Abstract: Systems and methods are provided for designing and/or modifying a radiation therapy bolus for the reduction of hot spots. A digital bolus model may be modified based on the identification of a peak in the outer surface of the digital bolus model, where the peak satisfies search criteria associated with the generation of a hot spot through scattering from the peak. The digital bolus model is modified within a region surrounding the peak to smooth the peak and thereby reduce the intensity of the hot spot. The modified digital bolus model may be employed to fabricate a bolus for use in radiation therapy. The search criteria may be evaluated according to a proximity between a location measure associated with the peak and a location measure associated with the hot spot, optionally when the location measures are projected in a reference plane that resides perpendicular to the beam axis.