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Chan LKW, Lee KWA, Lee CH, Lam KWP, Lee KFV, Wu R, Wan J, Shivananjappa S, Sky WTH, Choi H, Yi KH. Cosmeceuticals in photoaging: A review. Skin Res Technol 2024; 30:e13730. [PMID: 39233460 PMCID: PMC11375026 DOI: 10.1111/srt.13730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 04/18/2024] [Indexed: 09/06/2024]
Abstract
BACKGROUND Photoaging is a process of the architecture of normal skin damaged by ultraviolet radiation. Topical cosmeceuticals have been used to treat this condition. The authors aimed to understand the mechanism and level of evidence of different commonly used cosmeceuticals used to treat photodamaged skin. OBJECTIVE A range of commonly used topical cosmeceuticals (botanicals, peptides, and hydroquinone) has been used in cosmetic medicine for many years to treat photodamaged skin. This review article compares their efficacy and level of evidence. MATERIAL AND METHODS This study was a systematic review to evaluate the efficacy of different topical cosmeceuticals. Keywords including "Photoaging," "Azelaic acid," "Soy," "Green Tea," "Chamomile," "Ginkgo," "Tea Tree Oil," "Resveratrol," "Cucumber," "Ginseng," "Centella asiatica," "Licorice Root," "Aloe Vera," "Peptides," "Argireline," "Hydroquinone," were typed on OVID, PUBMED, MEDLINE for relevant studies published on photoaging treatment. RESULTS Most of the evidence behind cosmeceuticals is of high-quality ranging from Level I to Level II. In particular, the evidence base behind peptides is the strongest with most studies achieving Level Ib status in the evidence hierarchy. CONCLUSION Topical cosmeceuticals like botanicals, peptides and hydroquinone can effectively treat photodamaged skin.
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Affiliation(s)
| | | | | | | | | | - Raymond Wu
- Asia-Pacific Aesthetic Academy, Hong Kong, Hong Kong
| | - Jovian Wan
- Asia-Pacific Aesthetic Academy, Hong Kong, Hong Kong
| | | | | | - Hosung Choi
- Piena Aesthetic Clinic, Gangnam, Seoul, South Korea
| | - Kyu-Ho Yi
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
- Maylin Clinic (Apgujeong), Seoul, South Korea
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Dontje AEWK, Schuiling-Veninga CCM, van Hunsel FPAM, Ekhart C, Demirci F, Woerdenbag HJ. The Therapeutic Potential of Essential Oils in Managing Inflammatory Skin Conditions: A Scoping Review. Pharmaceuticals (Basel) 2024; 17:571. [PMID: 38794141 PMCID: PMC11123799 DOI: 10.3390/ph17050571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/23/2024] [Accepted: 04/28/2024] [Indexed: 05/26/2024] Open
Abstract
Conventional therapy is commonly used for the treatment of inflammatory skin conditions, but undesirable effects, such as erythema, dryness, skin thinning, and resistance to treatment, may cause poor patient compliance. Therefore, patients may seek complementary treatment with herbal plant products including essential oils (EOs). This scoping review aims to generate a broad overview of the EOs used to treat inflammatory skin conditions, namely, acne vulgaris, dermatitis and eczema, psoriasis, and rosacea, in a clinical setting. The quality, efficacy, and safety of various EOs, as well as the way in which they are prepared, are reviewed, and the potential, as well as the limitations, of EOs for the treatment of inflammatory skin conditions are discussed. Twenty-nine eligible studies (case studies, uncontrolled clinical studies, and randomized clinical studies) on the applications of EOs for inflammatory skin conditions were retrieved from scientific electronic databases (PubMed, Embase, Scopus, and the Cochrane Library). As an initial result, tea tree (Melaleuca alternifolia) oil emerged as the most studied EO. The clinical studies with tea tree oil gel for acne treatment showed an efficacy with fewer adverse reactions compared to conventional treatments. The uncontrolled studies indicated the potential efficacy of ajwain (Trachyspermum ammi) oil, eucalyptus (Eucalyptus globulus) oil, and cedarwood (Cedrus libani) oil in the treatment of acne, but further research is required to reach conclusive evidence. The placebo-controlled studies revealed the positive effects of kānuka (Kunzea ericoides) oil and frankincense (Boswellia spp.) oil in the treatment of psoriasis and eczema. The quality verification of the EO products was inconsistent, with some studies lacking analyses and transparency. The quality limitations of some studies included a small sample size, a short duration, and the absence of a control group. This present review underscores the need for extended, well-designed clinical studies to further assess the efficacy and safety of EOs for treating inflammatory skin conditions with products of assured quality and to further elucidate the mechanisms of action involved.
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Affiliation(s)
- Anouk E. W. K. Dontje
- Department of Pharmaceutical Technology and Biopharmacy, Groningen Research Institute of Pharmacy (GRIP), University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
| | - Catharina C. M. Schuiling-Veninga
- Department of Pharmacotherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy (GRIP), University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (C.C.M.S.-V.); (F.P.A.M.v.H.)
| | - Florence P. A. M. van Hunsel
- Department of Pharmacotherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy (GRIP), University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (C.C.M.S.-V.); (F.P.A.M.v.H.)
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvalei 7, 5237 MH ‘s-Hertogenbosch, The Netherlands;
| | - Corine Ekhart
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvalei 7, 5237 MH ‘s-Hertogenbosch, The Netherlands;
| | - Fatih Demirci
- Department of Pharmacognosy, Faculty of Pharmacy, Anadolu University, 26470 Eskisehir, Türkiye;
| | - Herman J. Woerdenbag
- Department of Pharmaceutical Technology and Biopharmacy, Groningen Research Institute of Pharmacy (GRIP), University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
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3
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Gökkaya İ, Koçer GG, Renda G. What Does a Community Think About Aromatherapy? Holist Nurs Pract 2024; 38:73-84. [PMID: 38363968 DOI: 10.1097/hnp.0000000000000634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
The awareness and usage of aromatherapy applications are increasing day by day in society. The current study aims to evaluate the thoughts and attitudes of individuals toward aromatherapy in Türkiye and to determine factors affecting the use of aromatherapy. This community-based descriptive study is conducted throughout Türkiye. Nine hundred eighty-five questionnaires were suitable for data quality. SPSS 23.0 statistical package program was used, and the statistical significance level was accepted as P value of less than .05. Approximately 72.4% of the participants have heard of aromatherapy. The rate of hearing about the concept of aromatherapy was found to be statistically significantly higher among women (P = .000), those residing in a province/district (P = .011), and those working in an income-generating positions (P = .003). It was determined that 58.9% of the participants used any essential oil. The 5 most commonly used essential oils are lavender, tea tree, peppermint, rose, and thyme, respectively. The rate of essential oil use in women is higher than in men (P = .000). The conditions in which essential oils are most frequently used are to provide beauty to the skin (51.7%), skin diseases (51.0%), and respiratory tract diseases (46.0%), respectively. The most common sources of information about the essential oils used by the participants are the Internet/social media (57.6%) and pharmacists (53.4%). The results of this research revealed that the awareness and use of aromatherapy practice in the community are high according to the literature. Considering the high tendency to use these products among the public, physicians, pharmacists, and nurses must provide consultancy services on the use of these products.
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Affiliation(s)
- İçim Gökkaya
- Department of Pharmacognosy (Ms Gökkaya and Dr Renda) and Faculty of Pharmacy (Mss Gökkaya, Renda, and Koçer), Karadeniz Technical University, Ortahisar, Trabzon, Türkiye
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4
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Bungau AF, Radu AF, Bungau SG, Vesa CM, Tit DM, Purza AL, Endres LM. Emerging Insights into the Applicability of Essential Oils in the Management of Acne Vulgaris. Molecules 2023; 28:6395. [PMID: 37687224 PMCID: PMC10489792 DOI: 10.3390/molecules28176395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
The occurrence of pustules, comedones, nodules, and cysts defines acne vulgaris, a prevalent chronic inflammatory dermatological condition. In the past few decades, essential oils extracted from varied natural sources have acquired recognition due to their potential medicinal applications in acne therapy. However, there is not yet sufficient medical data to fully characterize this interaction. Multiple factors contribute to the development of acne vulgaris, including excessive sebaceous production, inflammatory processes, hyperkeratinization, and infection with Cutibacterium acnes. Essential oils, including oregano, lavender, lemon grass, myrtle, lemon, thyme, eucalyptus, rosemary, and tea tree, have been found to possess anti-inflammatory, antioxidant, and antimicrobial properties, which may target the multifactorial causes of acne. Analytical methods for determining antioxidant potential (i.e., total phenolic content, diphenyl-1-picrylhydrazyl free radical scavenging assay, reducing power assay, ferrous ion chelating activity, thiobarbituric acid reactive species assay, β-carotene bleaching assay, etc.) are essential for the evaluation of these essential oils, and their method optimization is crucial. Further studies could include the development of novel acne treatments incorporating essential oils and an assessment of their efficacy in large clinical trials. In addition, further research is necessary to ascertain the mechanisms of action of essential oils and their optimal doses and safety profiles for optimal implementation in the management of acne vulgaris.
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Affiliation(s)
- Alexa Florina Bungau
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania; (A.F.B.); (C.M.V.); (D.M.T.)
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Andrei-Flavius Radu
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania; (A.F.B.); (C.M.V.); (D.M.T.)
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Simona Gabriela Bungau
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania; (A.F.B.); (C.M.V.); (D.M.T.)
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania;
| | - Cosmin Mihai Vesa
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania; (A.F.B.); (C.M.V.); (D.M.T.)
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Delia Mirela Tit
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania; (A.F.B.); (C.M.V.); (D.M.T.)
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania;
| | - Anamaria Lavinia Purza
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania;
| | - Laura Maria Endres
- Department of Psycho-Neurosciences and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
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Nascimento T, Gomes D, Simões R, da Graça Miguel M. Tea Tree Oil: Properties and the Therapeutic Approach to Acne-A Review. Antioxidants (Basel) 2023; 12:1264. [PMID: 37371994 DOI: 10.3390/antiox12061264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Acne vulgaris is an inflammatory dermatological pathology that affects mostly young people. However, it can also appear in adulthood, mainly in women. It has a high psychosocial impact, not only at the time of active lesions but also due to the consequences of lesions such as scarring and hyperpigmentation. Several factors are involved in the physiopathology of acne and the constant search for active ingredients is a reality, namely phytotherapeutic ingredients. Tea tree oil is an essential oil extracted from Melaleuca alternifolia (Maiden & Betch) Cheel with known antibacterial, anti-inflammatory, and antioxidant properties, making it a candidate for the treatment of acne. This review aims to describe the various properties of tea tree oil that make it a possible ingredient to use in the treatment of acne and to present several human studies that have evaluated the efficacy and safety of using tea tree oil in the treatment of acne. It can be concluded that tea tree oil has good antibacterial, anti-inflammatory, and antioxidant properties that result in a decrease in the number of inflammatory lesions, mainly papules, and pustules. However, given the diversity of study designs, it is not possible to draw concrete conclusions on the efficacy and safety of this oil in the treatment of acne.
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Affiliation(s)
- Tânia Nascimento
- Escola Superior de Saúde, Universidade do Algarve (ESSUAlg), Campus de Gambelas, Edifício 2, 8005-139 Faro, Portugal
- Algarve Biomedical Center Research Institute (ABC-RI), Universidade do Algarve, Campus de Gambelas, Edifício 2, 8005-139 Faro, Portugal
| | - Diana Gomes
- Faculdade de Ciências e Tecnologia, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
| | - Ricardo Simões
- Faculdade de Ciências e Tecnologia, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
| | - Maria da Graça Miguel
- Faculdade de Ciências e Tecnologia, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
- Mediterranean Institute for Agriculture, Environment and Development, Mediterranean Institute for Agriculture, Environment and Development, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
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6
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Orchard A, Moosa T, Motala N, Kamatou G, Viljoen A, van Vuuren S. Commercially Available Viola odorata Oil, Chemical Variability and Antimicrobial Activity. Molecules 2023; 28:molecules28041676. [PMID: 36838663 PMCID: PMC9958603 DOI: 10.3390/molecules28041676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/31/2023] [Accepted: 02/04/2023] [Indexed: 02/12/2023] Open
Abstract
Viola odorata L. oil is frequently recommended in the aromatherapeutic literature for treating respiratory, urinary, and skin infections; however, antimicrobial evidence is lacking. In addition, in aromatherapy, combinations of essential oils are predominantly utilized with the goal of achieving therapeutic synergy, yet no studies investigating the interaction of essential oil combinations with V. odorata oil exists. This study thus aimed to address these gaps by investigating the antimicrobial activity of three Viola odorata oil samples, sourced from different suppliers, independently and in combination with 20 different commercial essential oils, against micro-organisms involved in respiratory, skin, and urinary tract infections associated with global resistance trends. These pathogens include several of the ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp.) The chemical profile of the oils was determined using gas chromatography coupled with mass spectrometry. The minimum inhibitory concentrations (MIC) were determined using the broth micro-dilution method. The interactive profiles for the combinations were assessed by calculating the fractional inhibitory concentration index (ΣFIC). The main compounds varied across the three samples, and included phenethyl alcohol, isopropyl myristate, 2-nonynoic acid, methyl ester, α-terpineol, α-cetone, and benzyl acetate. The V. odorata oil samples displayed overall poor antimicrobial activity when tested alone; however, the antimicrobial activity of the combinations resulted in 55 synergistic interactions where the combination with Santalum austrocaledonicum resulted in the lowest MIC values as low as 0.13 mg/mL. The frequency of the synergistic interactions predominantly occurred against Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterococcus faecium with noteworthy MIC values ranging from 0.25-1.00 mg/mL. This study also reports on the variability of V. odorata oils sold commercially. While this warrants caution, the antimicrobial benefit in combination provides an impetus for further studies to investigate the therapeutic potential.
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Affiliation(s)
- Ané Orchard
- Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Tasneem Moosa
- Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Nabeelah Motala
- Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Guy Kamatou
- Department of Pharmaceutical Sciences, Faculty of Science, Tshwane University of Technology, Private Bag X680, Pretoria 0001, South Africa
| | - Alvaro Viljoen
- Department of Pharmaceutical Sciences, Faculty of Science, Tshwane University of Technology, Private Bag X680, Pretoria 0001, South Africa
- SAMRC Herbal Drugs Research Unit, Department of Pharmaceutical Sciences, Private Bag X680, Pretoria 0001, South Africa
| | - Sandy van Vuuren
- Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
- Correspondence:
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Asnaashari S, Kazemnezhad M, Masoud F, Javadzadeh Y. An overview on the anti-acne properties of herbal essential oils. J Herb Med 2023. [DOI: 10.1016/j.hermed.2023.100642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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8
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Kairey L, Agnew T, Bowles EJ, Barkla BJ, Wardle J, Lauche R. Efficacy and safety of Melaleuca alternifolia (tea tree) oil for human health-A systematic review of randomized controlled trials. Front Pharmacol 2023; 14:1116077. [PMID: 37033604 PMCID: PMC10080088 DOI: 10.3389/fphar.2023.1116077] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/04/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction: Leaves of the Australian tea tree plant Melaleuca alternifolia were used traditionally by First Nations Australians for treating wounds, burns, and insect bites. Tea tree oil, the essential oil steam-distilled from M. alternifolia, is well-known for its medicinal properties, the evidence for most applications however is limited. This review aimed to critically appraise evidence from clinical trials examining the therapeutic efficacy and safety of tea tree oil on outcomes. Methods: Randomized controlled trials with participants of any age, gender, or health status, comparing tea tree oil to any control were included, without limit on publication date. Electronic databases were searched on 12 August 2022 with additional records sourced from article reference sections, reviews, and industry white papers. Risk of bias was assessed by two authors independently using the Cochrane risk-of-bias 1.0 tool. Results were summarized and synthesized thematically. Results: Forty-six articles were eligible from the following medical fields (Dentistry n = 18, Dermatology n = 9, Infectious disease n = 9, Ophthalmology n = 6, Podiatry n = 3; and Other n = 1). Results indicate that oral mouthwashes with 0.2%-0.5% tea tree oil may limit accumulation of dental plaque. Gels containing 5% tea tree oil applied directly to the periodontium may aid treatment of periodontitis as an adjunctive therapy to scaling and root planing. More evidence is needed to confirm the benefits of tea tree oil for reducing acne lesions and severity. Local anti-inflammatory effects on skin, if any, also require further elucidation. Topical tea tree oil regimens show similar efficacy to standard treatments for decolonizing the body from methicillin-resistant Staphylococcus aureus, although intra-nasal use of tea tree oil may cause irritation to mucous membranes. Tea tree oil with added iodine may provide an effective treatment for molluscum contagiosum lesions in young children. More evidence on efficacy of tea tree oil-based eyelid wipes for Demodex mite control are needed. Side effects were reported in 60% of included studies and were minor, except where tea tree oil was applied topically in concentrations ≥ 25%. Discussion: Overall, the quality of research was poor to modest and higher quality trials with larger samples and better reporting are required to substantiate potential therapeutic applications of tea tree oil. Systematic Review Registration: PROSPERO, identifier [CRD42021285168].
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Affiliation(s)
- Lana Kairey
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
| | - Tamara Agnew
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
| | - Esther Joy Bowles
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
| | - Bronwyn J. Barkla
- Southern Cross Plant Science, Faculty of Science and Engineering, Southern Cross University, Lismore, NSW, Australia
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
| | - Romy Lauche
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
- *Correspondence: Romy Lauche,
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Kim M, Sowndhararajan K, Kim S. The Chemical Composition and Biological Activities of Essential Oil from Korean Native Thyme Bak-Ri-Hyang (Thymus quinquecostatus Celak.). Molecules 2022; 27:molecules27134251. [PMID: 35807496 PMCID: PMC9268194 DOI: 10.3390/molecules27134251] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 02/01/2023] Open
Abstract
Thymus quinquecostatus Celak. (Korean name: bak-ri-hyang) is an important medicinal and aromatic herb in Korea, which is named for the spread of its fragrance over a distance of approximately 40 km. In traditional Korean systems of medicine, T. quinquecostatus has been used to treat cancer, constipation, hepatic disease, arteriosclerosis, poor circulation in women, constipation, and menstrual irregularities. At present, T. quinquecostatus is used only for ornamental and ground cover purposes. A literature search was conducted to retrieve information regarding the essential oil composition and biological properties of T. quinquecostatus from PubMed, Science Direct, Wiley, Springer, Taylor and Francis, Wiley, and other literature databases. T. quinquecostatus can be divided into different chemotypes, such as γ-terpinene, thymol, phenol, carvacrol, and geraniol, according to the presence of major components in its essential oil. Further, the essential oil from T. quinquecostatus has been reported to possess various therapeutic properties such as antioxidant, antimicrobial, anticancer, anti-inflammatory, analgesic, sleep prolonging, soothing, skin protection and whitening, anti-aging, anti-obesity, and anti-acne properties. In conclusion, this review will be helpful for utilizing the T. quinquecostatus plant in different industries including food, pharmaceuticals, pesticides, perfumery, and cosmetics.
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Affiliation(s)
- Minju Kim
- School of Natural Resources and Environmental Science, Kangwon National University, Chuncheon 24341, Korea;
| | | | - Songmun Kim
- School of Natural Resources and Environmental Science, Kangwon National University, Chuncheon 24341, Korea;
- Correspondence: ; Tel.: +82-33-250-6447
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The Role of Herbal Medicine in the Treatment of Acne Vulgaris: A Systematic Review of Clinical Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2011945. [PMID: 35754694 PMCID: PMC9217581 DOI: 10.1155/2022/2011945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 05/25/2022] [Accepted: 05/28/2022] [Indexed: 12/29/2022]
Abstract
Over the past few decades, interest in medicinal plants and phytochemicals for the treatment of skin disorders, including acne vulgaris, has progressively increased. Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit, which mainly occurs in adolescents and young adults. The treatment focuses on the four main factors involved in its pathogenesis: increased sebum production, hyperkeratinization, overgrowth of Cutibacterium acnes, and inflammation. The treatment includes topical retinoids, benzoyl peroxide, antibiotics, and oral isotretinoin. In this regard, the use of herbal medicine as a complementary and alternative medicine is a promising strategy. The main objective of this study was to systematically evaluate the efficacy and safety of medicinal plants and phytochemicals in the treatment of acne vulgaris. Three scientific databases (PubMed, Web of Science, and Scopus) were searched from inception to January 2021. Clinical trials comparing herbal therapies with placebo or other medicines for the treatment of acne vulgaris were included and analyzed. Outcome measures of interest comprised acne lesions (inflammatory and noninflammatory), sebum production, acne severity, and quality of life. The risk of bias in the included randomized controlled trials (RCTs) was assessed using the Cochrane risk-of-bias tool. A total of 34 clinical trials involving 1753 participants met the inclusion criteria for this systematic review. Most trials showed that herbal medicine significantly reduces inflammatory and noninflammatory acne lesions and has a relevant effect on acne severity. Some medicinal plants revealed equal or higher efficacy to standard treatments. No significant difference between groups in sebum production and quality of life was observed and no severe adverse events were reported. This systematic review provides evidence that medicinal plants and phytochemicals are promising treatments for mild to moderate acne vulgaris. However, more quality of evidence and standardized methodologies are needed to support their effectiveness and safety claims.
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Bungau SG, Tit DM, Vesa CM, Abid A, Szilagyi DV, Radu AF, Bungau AF, Tarce AG, Behl T, Stoicescu M, Brisc CM, Gitea D, Nechifor AC, Endres L. Non-conventional therapeutical approaches to acne vulgaris related to its association with metabolic disorders. Eur J Pharmacol 2022; 923:174936. [PMID: 35378101 DOI: 10.1016/j.ejphar.2022.174936] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/12/2022] [Accepted: 03/30/2022] [Indexed: 12/31/2022]
Abstract
The ever-increasing frequency of metabolic syndrome (MetS) is still a major challenge of the public health care system, worldwide. In recent years, researchers have been drawn to the uncommon (at first look) link between skin illnesses and MetS. Because of the pro-inflammatory mechanisms and insulin resistance (IR) that are upregulated in metabolic syndrome, many skin disorders are correlated to metabolic dysfunctions, including acne vulgaris. A comprehensive understanding of the link between MetS and acne vulgaris may contribute to the development of new treatment strategies. The current review focuses on dietary and therapeutic interventions and assesses the effect of various approaches such as improving diet by avoiding certain food products (i.e., milk and chocolate) or increasing the intake of others (i.e., food products rich in omega-3 fatty acids), metformin administration, therapy with plant extracts, plant essential oils, and probiotic supplementation on the improvement of certain acne vulgaris severity parameters. These therapeutic approaches, when combined with allopathic treatment, can improve the patients' quality of life.
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Affiliation(s)
- Simona Gabriela Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028, Oradea, Romania; Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087, Oradea, Romania.
| | - Delia Mirela Tit
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028, Oradea, Romania; Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087, Oradea, Romania.
| | - Cosmin Mihai Vesa
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073, Oradea, Romania.
| | - Areha Abid
- Department of Food and Bioproduct Science, College of Agriculture and Bioresources, University of Saskatchewan, Canada.
| | - Denisa-Viola Szilagyi
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087, Oradea, Romania.
| | - Andrei-Flavius Radu
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087, Oradea, Romania.
| | - Alexa Florina Bungau
- Faculty of Medicine and Pharmacy, University of Oradea, 410073, Oradea, Romania.
| | | | - Tapan Behl
- Department of Pharmacology, Chitkara College of Pharmacy, Chitkara University, Punjab, 140401, India.
| | - Manuela Stoicescu
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073, Oradea, Romania.
| | - Cristina Mihaela Brisc
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073, Oradea, Romania.
| | - Daniela Gitea
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028, Oradea, Romania.
| | - Aurelia Cristina Nechifor
- Analytical Chemistry and Environmental Engineering Department, University Politehnica of Bucharest, 011061, Bucharest, Romania.
| | - Laura Endres
- Department of Psycho-neurosciences and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073, Oradea, Romania.
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Recent Developments in Methicillin-Resistant Staphylococcus aureus (MRSA) Treatment: A Review. Antibiotics (Basel) 2022; 11:antibiotics11050606. [PMID: 35625250 PMCID: PMC9137690 DOI: 10.3390/antibiotics11050606] [Citation(s) in RCA: 72] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/28/2022] [Accepted: 03/23/2022] [Indexed: 11/28/2022] Open
Abstract
Staphylococcus aureus (S. aureus) is a Gram-positive bacterium that may cause life-threatening diseases and some minor infections in living organisms. However, it shows notorious effects when it becomes resistant to antibiotics. Strain variants of bacteria, viruses, fungi, and parasites that have become resistant to existing multiple antimicrobials are termed as superbugs. Methicillin is a semisynthetic antibiotic drug that was used to inhibit staphylococci pathogens. The S. aureus resistant to methicillin is known as methicillin-resistant Staphylococcus aureus (MRSA), which became a superbug due to its defiant activity against the antibiotics and medications most commonly used to treat major and minor infections. Successful MRSA infection management involves rapid identification of the infected site, culture and susceptibility tests, evidence-based treatment, and appropriate preventive protocols. This review describes the clinical management of MRSA pathogenesis, recent developments in rapid diagnosis, and antimicrobial treatment choices for MRSA.
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Qadir A, Ullah SNMN, Gupta DK, Khan N. Phytoconstituents loaded nanomedicines for the management of Acne. J Cosmet Dermatol 2022; 21:3240-3255. [DOI: 10.1111/jocd.14999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/05/2022] [Accepted: 04/13/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Abdul Qadir
- Department of Pharmaceutics School of pharmaceutical education and research Jamia Hamdard New Delhi 110062
- Department of Research and Developments Herbalfarm Health care Private Limited New Delhi 110020
| | | | - Dipak Kumar Gupta
- Department of Pharmaceutics School of pharmaceutical education and research Jamia Hamdard New Delhi 110062
| | - Nausheen Khan
- Department of Pharmacognosy and Phytochemistry school of pharmaceutical education and research Jamia Hamdard New Delhi 110062
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Khameneh B, Eskin NAM, Iranshahy M, Fazly Bazzaz BS. Phytochemicals: A Promising Weapon in the Arsenal against Antibiotic-Resistant Bacteria. Antibiotics (Basel) 2021; 10:1044. [PMID: 34572626 PMCID: PMC8472480 DOI: 10.3390/antibiotics10091044] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 12/12/2022] Open
Abstract
The extensive usage of antibiotics and the rapid emergence of antimicrobial-resistant microbes (AMR) are becoming important global public health issues. Many solutions to these problems have been proposed, including developing alternative compounds with antimicrobial activities, managing existing antimicrobials, and rapidly detecting AMR pathogens. Among all of them, employing alternative compounds such as phytochemicals alone or in combination with other antibacterial agents appears to be both an effective and safe strategy for battling against these pathogens. The present review summarizes the scientific evidence on the biochemical, pharmacological, and clinical aspects of phytochemicals used to treat microbial pathogenesis. A wide range of commercial products are currently available on the market. Their well-documented clinical efficacy suggests that phytomedicines are valuable sources of new types of antimicrobial agents for future use. Innovative approaches and methodologies for identifying plant-derived products effective against AMR are also proposed in this review.
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Affiliation(s)
- Bahman Khameneh
- Department of Pharmaceutical Control, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad 9177948954, Iran;
| | - N. A. Michael Eskin
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada;
| | - Milad Iranshahy
- Department of Pharmacognosy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad 9177948954, Iran
| | - Bibi Sedigheh Fazly Bazzaz
- Department of Pharmaceutical Control, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad 9177948954, Iran;
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad 9177948954, Iran
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Psychological and Antibacterial Effects of Footbath Using the Lindera umbellata Essential Oil. Molecules 2021; 26:molecules26175128. [PMID: 34500561 PMCID: PMC8434156 DOI: 10.3390/molecules26175128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 08/17/2021] [Accepted: 08/23/2021] [Indexed: 12/05/2022] Open
Abstract
Lindera umbellata (Lu) essential oil primarily contains linalool and has relaxation properties. We investigated the psychological and antibacterial effects of footbath with Lu essential oil. The participants included 20 women without medical history and received two intervention plans: footbath without any essential oil and footbath using Lu essential oil. Next, questionnaires regarding impressions and mood states were provided for them to answer. In addition, their autonomic nervous system activity was measured, and the aerobic viable of count on the feet was determined. The high-frequency value reflecting the parasympathetic nervous system activity significantly increased after footbath using Lu essential oil. In the questionnaire about the mood states, the subscale scores of tension–anxiety, depression, fatigue, and confusion after intervention were lower than those before intervention regardless of the use of the essential oil. Conversely, the anger–hostility score decreased only in the group using Lu essential oil. Furthermore, the decrease in aerobic viable count after intervention was not significantly different between the two groups. Footbath using Lu essential oil increased the parasympathetic nervous system activity and relieved anger. Taken together, we suggest that footbath using Lu essential oil has a relaxation effect.
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Jones VA, Patel PM, Wilson C, Wang H, Ashack KA. Complementary and alternative medicine treatments for common skin diseases: A systematic review and meta-analysis. JAAD Int 2021; 2:76-93. [PMID: 34409356 PMCID: PMC8362305 DOI: 10.1016/j.jdin.2020.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2020] [Indexed: 12/16/2022] Open
Abstract
Background Complementary and alternative medicine (CAM) treatments are growing in popularity as alternative treatments for common skin conditions. Objectives To perform a systematic review and meta-analysis to determine the tolerability and treatment response to CAM treatments in acne, atopic dermatitis (AD), and psoriasis. Methods PubMed/Medline and Embase databases were searched to identify eligible studies measuring the effects of CAM in acne, AD, and psoriasis. Effect size with 95% confidence interval (CI) was estimated using the random-effect model. Results The search yielded 417 articles; 40 studies met the inclusion criteria. The quantitative results of CAM treatment showed a standard mean difference (SMD) of 3.78 (95% CI [−0.01, 7.57]) and 0.58 (95% CI [−6.99, 8.15]) in the acne total lesion count, a SMD of −0.70 (95% CI [−1.19, −0.21]) in the eczema area and severity index score and a SMD of 0.94 (95% CI [−0.83, 2.71]) in the scoring of atopic dermatitis score for AD, and a SMD of 3.04 (95% CI [−0.35, 6.43]) and 5.16 (95% CI [−0.52, 10.85]) in the Psoriasis Area Severity Index score for psoriasis. Limitations Differences between the study designs, sample sizes, outcome measures, and treatment durations limit the generalizability of data. Conclusions Based on our quantitative findings we conclude that there is insufficient evidence to support the efficacy and the recommendation of CAM for acne, AD, and psoriasis.
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Key Words
- AD, atopic dermatitis
- AV, aloe vera
- CAM, complementary and alternative medicine
- CCO, coconut oil
- GT, green tea
- PASI, psoriasis area and severity index
- SCORAD, scoring of atopic dermatitis
- SMD, standardized mean difference
- SSO, sunflower seed oil
- TCS, topical corticosteroid
- TLC, total lesion count
- TTO, tea tree oil
- acne vulgaris
- aloe vera
- atopic dermatitis
- coconut oil
- colloidal oatmeal
- complementary alternative medicine
- curcumin
- eczema
- green tea
- honey
- meta-analysis
- natural ingredients
- psoriasis
- shea butter
- sunflower seed oil
- systematic review
- tea tree oil
- turmeric
- witch hazel
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Affiliation(s)
- Virginia A. Jones
- Department of Dermatology, University of Illinois at Chicago, Chicago, Illinois
| | - Payal M. Patel
- Department of Dermatology, University of Illinois at Chicago, Chicago, Illinois
| | - Claire Wilson
- Department of Dermatology, University of Illinois at Chicago, Chicago, Illinois
| | - Hongnan Wang
- Department of Mathematics, Statistics and Computer Science, University of Illinois at Chicago, Chicago, Illinois
| | - Kurt A. Ashack
- Department of Dermatology, University of Illinois at Chicago, Chicago, Illinois
- Dermatology Associates of West Michigan, Grand Rapids, Michigan
- Correspondence to: Kurt A. Ashack, MD, MHS, Dermatology Associates of West Michigan, 1740 East Paris Ave SE, Grand Rapids, MI 49546.
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Abstract
Our understanding of the role of Cutibacterium acnes in the pathophysiology of acne has recently undergone a paradigm shift: rather than C. acnes hyperproliferation, it is the loss of balance between the different C. acnes phylotypes, together with a dysbiosis of the skin microbiome, which results in acne development. The loss of diversity of C. acnes phylotypes acts as a trigger for innate immune system activation, leading to cutaneous inflammation. A predominance of C. acnes phylotype IA1 has been observed, with a more virulent profile in acne than in normal skin. Other bacteria, mainly Staphylococcus epidermis, are also implicated in acne. S. epidermidis and C. acnes interact and are critical for the regulation of skin homeostasis. Recent studies also showed that the gut microbiome is involved in acne, through interactions with the skin microbiome. As commonly used topical and systemic antibiotics induce cutaneous dysbiosis, our new understanding of acne pathophysiology has prompted a change in direction for acne treatment. In the future, the development of individualized acne therapies will allow targeting of the pathogenic strains, leaving the commensal strains intact. Such alternative treatments, involving modifications of the microbiome, will form the next generation of ‘ecobiological’ anti-inflammatory treatments.
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Affiliation(s)
- Brigitte Dréno
- Dermatology Department, CHU Nantes, CIC 1413, CRCINA, University Nantes, Nantes, France
- CIC 1413, CRCINA, U1232, Nantes, France
| | | | - Amir Khammari
- Dermatology Department, CHU Nantes, CIC 1413, CRCINA, University Nantes, Nantes, France
- CIC 1413, CRCINA, U1232, Nantes, France
| | - Stéphane Corvec
- Bacteriology and Hygiene Unit, Biology Institute, Nantes, France
- CRCINA, U1232, Nantes, France
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Johansen B, Duval RE, Sergere JC. Antimicrobial Spectrum of Titroleane™: A New Potent Anti-Infective Agent. Antibiotics (Basel) 2020; 9:E391. [PMID: 32650521 PMCID: PMC7400619 DOI: 10.3390/antibiotics9070391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 07/03/2020] [Accepted: 07/05/2020] [Indexed: 01/22/2023] Open
Abstract
Tea Tree oil (TTO) is well known for its numerous good properties but might be also irritating or toxic when used topically or ingested, thus limiting the number of possible applications in Humans. The aim of the study was to characterize the antimicrobial spectrum as well as the toxicity of Titroleane™, a new anti-infective agent obtained from TTO but cleared of its toxic monoterpenes part. The susceptibility to Titroleane™ of various pathogens (bacteria and fungi) encountered in animal and human health was studied in comparison with that of TTO. Antimicrobial screening was carried out using the broth microdilution method. Activities against aerobic, anaerobic, fastidious and non-fastidious microorganisms were performed. For all microorganisms tested, the MIC values for Titroleane™ ranged from 0.08% to 2.5%, except for Campylobacter jejuni, and Aspergillus niger. In particular, Titroleane™ showed good efficacy against skin and soft tissue infection pathogens, such as methicillin resistant Staphylococcus aureus (MRSA), intra-abdominal infections and oral pathogens, as well as fish farming pathogens. Toxicity testing showed little and similar cytotoxicities between TTO and Titroleane™ of 37% and 23%, respectively at a concentration of 0.025% (v/v). Finally, we demonstrated that the antimicrobial activity of Titroleane™ is similar to that of TTO.
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Affiliation(s)
- Bianca Johansen
- SETUBIO SA, Bioparc Vichy, F-03270 Hauterive, France
- Université de Lorraine, CNRS, L2CM, F-54000 Nancy, France
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Svitina H, Swanepoel R, Rossouw J, Netshimbupfe H, Gouws C, Hamman J. Treatment of Skin Disorders with Aloe Materials. Curr Pharm Des 2020; 25:2208-2240. [PMID: 31269881 DOI: 10.2174/1381612825666190703154244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 06/20/2019] [Indexed: 01/09/2023]
Abstract
The skin is the largest organ and functions as a barrier to protect the underlying tissues against the elements and pathogens, while also fulfilling many physiological roles and biochemical functions such as preventing excessive water loss. Skin disorders vary greatly in terms of origin, severity, symptoms and affect persons of all ages. Many plants have been used for medicinal purposes since ancient times including the treatment of skin disorders and diseases. Aloe represents one of the earliest medicinal plant species mentioned in antique scriptures and even in rock art dating back thousands of years. Different Aloe species and materials have been used in the prevention and treatment of skin related disorders. Aloe vera is the most commonly used Aloe species for medicinal purposes. Some of the most prominent skin related applications and disorders that Aloe materials have been investigated for are discussed in this paper, which include cosmetic, radiation, cancer, wound and antimicrobial applications. Both in vitro and in vivo studies are included in the discussions of this paper and comprehensive summaries of all these studies are given in tables in each section. Although some contradictory results were obtained among studies, certain Aloe materials have shown excellent efficacy and exhibited potential for the treatment of skin related disorders and cosmetic applications.
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Affiliation(s)
- Hanna Svitina
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Roan Swanepoel
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Jacques Rossouw
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Happiness Netshimbupfe
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Chrisna Gouws
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Josias Hamman
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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Abstract
BACKGROUND Acne is a common, economically burdensome condition that can cause psychological harm and, potentially, scarring. Topical benzoyl peroxide (BPO) is a widely used acne treatment; however, its efficacy and safety have not been clearly evaluated. OBJECTIVES To assess the effects of BPO for acne. SEARCH METHODS We searched the following databases up to February 2019: the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS. We also searched five trials registers and checked the reference lists of relevant randomised controlled trials (RCTs) and systematic reviews. SELECTION CRITERIA We included RCTs that compared topical BPO used alone (including different formulations and concentrations of BPO) or as part of combination treatment against placebo, no treatment, or other active topical medications for clinically diagnosed acne (used alone or in combination with other topical drugs not containing BPO) on the face or trunk. DATA COLLECTION AND ANALYSIS We used standard methodological procedures as expected by Cochrane. Primary outcome measures were 'participant global self-assessment of acne improvement' and 'withdrawal due to adverse events in the whole course of a trial'. 'Percentage of participants experiencing any adverse event in the whole course of a trial' was a key secondary outcome. MAIN RESULTS We included 120 trials (29,592 participants randomised in 116 trials; in four trials the number of randomised participants was unclear). Ninety-one studies included males and females. When reported, 72 trials included participants with mild to moderate acne, 26 included participants with severe acne, and the mean age of participants ranged from 18 to 30 years. Our included trials assessed BPO as monotherapy, as add-on treatment, or combined with other active treatments, as well as BPO of different concentrations and BPO delivered through different vehicles. Comparators included different concentrations or formulations of BPO, placebo, no treatment, or other active treatments given alone or combined. Treatment duration in 80 trials was longer than eight weeks and was only up to 12 weeks in 108 trials. Industry funded 50 trials; 63 trials did not report funding. We commonly found high or unclear risk of performance, detection, or attrition bias. Trial setting was under-reported but included hospitals, medical centres/departments, clinics, general practices, and student health centres. We reported on outcomes assessed at the end of treatment, and we classified treatment periods as short-term (two to four weeks), medium-term (five to eight weeks), or long-term (longer than eight weeks). For 'participant-reported acne improvement', BPO may be more effective than placebo or no treatment (risk ratio (RR) 1.27, 95% confidence interval (CI) 1.12 to 1.45; 3 RCTs; 2234 participants; treatment for 10 to 12 weeks; low-certainty evidence). Based on low-certainty evidence, there may be little to no difference between BPO and adapalene (RR 0.99, 95% CI 0.90 to 1.10; 5 RCTs; 1472 participants; treatment for 11 to 12 weeks) or between BPO and clindamycin (RR 0.95, 95% CI 0.68 to 1.34; 1 RCT; 240 participants; treatment for 10 weeks) (outcome not reported for BPO versus erythromycin or salicylic acid). For 'withdrawal due to adverse effects', risk of treatment discontinuation may be higher with BPO compared with placebo or no treatment (RR 2.13, 95% CI 1.55 to 2.93; 24 RCTs; 13,744 participants; treatment for 10 to 12 weeks; low-certainty evidence); the most common causes of withdrawal were erythema, pruritus, and skin burning. Only very low-certainty evidence was available for the following comparisons: BPO versus adapalene (RR 1.85, 95% CI 0.94 to 3.64; 11 RCTs; 3295 participants; treatment for 11 to 24 weeks; causes of withdrawal not clear), BPO versus clindamycin (RR 1.93, 95% CI 0.90 to 4.11; 8 RCTs; 3330 participants; treatment for 10 to 12 weeks; causes of withdrawal included local hypersensitivity, pruritus, erythema, face oedema, rash, and skin burning), erythromycin (RR 1.00, 95% CI 0.07 to 15.26; 1 RCT; 60 participants; treatment for 8 weeks; withdrawal due to dermatitis), and salicylic acid (no participants had adverse event-related withdrawal; 1 RCT; 59 participants; treatment for 12 weeks). There may be little to no difference between these groups in terms of withdrawal; however, we are unsure of the results because the evidence is of very low certainty. For 'proportion of participants experiencing any adverse event', very low-certainty evidence leaves us uncertain about whether BPO increased adverse events when compared with placebo or no treatment (RR 1.40, 95% CI 1.15 to 1.70; 21 RCTs; 11,028 participants; treatment for 10 to 12 weeks), with adapalene (RR 0.71, 95% CI 0.50 to 1.00; 7 RCTs; 2120 participants; treatment for 11 to 24 weeks), with erythromycin (no participants reported any adverse events; 1 RCT; 89 participants; treatment for 10 weeks), or with salicylic acid (RR 4.77, 95% CI 0.24 to 93.67; 1 RCT; 41 participants; treatment for 6 weeks). Moderate-certainty evidence shows that the risk of adverse events may be increased for BPO versus clindamycin (RR 1.24, 95% CI 0.97 to 1.58; 6 RCTs; 3018 participants; treatment for 10 to 12 weeks); however, the 95% CI indicates that BPO might make little to no difference. Most reported adverse events were mild to moderate, and local dryness, irritation, dermatitis, erythema, application site pain, and pruritus were the most common. AUTHORS' CONCLUSIONS Current evidence suggests that BPO as monotherapy or add-on treatment may be more effective than placebo or no treatment for improving acne, and there may be little to no difference between BPO and either adapalene or clindamycin. Our key efficacy evidence is based on participant self-assessment; trials of BPO versus erythromycin or salicylic acid did not report this outcome. For adverse effects, the evidence is very uncertain regarding BPO compared with adapalene, erythromycin, or salicylic acid. However, risk of treatment discontinuation may be higher with BPO compared with placebo or no treatment. Withdrawal may be linked to tolerability rather than to safety. Risk of mild to moderate adverse events may be higher with BPO compared with clindamycin. Further trials should assess the comparative effects of different preparations or concentrations of BPO and combination BPO versus monotherapy. These trials should fully assess and report adverse effects and patient-reported outcomes measured on a standardised scale.
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Affiliation(s)
- Zhirong Yang
- School of Clinical Medicine, University of CambridgePrimary Care Unit, Department of Public Health and Primary CareStrangeways Research Laboratory, 2 Worts’ CausewayCambridgeUKCB1 8RN
- School of Public Health, Peking UniversityCentre for Evidence Based Medicine and Clinical Research, Department of Epidemiology and BiostatisticsBeijingChina100191
| | - Yuan Zhang
- McMaster UniversityDepartment of Health Research Methods, Evidence, and Impact1280 Main Street WestHamiltonONCanadaL8S 4K1
| | - Elvira Lazic Mosler
- Catholic University of CroatiaDepartment of NursingIlica 242ZagrebCroatia10000
- General Hospital "Dr. Ivo Pedišić"Department for Dermatology and VenereologyJ.J. Strossmayera 59SisakCroatia44000
| | - Jing Hu
- School of Public Health, Peking UniversityCentre for Evidence Based Medicine and Clinical Research, Department of Epidemiology and BiostatisticsBeijingChina100191
| | - Hang Li
- Peking University First HospitalDepartment of Dermatology and Venereology8 Xishiku Main StreetBeijingXicheng DistrictChina100034
- Beijing Key Laboratory of Molecular Diagnosis on DermatosesBeijingChina
- National Clinical Research Center for Skin and Immune DiseasesBeijingChina
| | - Yanchang Zhang
- Yale School of Public HealthDepartment of Chronic Disease Epidemiology367 Cedar ST RM 704New HavenConnecticutUSA06510
| | - Jia Liu
- Xuanwu Hospital, Capital Medical UniversityDepartment of NeurologyChangchun Street 45BeijingChina100053
| | - Qian Zhang
- The University of Nottinghamc/o Cochrane Skin GroupA103, King's Meadow CampusLenton LaneNottinghamUKNG7 2NR
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Mazzarello V, Gavini E, Rassu G, Donadu MG, Usai D, Piu G, Pomponi V, Sucato F, Zanetti S, Montesu MA. Clinical Assessment of New Topical Cream Containing Two Essential Oils Combined with Tretinoin in the Treatment of Acne. Clin Cosmet Investig Dermatol 2020; 13:233-239. [PMID: 32210603 PMCID: PMC7073433 DOI: 10.2147/ccid.s236956] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 02/20/2020] [Indexed: 12/27/2022]
Abstract
Background Acne is a frequent adolescent disease characterized by inflammatory and non-inflammatory lesions whose topical treatment very often presents adverse phenomena such as irritation or resistance to antibiotics that reduce the patient’s compliance. The purpose of this study is to compare a commercial product (Acnatac gel) based on clindamycin-tretinoin (CTG) with a galenic compound containing 2 essential oils (Myrtus communisL. and Origanum vulgare) and tretinoin (MOTC) to evaluate its anti-acne effectiveness and action on the microclimate of the skin. Methods Sixty volunteers were randomly divided into an A group using MOTC and a B group, as a positive control, using CTG. The effectiveness was assessed with non-invasive skin analysis (Sebumeter, pH meter, Tewameter and Mexameter) and the counts of the number of lesions, after 15 and 30 days. Results In both groups, there is a worsening of transepidermal water loss (TEWL) due to tretinoin. MOTC has improved, starting from 15 days of treatment, the papular erythema (p = 0.0329 vs CTG) and has reduced at all times even the rashes of retinoids present in the healthy perilesional skin (p = 0.0329 and p = 0.0017, respectively, at 15 and 30 days). Conclusion MOTC has shown, compared to Acnatac, to have anti-acne efficacy and to possess an anti-inflammatory activity, due to essential oils, able to reduce in vivo erythematous lesions and those induced by retinoids.
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Affiliation(s)
- Vittorio Mazzarello
- Skinlab, Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Elisabetta Gavini
- Departmentof Chemistry and Pharmacy, University of Sassari, Sassari, Italy
| | - Giovanna Rassu
- Departmentof Chemistry and Pharmacy, University of Sassari, Sassari, Italy
| | - Matthew Gavino Donadu
- Skinlab, Department of Biomedical Sciences, University of Sassari, Sassari, Italy.,Departmentof Chemistry and Pharmacy, University of Sassari, Sassari, Italy
| | - Donatella Usai
- Skinlab, Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Gabriella Piu
- Skinlab, Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Valeria Pomponi
- Skinlab, Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Federica Sucato
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Stefania Zanetti
- Skinlab, Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Maria Antonia Montesu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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New Herbal Biomedicines for the Topical Treatment of Dermatological Disorders. Biomedicines 2020; 8:biomedicines8020027. [PMID: 32046246 PMCID: PMC7168306 DOI: 10.3390/biomedicines8020027] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/03/2020] [Accepted: 02/06/2020] [Indexed: 11/17/2022] Open
Abstract
Herbal extracts and isolated plant compounds play an increasing role in the treatment of skin disorders and wounds. Several new herbal drugs, medicinal products and cosmetic products for the treatment of various skin conditions have been developed in recent years. In this nonsystematic review, we focus on herbal drugs that were tested in controlled clinical studies or in scientifically sound preclinical studies. The herbal biomedicines are intended to treat atopic dermatitis (St. John's wort, licorice, tormentil, bitter substances, evening primrose), psoriasis (araroba tree, lace flower, barberry bark, indigo, turmeric, olibanum, St. John's wort), actinic keratosis (birch bark, petty spurge), herpes simplex (lemon balm, sage and rhubarb), rosacea (green tea, licorice, tormentil) and acne vulgaris (tea tree oil, green tea, hop), or to improve photo protection (green tea, Dyer's weed, cocoa tree, carotinoids, licorice), aesthetic dermatology (licorice, pine bark, gotu kola) and wound healing (birch bark, onion).
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Mokhtari F, Shajari A, Iraji F, Faghihi G, Siadat AH, Sadeghian G, Adibi N. The effectiveness of adapalene 0.1% with intense pulsed light versus benzoyl peroxide 5% with intense pulsed light in the treatment of acne vulgaris: A comparative study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2019; 24:101. [PMID: 31850090 PMCID: PMC6906921 DOI: 10.4103/jrms.jrms_398_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/23/2019] [Accepted: 08/26/2019] [Indexed: 11/17/2022]
Abstract
Background: Acne vulgaris (AV) is one of the most common skin diseases with major psychological impacts. Hence, selecting the best treatment modality is so important; there are different ways to treat AV such as topical and systemic agents, laser, and also photodynamic therapy. In this study, we tried to assess the difference between the efficacy of combination therapy with intense pulsed light (IPL) and benzoyl peroxide (BPO) in comparison with IPL and adapalene (AD) in the treatment of the mild to moderate AV. Materials and Methods: Thirty Iranian females in reproductive age with mild to moderate acne were enrolled in this study. The left and right side of the patients were randomized to receive either AD 0.1% or BPO 5% every other day plus three sessions of monthly apart IPL in the treatment of AV. Different parameters of AV such as acne severity index (ASI), total acne lesions counting (TLC), and Acne Global Severity Scale (AGSS) were measured before, during, and after the treatments. Results: There was a significant difference regarding AGSS, TLC, and ASI before and after treatment with AD plus IPL (P < 0.001). Furthermore, there was a significant difference regarding AGSS, TLC, and ASI before and after treatment with BP plus IPL (P < 0.001). However, no significant difference regarding AGSS, TLC, and ASI were observed between the 2 groups after treatment (P > 0.05). No significant side effects were observed in both groups. Conclusion: Our study shows that there was not any significant difference between combining IPL with either AD or BPO so we can use either one of these combinations to achieve similar efficacy.
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Affiliation(s)
- Fatemeh Mokhtari
- Department of Dermatology, Isfahan Medical University, Isfahan, Iran.,Skin Disease and Leishmaniosis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Atefeh Shajari
- Department of Dermatology, Isfahan Medical University, Isfahan, Iran
| | - Fariba Iraji
- Department of Dermatology, Isfahan Medical University, Isfahan, Iran.,Skin Disease and Leishmaniosis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gita Faghihi
- Department of Dermatology, Isfahan Medical University, Isfahan, Iran.,Skin Disease and Leishmaniosis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Hossein Siadat
- Department of Dermatology, Isfahan Medical University, Isfahan, Iran.,Skin Disease and Leishmaniosis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Giti Sadeghian
- Skin Disease and Leishmaniosis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Neda Adibi
- Skin Disease and Leishmaniosis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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24
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Kokoska L, Kloucek P, Leuner O, Novy P. Plant-Derived Products as Antibacterial and Antifungal Agents in Human Health Care. Curr Med Chem 2019; 26:5501-5541. [PMID: 30182844 DOI: 10.2174/0929867325666180831144344] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/02/2018] [Accepted: 07/19/2018] [Indexed: 01/10/2023]
Abstract
A number of papers reporting antimicrobial properties of extracts, essential oils, resins and various classes of compounds isolated from higher plants have been published in recent years; however, a comprehensive analysis of plant-derived antimicrobial agents currently applied in practice for the improvement of human health is still lacking. This review summarizes data on clinical efficacy, antimicrobial effects and the chemistry of commercially available antibacterial and antifungal agents of plant origin currently used in the prevention and treatment of gastrointestinal, oral, respiratory, skin, and urinary infections. As a result of an analysis of the literature, more than 40 plant-derived over-the-counter pharmaceuticals, dietary supplements, cosmetics, herbal medicines, and functional foods containing complex mixtures (e.g. Glycyrrhiza glabra extract, Melaleuca alternifolia essential oil, and Pistacia lentiscus resin), pure compounds (e.g. benzoic acid, berberine, eucalyptol, salicylic acid and thymol) as well as their derivatives and complexes (e.g. bismuth subsalicylate and zinc pyrithione) have been identified. The effectiveness of many of these products is illustrated by results of clinical trials and supported by data on there in vitro antimicrobial activity. A broad spectrum of various commercial products currently available on the market and their welldocumented clinical efficacy suggests that plants are prospective sources for the identification of new types of antimicrobial agents in future. Innovative approaches and methodologies for effective proof-of-concept research and the development of new types of plant-derived products effective against recently emerging problems related to human microbial diseases (e.g. antimicrobial resistance) are also proposed in this review.
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Affiliation(s)
- Ladislav Kokoska
- Department of Crop Sciences and Agroforestry, Faculty of Tropical AgriSciences, Czech University of Life Sciences Prague, Kamycka 129, Prague - Suchdol, 165 00, Czech Republic
| | - Pavel Kloucek
- Department of Quality of Agricultural Products, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, Kamycka 129, Prague - Suchdol, 165 00, Czech Republic
| | - Olga Leuner
- Department of Crop Sciences and Agroforestry, Faculty of Tropical AgriSciences, Czech University of Life Sciences Prague, Kamycka 129, Prague - Suchdol, 165 00, Czech Republic
| | - Pavel Novy
- Department of Quality of Agricultural Products, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, Kamycka 129, Prague - Suchdol, 165 00, Czech Republic
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25
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Navel V, Mulliez A, Benoist d’Azy C, Baker JS, Malecaze J, Chiambaretta F, Dutheil F. Efficacy of treatments for Demodex blepharitis: A systematic review and meta-analysis. Ocul Surf 2019; 17:655-669. [DOI: 10.1016/j.jtos.2019.06.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/21/2019] [Accepted: 06/17/2019] [Indexed: 02/06/2023]
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26
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Gurnee EA, Kamath S, Kruse L. Complementary and alternative therapy for pediatric acne: A review of botanical extracts, dietary interventions, and oral supplements. Pediatr Dermatol 2019; 36:596-601. [PMID: 31231870 DOI: 10.1111/pde.13904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Many supplements and products containing botanical extracts are marketed to patients for the treatment of acne vulgaris. Additionally, increasing attention has been paid to the role of diet in acne vulgaris. Studies on this topic including pediatric patients are limited, with variable efficacy data. Despite these limitations, knowledge of alternative therapies in pediatric acne vulgaris is often expected from pediatric dermatologists. Here we review available data on the efficacy of complementary and alternative medicines for treatment of acne in pediatric patients, focusing on topical, oral, and dietary modifications.
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Affiliation(s)
- Emily A Gurnee
- Division of Dermatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.,Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Sonia Kamath
- Division of Dermatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.,Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lacey Kruse
- Division of Dermatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.,Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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27
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Araviiskaia E, Lopez Estebaranz JL, Pincelli C. Dermocosmetics: beneficial adjuncts in the treatment of acne vulgaris. J DERMATOL TREAT 2019; 32:3-10. [DOI: 10.1080/09546634.2019.1628173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Elena Araviiskaia
- First Pavlov State Medical Univeristy of St. Petersburg, St. Petersburg, Russia
| | | | - Carlo Pincelli
- Laboratory of Cutaneous Biology, Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
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28
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Lubtikulthum P, Kamanamool N, Udompataikul M. A comparative study on the effectiveness of herbal extracts vs 2.5% benzoyl peroxide in the treatment of mild to moderate acne vulgaris. J Cosmet Dermatol 2019; 18:1767-1775. [PMID: 31012999 DOI: 10.1111/jocd.12962] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/23/2019] [Accepted: 03/22/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | - Nanticha Kamanamool
- Department of Preventive and Social Medicine Srinakharinwirot University Bangkok Thailand
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29
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Laurain-Mattar D, Couic-Marinier F. Huile essentielle d’Arbre à thé ou de Tea tree. ACTUALITES PHARMACEUTIQUES 2019. [DOI: 10.1016/j.actpha.2018.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Hop Extract Acts as an Antioxidant with Antimicrobial Effects against Propionibacterium Acnes and Staphylococcus Aureus. Molecules 2019; 24:molecules24020223. [PMID: 30634461 PMCID: PMC6359372 DOI: 10.3390/molecules24020223] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 12/29/2018] [Accepted: 01/03/2019] [Indexed: 01/30/2023] Open
Abstract
Acne is associated with hyperkeratosis, elevated levels of skin sebum and growth of Propionibacterium acnes (P. acnes) and Staphylococcus aureus (S. aureus). Furthermore, P. acnes promotes inflammation by inducing IL-6 production and oxidative stress. The aim of this study was to assess the antioxidant, anti-inflammatory and antibacterial potential of a hop-CO2-extract with 50% humulone and lupulone. The susceptibility of P. acnes and S. aureus to the hop extract was tested by using the broth microdilution technique. The minimal inhibitory concentrations (MIC) for P. acnes and S. aureus were 3.1 and 9.4 µg/mL, respectively. In addition, the hop extract showed an antioxidative effect with a half maximal inhibitory concentration (IC50) of 29.43 µg/mL as well as additional anti-inflammatory effects by reducing the IL-6 expression (IC50: 0.8 µg/mL). In addition, a gel formulation with 0.3% hop extract (w/w) had antibacterial activity against P. acnes and S. aureus (inhibition zone value: 5.5 mm and 3 mm, respectively) which was significantly superior to the placebo gel. The positive control (a gel with the antibiotic clindamycin) showed an inhibition zone of 9 mm. Due to its antioxidant, anti-inflammatory and antibacterial effects hop extract might be a treatment option for acne-prone skin.
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31
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Mazzarello V, Donadu MG, Ferrari M, Piga G, Usai D, Zanetti S, Sotgiu MA. Treatment of acne with a combination of propolis, tea tree oil, and Aloe vera compared to erythromycin cream: two double-blind investigations. Clin Pharmacol 2018; 10:175-181. [PMID: 30588129 PMCID: PMC6298394 DOI: 10.2147/cpaa.s180474] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Antibiotics that suppress Propionibacterium acnes are the standard treatment for acne but are becoming less effective, due to the appearance of antibiotic-resistant strains. Many plants are known to have innate antimicrobial action and can be used as alternatives to antibiotics; thus, it is necessary to prove their effectiveness in vivo. This study aimed to evaluate the anti-acne efficacy of a new cream based on three natural extracts, comparing it to erythromycin cream and placebo. Patients and methods Sixty patients with mild to moderate acne vulgaris were randomly divided into three groups: treated with cream containing 20% propolis, 3% "tea tree oil", and 10% "Aloe vera" (PTAC) (n=20); or with 3 % erythromycin cream (ERC) (n=20); or with placebo (n=20). At baseline, after 15 and 30 days, investigators evaluated response to treatment by counting acne lesions through noninvasive measurements and macrophotography. Results All the clinical and instrumental values studied were statistically different from placebo except for sebometry, pHmetry, and erythema index values, measured on healthy skin. Unlike in the placebo group, papular and scar lesions showed high erythema reduction after 15 and 30 days of PTAC and ERC application. Conclusion The PTAC formulation was better than ERC in reducing erythema scars, acne severity index, and total lesion count.
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Affiliation(s)
- V Mazzarello
- Skinlab, Department of Biomedical Sciences, University of Sassari, Sassari, Italy,
| | - M G Donadu
- Skinlab, Department of Biomedical Sciences, University of Sassari, Sassari, Italy,
| | - M Ferrari
- Skinlab, Department of Biomedical Sciences, University of Sassari, Sassari, Italy,
| | - G Piga
- Skinlab, Department of Biomedical Sciences, University of Sassari, Sassari, Italy,
| | - D Usai
- Skinlab, Department of Biomedical Sciences, University of Sassari, Sassari, Italy,
| | - S Zanetti
- Skinlab, Department of Biomedical Sciences, University of Sassari, Sassari, Italy,
| | - M A Sotgiu
- Skinlab, Department of Biomedical Sciences, University of Sassari, Sassari, Italy,
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32
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Taleb MH, Abdeltawab NF, Shamma RN, Abdelgayed SS, Mohamed SS, Farag MA, Ramadan MA. Origanum vulgare L. Essential Oil as a Potential Anti-Acne Topical Nanoemulsion-In Vitro and In Vivo Study. Molecules 2018; 23:E2164. [PMID: 30154336 PMCID: PMC6225355 DOI: 10.3390/molecules23092164] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/10/2018] [Accepted: 08/20/2018] [Indexed: 11/26/2022] Open
Abstract
Antibiotics are often prescribed in acne treatment; however, Propionibacterium acnes and Staphylococcus epidermidis, the two of the major acne-associated bacteria, developed antibiotic resistance. Essential oils (EOs) present a natural, safe, efficacious and multifunctional alternative treatment. This study aimed to assess the potential anti-acne activity of selected seven EOs commonly used in Mediterranean folk medicine. Antimicrobial activity screening of these oils showed oregano to exhibit the strongest antimicrobial activity with minimum inhibitory concentration (MIC) of 0.34 mg/mL and minimum bactericidal concentration (MBC) of 0.67 mg/mL against P. acnes; and MIC of 0.67 mg/mL and MBC of 1.34 mg/mL against S. epidermidis. The composition of the most effective EOs (oregano and thyme) was determined using gas chromatography-mass spectrometry (GC-MS). Monoterpenoid phenols predominated oregano and thyme EO with thymol percentile 99 and 72, respectively. Thymol showed MIC 0.70 mg/mL against both P. acnes and S. epidermidis whereas MBC was 1.40 and 2.80 mg/mL against P. acnes and S. epidermidis, respectively. Moreover, oregano exhibited the strongest anti-biofilm effect against S. epidermidis with MBIC 1.34 mg/mL and killing dynamic time of 12 and 8 h against P. acnes and S. epidermidis, respectively. Oregano, the most effective EO, was formulated and tested as a nanoemulsion in an acne animal mouse model. The formulation showed superior healing and antimicrobial effects compared to the reference antibiotic. Collectively, our data suggested that oregano oil nanoemulsion is a potential natural and effective alternative for treating acne and overcoming the emerging antibiotic resistance.
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Affiliation(s)
- Mohammed H Taleb
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt.
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Al-Azhar University⁻Gaza, PO Box 1277, Gaza 79702, Palestine.
| | - Nourtan F Abdeltawab
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt.
| | - Rehab N Shamma
- Department of Pharmaceutics and Industrial pharmacy, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt.
| | - Sherein S Abdelgayed
- Department of Pathology, Faculty of Veterinary Medicine, Cairo University, Cairo 12211, Egypt.
| | - Sarah S Mohamed
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt.
| | - Mohamed A Farag
- Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt.
- Department of Chemistry, School of Sciences & Engineering, The American University in Cairo, Cairo 11853, Egypt.
| | - Mohammed A Ramadan
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt.
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33
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Neves RC, Makino H, Cruz TP, Silveira MM, Sousa VR, Dutra V, Lima ME, Belli CB. In vitro and in vivo efficacy of tea tree essential oil for bacterial and yeast ear infections in dogs. PESQUISA VETERINÁRIA BRASILEIRA 2018. [DOI: 10.1590/1678-5150-pvb-5055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
ABSTRACT: Otitis externa is a common complaint in dogs. Bacteria and yeasts are commonly involved and may perpetuate inflammatory reactions inside the ear canal. Otoscopy, cytological examination of secretion and microbiological culture embody forms of diagnosis. Cytology also has great use in accessing treatment evolution. Therapy usually consists of cleaning ear canals and subsequent use of antibiotics or antifungal products. As some of them may cause hypersensitivity and even ototoxicity, searching for new pharmacological bases is currently necessary and justifies this study, which aimed to evaluate in vitro and in vivo efficacy of tea tree essential oil for bacterial and yeast ear infections in dogs. Twenty-eight dogs from a particular shelter in Cuiabá (Mato Grosso, Brazil), presenting clinical signs of otitis externa, were enrolled in this clinical trial. In all of them, clinical and cytological evaluations, as well as culture and susceptibility testing of the affected ears were carried out. From each dog, one ear was treated with 5% tea tree essential oil lotion and the other with standard otic formulation, according to the type of infection (bacterial, yeast or both). In vitro susceptibility testings of all ear cultures, to the same drugs used in treatment, were also carried out. Culture results showed 62.5% bacterial and fungal infection, 33.9% bacterial infection and 3.6% fungal infection, from the 56 ear samples collected. The most common microorganisms isolated were Staphylococcus intermedius, Staphylococcus aureus, Proteus mirabilis and Malassezia pachydermatis. Gram-positive bacteria were susceptible to gentamycin in 60.5% and resistant in 16.3% of the samples. Five percent tea tree essential oil formulation produced a 5mm clear zone of inhibition around the disks in one of the 63 samples evaluated. Pure (100%) tea tree essential oil formulation produced a 10mm clear zone of inhibition around the disks in four of the 63 samples evaluated, a 9mm zone in three samples, an 8mm zone in 16 samples, a 7mm zone in seven samples, a 6mm zone in two samples and there was no clear zone in 31 samples. Inhibition zones were produced by strains of Staphylococcus intermedius, Staphylococcus hyicus, Corynebacterium sp., Proteus mirabilis and Enterobacter sp. tea tree essential oil ear solution significantly induced remission of clinical signs both in bacterial and yeast ear infections. It also reduced as much Malassezia pachydermatis ear infection as the nystatin solution used in this study, while gentamycin solution showed better antibacterial effect. More studies should be conducted to evaluate in vitro diffusion properties of tea tree essential oil. Good antimicrobial spectrum and the absence of adverse reactions confirm the importance of developing a tea tree formulation as an alternative therapy for ear infections in dogs.
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Najafi-Taher R, Ghaemi B, Amani A. Delivery of adapalene using a novel topical gel based on tea tree oil nano-emulsion: Permeation, antibacterial and safety assessments. Eur J Pharm Sci 2018; 120:142-151. [DOI: 10.1016/j.ejps.2018.04.029] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 04/17/2018] [Accepted: 04/19/2018] [Indexed: 11/30/2022]
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35
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Orchard A, van Vuuren SF, Viljoen AM, Kamatou G. The in vitro antimicrobial evaluation of commercially essential oils and their combinations against acne. Int J Cosmet Sci 2018; 40:226-243. [PMID: 29574906 DOI: 10.1111/ics.12456] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 02/28/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The study investigated the efficacy of commercial essential oil combinations against the two pathogens responsible for acne with the aim to identify synergy and favourable oils to possibly use in a blend. MATERIALS AND METHODS Antimicrobial activity was assessed using the minimum inhibitory concentration (MIC) assay against Staphylococcus epidermidis (ATCC 2223) and Propionibacterium acnes (ATCC 11827), and the fractional inhibitory concentration index (ΣFIC) was calculated. Combinations displaying synergistic interactions were further investigated at varied ratios and the results plotted on isobolograms. RESULTS From the 408 combinations investigated, 167 combinations were identified as displaying noteworthy antimicrobial activity (MIC value ≤1.00 mg mL-1 ). Thirteen synergistic interactions were observed against S. epidermidis, and three synergistic combinations were observed against P. acnes. It was found that not one of the synergistic interactions identified were based on the combinations recommended in the layman's aroma-therapeutic literature. Synergy was evident rather from leads based on antimicrobial activity from previous studies, thus emphasizing the importance of scientific validation. Leptospermum scoparium J.R.Forst. and G.Forst (manuka) was the essential oil mostly involved in synergistic interactions (four) against S. epidermidis. Cananga odorata (Lam.) Hook.f. and Thomson (ylang ylang) essential oil was also frequently involved in synergy where synergistic interactions could be observed against both pathogens. The combination with the lowest MIC value against both acne pathogens was Vetiveria zizanioides Stapf (vetiver) with Cinnamomum verum J.Presl (cinnamon bark) (MIC values 0.19-0.25 mg mL-1 ). Pogostemon patchouli Benth. (patchouli), V. zizanioides, C. verum and Santalum spp. (sandalwood) could be identified as the oils that contributed the most noteworthy antimicrobial activity towards the combinations. The different chemotypes of the essential oils used in the combinations predominantly resulted in similar antimicrobial activity. CONCLUSIONS The investigated essential oil combinations resulted in at least 50% of the combinations displaying noteworthy antimicrobial activity. Most of the synergistic interactions do not necessarily correspond to the recommended layman's aroma-therapeutic literature, which highlights a need for scientific validation of essential oil antimicrobial activity. No antagonism was observed.
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Affiliation(s)
- A Orchard
- Department of Pharmacy and Pharmacology, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, South Africa
| | - S F van Vuuren
- Department of Pharmacy and Pharmacology, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, South Africa
| | - A M Viljoen
- Department of Pharmaceutical Sciences, Faculty of Science, Tshwane University of Technology, Private Bag X680, Pretoria, 0001, South Africa
- Department of Pharmaceutical Sciences, SAMRC Herbal Drugs Research Unit, Tshwane University of Technology, Private Bag X680, Pretoria, 0001, South Africa
| | - G Kamatou
- Department of Pharmaceutical Sciences, Faculty of Science, Tshwane University of Technology, Private Bag X680, Pretoria, 0001, South Africa
- Department of Pharmaceutical Sciences, SAMRC Herbal Drugs Research Unit, Tshwane University of Technology, Private Bag X680, Pretoria, 0001, South Africa
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Abstract
Complementary and alternative medicine approaches are popular among some patient segments due to the perception that they are "natural" and thus are believed to be less likely to be dangerous, to be less toxic, or to cause fewer side effects. In dermatology, these can include aromatherapy, botanicals, and essential oils (plant extracts). Preliminary evidence, biological activity studies, and small pilot clinical trials conducted outside of North America, mostly in young adults, suggest that some may have value in acne treatment. When additional research and larger clinical trials are conducted, both clinicians and patients will be able to understand the risks and benefits compared with allopathic remedies.
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Affiliation(s)
- Warren J Winkelman
- Nestlé Skin Health Investigation, Education, Longevity Development (SHIELD), New York, NY.
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37
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Grobel H, Murphy SA. Acne Vulgaris and Acne Rosacea. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00077-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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38
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Tan AU, Schlosser BJ, Paller AS. A review of diagnosis and treatment of acne in adult female patients. Int J Womens Dermatol 2017; 4:56-71. [PMID: 29872679 PMCID: PMC5986265 DOI: 10.1016/j.ijwd.2017.10.006] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 10/11/2017] [Accepted: 10/11/2017] [Indexed: 01/19/2023] Open
Abstract
This review focuses on the treatment options for adult female patients with acne. Acne in adult female patients may start during adolescence and persist or have an onset in adulthood. Acne has various psychosocial effects that impact patients’ quality of life. Treatment of acne in adult women specifically has its challenges due to the considerations of patient preferences, pregnancy, and lactation. Treatments vary widely and treatment should be tailored specifically for each individual woman. We review conventional therapies with high levels of evidence, additional treatments with support from cohort studies and case reports, complementary and/or alternative therapies, and new agents under development for the treatment of patients with acne.
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Affiliation(s)
- A U Tan
- Northwestern University, Department of Dermatology, Chicago, IL
| | - B J Schlosser
- Northwestern University, Department of Dermatology, Chicago, IL
| | - A S Paller
- Northwestern University, Department of Dermatology, Chicago, IL
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39
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Eber AE, Perper M, Magno R, Nouri K. Acne treatment in antiquity: can approaches from the past be relevant in the future? Int J Dermatol 2017; 56:1071-1073. [PMID: 28856672 DOI: 10.1111/ijd.13741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 06/19/2017] [Accepted: 07/27/2017] [Indexed: 01/18/2023]
Affiliation(s)
- Ariel Eva Eber
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Marina Perper
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Robert Magno
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Keyvan Nouri
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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40
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Commercial Essential Oils as Potential Antimicrobials to Treat Skin Diseases. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:4517971. [PMID: 28546822 PMCID: PMC5435909 DOI: 10.1155/2017/4517971] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 10/09/2016] [Indexed: 01/22/2023]
Abstract
Essential oils are one of the most notorious natural products used for medical purposes. Combined with their popular use in dermatology, their availability, and the development of antimicrobial resistance, commercial essential oils are often an option for therapy. At least 90 essential oils can be identified as being recommended for dermatological use, with at least 1500 combinations. This review explores the fundamental knowledge available on the antimicrobial properties against pathogens responsible for dermatological infections and compares the scientific evidence to what is recommended for use in common layman's literature. Also included is a review of combinations with other essential oils and antimicrobials. The minimum inhibitory concentration dilution method is the preferred means of determining antimicrobial activity. While dermatological skin pathogens such as Staphylococcus aureus have been well studied, other pathogens such as Streptococcus pyogenes, Propionibacterium acnes, Haemophilus influenzae, and Brevibacterium species have been sorely neglected. Combination studies incorporating oil blends, as well as interactions with conventional antimicrobials, have shown that mostly synergy is reported. Very few viral studies of relevance to the skin have been made. Encouragement is made for further research into essential oil combinations with other essential oils, antimicrobials, and carrier oils.
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Yadav E, Kumar S, Mahant S, Khatkar S, Rao R. Tea tree oil: a promising essential oil. JOURNAL OF ESSENTIAL OIL RESEARCH 2016. [DOI: 10.1080/10412905.2016.1232665] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Cho YC, Kim YR, Kim BR, Bach TT, Cho S. Thunbergia alata inhibits inflammatory responses through the inactivation of ERK and STAT3 in macrophages. Int J Mol Med 2016; 38:1596-1604. [DOI: 10.3892/ijmm.2016.2746] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 09/05/2016] [Indexed: 11/06/2022] Open
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Ferreira Lins R, Rogério Lustri W, Minharro S, Alonso A, de Sousa Neto D. On the formation, physicochemical properties and antibacterial activity of colloidal systems containing tea tree (Melaleuca alternifolia) oil. Colloids Surf A Physicochem Eng Asp 2016. [DOI: 10.1016/j.colsurfa.2016.02.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Malhi HK, Tu J, Riley TV, Kumarasinghe SP, Hammer KA. Tea tree oil gel for mild to moderate acne; a 12 week uncontrolled, open-label phase II pilot study. Australas J Dermatol 2016; 58:205-210. [PMID: 27000386 DOI: 10.1111/ajd.12465] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 01/25/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND The efficacy, tolerability and acceptability of a tea tree oil gel (200 mg/g) and face wash (7 mg/g) were evaluated for the treatment of mild to moderate facial acne. METHODS In this open-label, uncontrolled phase II pilot study, participants applied tea tree oil products to the face twice daily for 12 weeks and were assessed after 4, 8 and 12 weeks. Efficacy was determined from total numbers of facial acne lesions and the investigator global assessment (IGA) score. Tolerability was evaluated by the frequency of adverse events and the mean tolerability score determined at each visit. Product acceptability was assessed via a questionnaire at the end of the study period. RESULTS Altogether 18 participants were enrolled, of whom 14 completed the study. Mean total lesion counts were 23.7 at baseline, 17.2 at 4, 15.1 at 8 and 10.7 at 12 weeks. Total lesion counts differed significantly over time by repeated measures anova (P < 0.0001). The mean IGA score was 2.4 at baseline, 2.2 at 4, 2.0 at 8 and 1.9 at 12 weeks, which also differed significantly over time (P = 0.0094). No serious adverse events occurred and minor local tolerability events were limited to peeling, dryness and scaling, all of which resolved without intervention. CONCLUSION This study shows that the use of the tea tree oil products significantly improved mild to moderate acne and that the products were well tolerated.
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Affiliation(s)
- Harsimran Kaur Malhi
- Department of General Medicine, St John of God Hospital, Perth, Western Australia, Australia
| | - Jenny Tu
- Department of Dermatology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Thomas V Riley
- PathWest Laboratory Medicine WA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia.,School of Pathology and Laboratory Medicine (M504), University of Western Australia, Perth, Western Australia, Australia
| | - Sujith Prasad Kumarasinghe
- Department of Dermatology, Royal Perth Hospital, Perth, Western Australia, Australia.,Hollywood Medical Centre, Perth, Western Australia, Australia
| | - Katherine A Hammer
- School of Pathology and Laboratory Medicine (M504), University of Western Australia, Perth, Western Australia, Australia
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Araviiskaia E, Dréno B. The role of topical dermocosmetics in acne vulgaris. J Eur Acad Dermatol Venereol 2016; 30:926-35. [PMID: 26916232 DOI: 10.1111/jdv.13579] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 11/27/2015] [Indexed: 12/26/2022]
Abstract
Acne is a common chronic inflammatory disease and treatment modalities based on acne severity are well established. The role of dermocosmetics in dermatology, and in particular acne, is becoming more important as more research elucidates the mechanisms of action of products in the pathogenesis of acne. Dermocosmetics have the potential to be used as monotherapy or in combination with medical treatment. Therefore, it has become important for dermatologists to understand dermocosmetics to effectively and appropriately advise patients on their use. The objective of this review was to provide new insights into the role of traditional and novel ingredients in dermocosmetics for the treatment of acne, based on the authors' objective assessment of the published literature. The type of products discussed include: those which have a sebostatic effect, such as topical antioxidants and niacinamide; agents targeting abnormal keratinization, such as salicylic acid, lipo-hydroxy acid, alpha-hydroxy acids, retinol-based products and linoleic acid; agents targeting Propionibacterium acnes, such as lauric acid; and anti-inflammatory agents such as nicotinamide, alpha-linolenic acid and zinc salts. Despite the scientific advances in understanding these cosmetic ingredients, there still remains a lack of rigorous controlled studies in this area.
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Affiliation(s)
- E Araviiskaia
- First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | - B Dréno
- Department of DermatoCancerology, Nantes University, Nantes, France
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Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, Bowe WP, Graber EM, Harper JC, Kang S, Keri JE, Leyden JJ, Reynolds RV, Silverberg NB, Stein Gold LF, Tollefson MM, Weiss JS, Dolan NC, Sagan AA, Stern M, Boyer KM, Bhushan R. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol 2016; 74:945-73.e33. [PMID: 26897386 DOI: 10.1016/j.jaad.2015.12.037] [Citation(s) in RCA: 723] [Impact Index Per Article: 90.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 12/15/2015] [Indexed: 02/06/2023]
Abstract
Acne is one of the most common disorders treated by dermatologists and other health care providers. While it most often affects adolescents, it is not uncommon in adults and can also be seen in children. This evidence-based guideline addresses important clinical questions that arise in its management. Issues from grading of acne to the topical and systemic management of the disease are reviewed. Suggestions on use are provided based on available evidence.
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Affiliation(s)
| | | | | | | | | | - Diane S Berson
- Weill Cornell Medical College, New York, New York; New York Presbyterian Hospital, New York, New York
| | - Whitney P Bowe
- SUNY Down State Medical Center-Brooklyn, New York, New York
| | - Emmy M Graber
- Boston University School of Medicine, Boston, Massachusetts; Boston Medical Center, Boston, Massachusetts
| | | | - Sewon Kang
- Johns Hopkins Medicine, Baltimore, Maryland
| | - Jonette E Keri
- University of Miami Health System, Miami, Florida; Miami VA Hospital, Miami, Florida
| | | | - Rachel V Reynolds
- Harvard Medical Faculty Physicians, Boston, Massachusetts; Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Nanette B Silverberg
- Mount Sinai Health System-Beth Israel, New York, New York; St. Lukes-Roosevelt, New York, New York
| | | | | | | | | | | | | | - Kevin M Boyer
- American Academy of Dermatology, Schaumburg, Illinois
| | - Reva Bhushan
- American Academy of Dermatology, Schaumburg, Illinois.
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Nasri H, Bahmani M, Shahinfard N, Moradi Nafchi A, Saberianpour S, Rafieian Kopaei M. Medicinal Plants for the Treatment of Acne Vulgaris: A Review of Recent Evidences. Jundishapur J Microbiol 2015; 8:e25580. [PMID: 26862380 PMCID: PMC4740760 DOI: 10.5812/jjm.25580] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 07/01/2015] [Accepted: 08/08/2015] [Indexed: 02/07/2023] Open
Abstract
Context: Acne vulgaris affects about 85% of teenagers and may continue to adulthood. There are about two million visits to physicians per year for teenagers and the direct cost of acne treatment in the US exceeds $1 billion per year. Evidence Acquisition: A wide variety of treatment regimens exist for acne vulgaris including benzoil peroxide, retinoids, isotretinoids, keratolytic soaps, alpha hydroxy acids, azelaic acid, salicilic acid as well as hormonal, anti-androgen or antiseborrheic treatments. However, none of these methods is free of side effects and their exact role in therapy is not clear. In this paper apart from presenting the possible causes of acne vulgaris and its available drugs, recently published papers about medicinal plants used in the treatment of acne vulgaris were reviewed. Results: Consumption of alternative and complementary medicine, including medicinal plants, is increasing and is common amongst patients affected by acne and infectious skin diseases. Medicinal plants have a long history of use and have been shown to possess low side effects. These plants are a reliable source for preparation of new drugs. Conclusions: Many plants seem to have inhibitory effects on the growth of bacteria, fungi and viruses in vitro. However, there are a few clinical evidences about the effectiveness and safety of these plants in the treatment of acne and other skin infections.
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Affiliation(s)
- Hamid Nasri
- Department of Nephrology, Division of Nephropathology, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Mahmoud Bahmani
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, IR Iran
| | - Najmeh Shahinfard
- Virtual School, Department of E-Learning in Medical Education, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Atefeh Moradi Nafchi
- Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, IR Iran
| | - Shirin Saberianpour
- Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, IR Iran
| | - Mahmoud Rafieian Kopaei
- Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, IR Iran
- Corresponding author: Mahmoud Rafieian Kopaei, Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, IR Iran. Tel: +98-3813346692, Fax: +98-3813330709, E-mail:
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Bezdjian A, Mujica-Mota MA, Azzi M, Daniel SJ. Assessment of ototoxicity of tea tree oil in a chinchilla animal model. Int J Pediatr Otorhinolaryngol 2014; 78:2136-9. [PMID: 25441606 DOI: 10.1016/j.ijporl.2014.09.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 09/21/2014] [Accepted: 09/22/2014] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The aim of the present study is to examine the effects of tea tree oil on hearing function and cochlear morphology after intratympanic administration in a chinchilla animal model. METHODS Nine chinchillas received intratympanic injection of 3% tea tree oil dissolved in olive oil in one ear, whereas the contralateral control ear received olive oil only. Outcome measures included auditory brainstem responses conducted before treatment and at 10 days and 30 days following the injection. Post-mortem cochlear morphology was assessed using scanning electron microscopy. RESULTS At 10 and 30 days following the injection, there was no significant change in auditory brain response thresholds at 8, 16, 20 or 25kHz. Scanning electron microscopy imaging showed no damage to auditory hair cells. CONCLUSION Tea tree oil (3%) does not appear to be ototoxic in a chinchilla animal model. Future preclinical and clinical studies are required to establish the effectiveness of TTO in treating otitis.
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Affiliation(s)
- Aren Bezdjian
- McGill Auditory Sciences Laboratory, Montreal Children's Hospital, Montreal, Quebec, Canada; Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Mario A Mujica-Mota
- McGill Auditory Sciences Laboratory, Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Michelle Azzi
- McGill Auditory Sciences Laboratory, Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Sam J Daniel
- McGill Auditory Sciences Laboratory, Montreal Children's Hospital, Montreal, Quebec, Canada; Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal Children's Hospital, Montreal, Quebec, Canada.
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Hammer KA. Treatment of acne with tea tree oil (melaleuca) products: a review of efficacy, tolerability and potential modes of action. Int J Antimicrob Agents 2014; 45:106-10. [PMID: 25465857 DOI: 10.1016/j.ijantimicag.2014.10.011] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 10/31/2014] [Indexed: 01/10/2023]
Abstract
Over-the-counter acne treatments containing tea tree oil from the plant Melaleuca alternifolia are widely available, and evidence indicates that they are a common choice amongst those self-treating their acne. The aims of this review were to collate and evaluate the clinical evidence on the use of tea tree oil products for treating acne, to review safety and tolerability and to discuss the underlying modes of therapeutic action.
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Affiliation(s)
- K A Hammer
- School of Pathology and Laboratory Medicine (M504), Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, 35 Stirling Hwy, Crawley, Perth 6009, WA, Australia.
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50
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Strom MA, Lio PA. Alternative Medicine in Pediatric Dermatology: What Is the Evidence? CURRENT DERMATOLOGY REPORTS 2014. [DOI: 10.1007/s13671-014-0086-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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