Shielding the skin: do African medicinal plants possess the ability to mitigate ionizing radiation-induced skin alterations?

BACKGROUND AND PURPOSE: Therapeutic exposure to ionizing radiation (IR) is fundamental to radiotherapy; however, radiation-induced skin toxicity remains a common and dose-limiting adverse effect. Although synthetic radioprotectors such as amifostine reduce radiation-mediated damage through free radical scavenging and DNA repair enhancement, their clinical application is constrained by significant side effects. Natural products, particularly antioxidant-rich medicinal plants, represent a promising complementary strategy for protecting skin tissue against radiation-induced oxidative and genotoxic injury. Despite this potential, plant-based radioprotective agents remain underexplored, particularly in Africa, a region with extensive traditional use of plants for skin disorders. A systematic review was performed to identify studies examining radiation-induced skin damage and the protective effects of African medicinal plants. A total of 26 studies met the inclusion criteria and were included in this review.

CONCLUSIONS: The literature demonstrates that therapeutic IR exposure induces oxidative stress, DNA damage and inflammatory responses in skin cells. This review identifies five African medicinal plants with reported radioprotective properties. However, only one species, Aloe arborescens, has been specifically evaluated for skin protection. The reported radioprotective effects were primarily attributed to antioxidant activity and modulation of cellular repair pathways. This systematic review identifies a significant research gap regarding African medicinal plants for skin radioprotection, despite their traditional use and documented biological activities. This review highlights the potential of these plants as adjunctive agents to mitigate radiation-induced skin toxicity, strengthening the rationale for further translational research in radiotherapy and photomedicine. Additionally, further research is warranted to validate these findings and to explore their potential translation into clinical applications.