Comparison of Three methods for skin tattooing in conformal radiotherapy, temporary (markers, henna) and permanent Steritatt CIVCO®: Patients and radiographers comfort

Mutahir A Tunio, Mansoor Rafi, Altaf Hashmi


Tattooing is routinely performed at the time of simulation before radiotherapy treatment. Worldwide different methods are used to mark the isocenter; most commonly are temporary marker pens, commercially available tattooing needles prefilled with non toxic India ink (Steritatt) and the henna. We aimed to compare these three different methods in the terms of durability, repetition of marking session, any allergy, patient comfort and radiographer satisfaction.
Materials and Methods:
Sixty patients with early prostate cancer were selected who were advised radiation for eight to nine weeks duration. At the time of simulation, skins were marked by one of three methods including temporary marker pens, henna and Steritatt CIVCO® needling. The patients were evaluated for the durability of markings, number the markings were repeated, allergic reaction, patient comfort was assessed by using a scoring system, they were asked on scale 1-2(1= happy with marking method, 2= seeking an alternate option) and radiographers were asked to score one of the method using a scale 1-3(1= better, 2= comparable, 3= worse).
Mean duration was 4 days (2-5), 18 days (10-27) and 40 days for temporary marker pens, henna, Steritatt respectively. Patients with henna, and permanent markings were equally satisfied; however radiographers were unsatisfied with henna because of prolonged drying period (median 15 minutes). No skin allergy was seen in any procedure.
Conclusion: Permanent markings remain the standard for a good radiotherapy unit; though patients were happy with henna markings but prolonged drying period, repetition of markings do not make henna a routine practice for skin markings.


radiotherapy, skin tattooing, temporary, permamant.

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The South African Radiographer | ISSN 0258 0241

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