million study ARA 290 to evaluate whether the drug improves survival when more than 24 hours after severe exposure to ionizing radiation. Test have indicated that the drug can be used in treating stroke, heart disease, and kidney failure through anti-inflammatory and tissue-protective action.

           Cellerant Therapeutics is receiving an additional $16.7 million dollars to extend an ongoing contract. Cellerant is working on studies and manufacturing of CLT-008 as a treatment for neutropenia, a disease in which exposure to high levels of ionizing radiation causes a serious decrease in the number of white blood cells.

            BARDA is also looking for candidates for additional grants to develop diagnostics and treatments for acute radiation exposure.

           “BARDA, an agency within the Office of the Assistant Secretary for Preparedness and Response in the U.S. Department of Health and Human Services, provides a comprehensive integrated portfolio approach to the advanced research and development, innovation, acquisition, and manufacturing infrastructure for vaccines, drugs, therapeutics, diagnostic tools, and non-pharmaceutical products for public health emergency threats. These threats include chemical, biological, radiological, and nuclear threats, pandemic influenza, and emerging infectious diseases.”

           In addition to the drug research being supported by BARDA a group of researchers at the Roswell Park Cancer Institute in Buffalo, New York are working on a drug called CBLB502. The drug was developed after it was discovered that bacteria flagellum which propel bacteria thru liquids has the ability to bind to receptors in human cells and confer protection against radiation. Tests on mice have shown that when the drug is injected into mice prior to radiation exposure, it helps cells resist the cellular suicide called apoptosis, protects the cells against free radicals which damage DNA and boosts their immune systems. No other drug in development is able to do all three of these things. Mice protected by this drug survived doses of radiation that killed unprotected mice.

Protective clothing has been developed for people who work around radioactive materials on a regular basis or who might be called to respond to a nuclear accident where radioactivity has been released into the environment.

Some ordinary fabrics can shield the skin from the ultraviolet light of the sun but others provide no protection. If you are concerned about sun exposure, you should check to insure that the material in shirts, hats, pants and shoes can block UV rays. Some but not all sunglasses block UV radiation.

Pregnant women who are concerned about everyday radiation from things like microwave ovens and laptop computers can now buy special blankets such as Belly Armor to protect the fetus in their womb.

            Glasses and face masking shields employing lead and acrylic plastic are used where there is a danger of radiation exposure to the face. They are primarily used by X-ray technicians.

            Gloves that reduce radiation exposure are available from many manufacturers. Older gloves employed lead and often required the use of powder on the hands before they were worn. Newer designs are thinner and more flexible without lead in the materials and without the need for powders. The gloves provide protection against alpha, beta, gamma and x-ray radiation. Applications include fluoroscopy, handling of radio isotopes, x-ray equipment operation and nuclear medicine.

            Rubber boots are manufactured for use against radiation. Like the gloves, the materials have become thinner, more flexible and do not have to utilize lead. There are galoshes style that are worn over regular shoes or boots as well as boots that are worn alone. These boots are used in environments where there may be radioactive materials on the ground or floor of a building. The boots provide protection against alpha, beta, gamma and x-ray radiation.

            Lead aprons and vests are used to protected patients and staff in x-ray facilities. Recently new materials have been developed which do not require lead for x-ray protection. This makes the materials in the aprons and vests lighter, thinner, more flexible and easier to clean.

            Full body suits are worn in environments where there is a danger of radiation exposure to the whole body. Once again, the older design of the suits employed lead in the materials but new materials such as Demron employ nanotechnology and do not require lead to provide good radiation protection t against alpha, beta, gamma and x-ray radiation.

Hazmat suits include full head covering hoods with a protective transparent face shields. They are sealed against air borne radioactive dust and moisture and utilize a filter system to permit the wearer to breath clear air. There are also suits that are sealed and have their own air tanks for use in very dangerous environments where the air contains toxic gases.

Eventually with the evolution of exoskeletons, emergency workers who have to deal with nuclear accidents at nuclear power plants will wear special suits of armor which will not only protect them from radiation but will also amplify their strength.

 

Radioactive materials are widely used in our high-tech society. There are medical application, industrial applications, research applications, nuclear power plants and nuclear weapons development. In addition, there is a great deal of radioactive waste left over from past uses. What can be done to protect people from the harmful effects of ionizing radiation?

            The damage done by radiation depends on the duration of the exposure, the distance from the source and the amount of radiation being emitted by the source.  Radiation protection is working with these three factors to reduce exposure.

            Duration of exposure can be reduced by improvement of procedures and good training of the people handling the radioactive material.

            Distance from the source can be increased by using remote handling equipment such as tongs, waldos and robots.

            Radiation escaping from the source can be reduced by the use of various shielding materials such as lead. The effectiveness of the radiation shielding material is related to both the density of the material and the thickness of the shield. Some elements are more effective at absorbing radioactivity than others.

            There are recommended international standards for protecting people from radiation exposure published by the International Commission on Radiological Protection. Most countries have some agency that issues permits to organizations requiring adherence to these guidelines.

            Any use of radioactive materials must have a strong justification where the advantages outweigh the disadvantages. There are limits for how much radiation a particular individual should be exposed to.  And there is the demand that everything possible be done to reduce the exposure of any individual to the absolutely lowest level possible.

            Alpha particles or helium nuclei can be stopped by a single sheet of paper.

            Beta particles or high energy electrons can be blocked by a an eighth of an inch of aluminum.  Glass, plastic, aluminum, wood or other low density materials are used to block beta radiation because higher density materials will give rise to additional radiation as the electrons interact with their atoms.

            Electromagnetic radiation such as x-rays and gamma rays are blocked by dense materials such as lead.  Lead is dense enough so that only an inch may be sufficient but other materials must be much thicker. Nuclear reactors utilize thick concrete walls in addition to lead. Ultraviolet light is also ionizing but can be easily blocked by thin layers of clothing, sunglasses or sunscreen ointment.

            Neutrons are very penetrating and much more difficult to shield than other types of radiation. Thick dense materials must be used but they can be rendered radioactive by the passing neutrons and cause additional problems for exposure and shielding.

            If you are going to be around radioactive materials, be sure that you understand the types and dangers. Follow all instructions to the letter and spend the minimal time necessary for your purpose. Use a dosimeter to keep track of your exposure and pay close attention to what it shows.

 

            Radiation is used to treat many different cancers. About one half of the new invasive cancer cases will be treated with radiation. The procedures and equipment have been developed to optimized damage to the cancerous tumors and tissue with minimal damage to surrounding healthy tissue. When a beam of radiation is directed at a tumor, the normal tissue in the path of the beam can be damaged.

            People vary in their sensitivity to therapeutic radiation and it is not possible to know in advance who may be the most sensitive and at risk from collateral damage. Damage to health tissue is divided into two types. Acute reactions are immediate effects of the radiation treatment. Chronic complications can occur months or years after treatment. Chronic damage to bones is called osteoradionecrosis. Chronic damage to soft tissue is called soft tissue radionecrosis.

            Acute reactions are treated symptomatically during the treatment of the cancer. If the normal tissue that is damaged is fast growing like gastrointestinal cells, normal tissue healing takes care of the radiation damage. Pain medication may be prescribed to relieve discomfort. This period usually lasts about six months which is referred to as the acute clinical period.

            During the second six months, the subacute clinical period, healing from acute damage ends and first signs of any long term damage appear. There may be ulceration of the tissue.           In the past, surgery was often required to cut out the dead tissue Depending on the area where the cancer occurred, such surgery could disfigure or even disable normal functioning. In addition, dead normal tissue in the path of the radiation may not heal after being cut during surgery.

            Most chronic radiation damage results from scarring which narrows the blood vessels in the area of the treatment. During the second to the fifth year which is called the chronic clinical period, permanent damage progresses. Without adequate blood flow, health tissue in area treated dies in what is called necrosis. During this time, danger of infection and trauma damage in the affected tissue increases.   

            In the late clinical period after five years have elapsed, problems can continue to manifest but at a slower rate than the chronic clinical period. There is increased danger of additional cancers caused by the original radiation treatment.

            In the 1970s, a treatment for tissue damaged by radiation was developed that utilized a chamber with raised oxygen levels. This is called a hyperbaric chamber. The treatment consists of providing 100% inhaled oxygen under pressure. This results in raising arterial oxygen five to ten times above the normal level. Perfusion of oxygen into the damaged tissue increases two to three times. This promotes healing and encourages the development of new blood vessels in the damaged tissue. The main benefit of hyperbaric treatment is this growth of new blood vessels which is known angiogenesis.

            This treatment may preclude the need for surgery. Many types of healthy tissue damaged in radiation treatments have been healed with these chambers.

            Hyper-Oxy Vitaeris 320 hyperbaric chamber:

 

          Skin can be damaged by exposure to radioactivity either by accident or by medical treatments involving radioisotopes. Some of the symptoms accompanying radiation exposure include redness, swelling, numbness, itching, tingling, dryness, peeling, changes in color, loss of hair, thinning, hardening and open wounds.  The natural healing capability of the human epidermis can deal with some radiation damage. Exposure to the sun, extremes of temperature, harsh soaps or chemicals should be avoided. There are also medical treatments which can assist healing radiation damage.  

          There are a large variety of topical creams, ointments, oils, moisturizers and other commercial products for treating skin irritation. It is recommended that skin treatments that contain perfumes, deodorants and alcohol not be used for radiation damage. Products containing vitamin E and Aloe Vera have been found to be soothing and to promote healing. Skin treatment products should be applied gently and in accord with product instructions. These products may be useful for minor skin irritations but open wounds should be examined by a physician and only use skin treatments products that are approved by the physician should be employed. 

          Itching often accompanies radiation skin damage. It can be a serious problem because the natural inclination is to scratch the itch. While this may provides temporary relief, in the long run it may aggravate the skin problem. It may be possible to get some symptomatic relief from radiation caused itching with the use of some over the counter skin soothing compounds. Ingredients which are often found in such products include menthol, calamine, camphor, eucalyptus, phenyleprine hydrochloride, diphenydramine hydrochloride, and other compounds. Severe itching can required something stronger and a doctor may suggest a prescription medication for treatment of itching. OTC oral antihistamines tablets such as diphenhydramine, chlorpheneramine, loratadine, fexofenadine, certirizine, clemastine  In addition, doctors may prescribe oral antihistamines such as levocetirizine, carbinoxamine, cyproheptadine, hydroxyzine, azelastine, doxepin.

          Radiation damage to the skin may be accompanied by inflammation which would require the use of anti-inflammatory drugs. Corticosteroid compounds such as hydrocortisone in concentrations of up to 1 percent are found in ointments and creams commonly to treat inflammation of the skin. Sometimes, corticosteroids are injected to treat skin inflammation.  Non-steroidal drugs, also referred to as NSAIDs such as aspirin, ibuprofen, and acetaminophen can also be used to treat inflammation.

          In some cases the skin may be broken and susceptible to infection after damage by radiation. In order to heal this condition, antibiotics must be added to the treatment in addition to the medication used to sooth and heal the irritation, itching and inflammation. Antibiotics may be administered oral, by injection or in the form of topical creams or ointments.

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