INTRODUCTION: Radiation-induced scalp dermatitis, a complication of radiotherapy for brain tumors, may impair the quality-of-life (QOL) of patients. Steroid ointments have been considered as the only effective treatment, but the author had reported that shiunko,a sort of oriental ointments, could relief well the symptoms of radiation-induced scalp dermatitis [Kampo Med 62(2):142-146, 2011]. In this preliminary study, In this preliminary study, the author hypothesized that the prophylactic use of shiunko could prevent or alleviate radiation-induced scalp dermatitis. MATERIALS AND METHOD: Ten patients (male 4 and female 6, ranges between 21 to 79 years-old, mean 60.3 years-old,) with malignant brain tumors were involved in this study. Radiation dose ranges between 45 to 60 Gy, mean 54.7 Gy). Shiunko was applied to the whole radiated field consecutively during the entire period of radiotherapy. The efficacies were evaluated according to Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0. RESULTS: Favorable therapeutic effects were observed in all patients. The scalp conditions were maintained well until the end of radiotherapy. The radiation dermatitis of all patients was estimated as Grade 1. But loss of hair was not avoided. DISCUSSION: Shiunko, which is covered by the Japanese health-insurance system for treating burns, is composed of only five natural remedies: lithospermi radix, angelicae radix, sesame oil, beeswax, and lard. Despite its simplicity, it has several unique activities, such as anti-bacterial activity, detoxification, anti-histamine activity, and moist wound healing. Furthermore, recent studies demonstrated vascular endothelial growth factor (VEGF) production and apoptosis induction, which promote wound healing. These preliminary results showed that shiunko is expected to be an effective ointment in preventing radiation-induced scalp dermatitis.