Skip to main content

Advertisement

SpringerLink
Log in

Alternative Medicine in Pediatric Dermatology: What Is the Evidence?

  • Pediatrics (R Sidbury, Section Editor)
  • Published:
Current Dermatology Reports Aims and scope Submit manuscript

Abstract

Many patients seek alternative and complementary therapies, particularly when diseases are incurable or when conventional treatments have undesirable side effects that are real or perceived. This article reviews some selective evidence behind alternative therapies utilized in the treatment of three common diseases in pediatric dermatology: atopic dermatitis, acne vulgaris, and cutaneous warts. While some show promise, the treatments discussed vary greatly in the quality and quantity of supporting evidence and should be carefully considered when advising patients on their use.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Jensen P. Use of alternative medicine by patients with atopic dermatitis and psoriasis. Acta Derm Venereol. 1990;70(5):421–4.

    CAS  PubMed  Google Scholar 

  2. Simpson EL, Basco M, Hanifin J. A cross-sectional survey of complementary and alternative medicine use in patients with atopic dermatitis. Am J Contact Dermat. 2003;14(3):144–7.

    PubMed  Google Scholar 

  3. Aguiar Júnior N dos R, Costa IMC. The use of alternative or complementary medicine for children with atopic dermatitis. An Bras Dermatol. 2011;86(1):167–8

  4. Kabashima K. New concept of the pathogenesis of atopic dermatitis: interplay among the barrier, allergy, and pruritus as a trinity. J Dermatol Sci. 2013;70(1):3–11. A very clearly written summary of the most cutting-edge thinking about the multi-factorial pathogenesis of atopic dermatitis.

    Article  PubMed  Google Scholar 

  5. Schneider L, Tilles S, Lio P, et al. Atopic dermatitis: a practice parameter update 2012. J Allergy Clin Immunol. 2013;131(2):295–9.e1-27. A detailed review of the evidence for diagnosis and treatment of atopic dermatitis, with discussion of some non-pharmacologic therapies as well.

    Article  PubMed  Google Scholar 

  6. Kojima R, Fujiwara T, Matsuda A, et al. Factors associated with steroid phobia in caregivers of children with atopic dermatitis. Pediatr Dermatol. 2013;30(1):29–35.

    Article  PubMed  Google Scholar 

  7. Prottey C, Hartop PJ, Press M. Correction of the cutaneous manifestations of essential fatty acid deficiency in man by application of sunflower-seed oil to the skin. J Invest Dermatol. 1975;64(4):228–34.

    Article  CAS  PubMed  Google Scholar 

  8. Jamieson GS, Baughman WF. The chemical composition of sunflower-seed oil. J Am Chem Soc. 1922;44(12):2952–7.

    Article  CAS  Google Scholar 

  9. Elias PM, Brown BE, Ziboh VA. The permeability barrier in essential fatty acid deficiency: evidence for a direct role for linoleic acid in barrier function. J Invest Dermatol. 1980;74(4):230–3.

    Article  CAS  PubMed  Google Scholar 

  10. Eichenfield LF, McCollum A, Msika P. The benefits of sunflower oleodistillate (SOD) in pediatric dermatology. Pediatr Dermatol. 2009;26(6):669–75.

    Article  PubMed  Google Scholar 

  11. Yessoufou a, Wahli W. Multifaceted roles of peroxisome proliferator-activated receptors (PPARs) at the cellular and whole organism levels. Swiss Med Wkly. 2010;140(September):w13071.

  12. Rivier M, Castiel I, Safonova I. Peroxisome proliferator-activated receptor-α enhances lipid metabolism in a skin equivalent model. J Investig. 2000;114(4):681–7.

    CAS  Google Scholar 

  13. Msika P, De Belilovsky C, Piccardi N, Chebassier N, Baudouin C, Chadoutaud B. New emollient with topical corticosteroid-sparing effect in treatment of childhood atopic dermatitis: SCORAD and quality of life improvement. Pediatr Dermatol. 2008;25(6):606–12.

    Article  PubMed  Google Scholar 

  14. Darmstadt GL, Saha SK, Ahmed a SMNU, et al. Effect of topical treatment with skin barrier-enhancing emollients on nosocomial infections in preterm infants in Bangladesh: a randomised controlled trial. Lancet. 2005;365(9464):1039–45.

    Article  CAS  PubMed  Google Scholar 

  15. Darmstadt GL, Saha SK, SMNU A a, et al. Effect of skin barrier therapy on neonatal mortality rates in preterm infants in Bangladesh: a randomized, controlled, clinical trial. Pediatrics. 2008;121(3):522–9.

    Article  PubMed  Google Scholar 

  16. LeFevre A, Shillcutt SD, Saha SK, et al. Cost-effectiveness of skin-barrier-enhancing emollients among preterm infants in Bangladesh. Bull World Health Organ. 2010;88(2):104–12.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Gong J, Lin L, Lin T, Hao F. Skin colonization by Staphylococcus aureus in patients with eczema and atopic dermatitis and relevant combined topical therapy: a double-blind multicentre randomized controlled trial. Br J Dermatol. 2006;155(4):680–7.

    Article  CAS  PubMed  Google Scholar 

  18. Park H-Y, Kim C-R, Huh I-S, et al. Staphylococcus aureus colonization in acute and chronic skin lesions of patients with atopic dermatitis. Ann Dermatol. 2013;25(4):410–6.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Leung DY, Harbeck R, Bina P, et al. Presence of IgE antibodies to staphylococcal exotoxins on the skin of patients with atopic dermatitis. Evidence for a new group of allergens. J Clin Invest. 1993;92(3):1374–80.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Nakamura Y, Oscherwitz J, Cease KB, et al. Staphylococcus δ-toxin induces allergic skin disease by activating mast cells. Nature. 2013;503(7476):397–401.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Verallo-Rowell VM, Dillague KM, Syah-Tjundawan BS. Novel antibacterial and emollient effects of coconut and virgin olive oils in adult atopic dermatitis. Dermat Contact, Atopic, Occup Drug. 2008;19(6):308–15.

    Google Scholar 

  22. Kong HH, Oh J, Deming C, et al. Temporal shifts in the skin microbiome associated with disease flares and treatment in children with atopic dermatitis. Genome Res. 2012;22(5):850–9. Exciting data and hypotheses around the role of the microbiome in atopic dermatitis.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Ismail IH, Oppedisano F, Joseph SJ, et al. Reduced gut microbial diversity in early life is associated with later development of eczema but not atopy in high-risk infants. Pediatr Allergy Immunol. 2012;23(7):674–81.

    Article  PubMed  Google Scholar 

  24. Kalliomäki M, Salminen S, Arvilommi H, Kero P, Koskinen P, Isolauri E. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet. 2001;357(9262):1076–9.

    Article  PubMed  Google Scholar 

  25. Kopp MV, Hennemuth I, Heinzmann A, Urbanek R. Randomized, double-blind, placebo-controlled trial of probiotics for primary prevention: no clinical effects of Lactobacillus GG supplementation. Pediatrics. 2008;121(4):e850–6.

    Article  PubMed  Google Scholar 

  26. Van der Aa LB, Heymans HS A, van Aalderen WMC, Sprikkelman AB. Probiotics and prebiotics in atopic dermatitis: review of the theoretical background and clinical evidence. Pediatr Allergy Immunol. 2010;21(2 Pt 2):e355–67.

    PubMed  Google Scholar 

  27. Pelucchi C, Chatenoud L, Turati F, et al. Probiotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: a meta-analysis. Epidemiology. 2012;23(3):402–14.

    Article  PubMed  Google Scholar 

  28. King RM, Wilson GV. Use of a diary technique to investigate psychosomatic relations in atopic dermatitis. J Psychosom Res. 1991;35(6):697–706.

    Article  CAS  PubMed  Google Scholar 

  29. Field T, Morrow C, Valdeon C, Larson S, Kuhn C, Schanberg S. Massage reduces anxiety in child and adolescent psychiatric patients. J Am Acad Child Adolesc Psychiatry. 1992;31(1):125–31.

    Article  CAS  PubMed  Google Scholar 

  30. Schachner L, Field T, Hernandez-Reif M, Duarte AM, Krasnegor J. Atopic dermatitis symptoms decreased in children following massage therapy. Pediatr Dermatol. 1998;15(5):390–5.

    Article  CAS  PubMed  Google Scholar 

  31. Thiboutot D, Gollnick H, Bettoli V, et al. New insights into the management of acne: an update from the Global Alliance to Improve Outcomes in Acne group. J Psychosom Res. 2009;60(5 Suppl):S1–S50.

    Google Scholar 

  32. Lee KC, Lio PA. Evidence-based recommendations for the diagnosis and treatment of paediatric acne. Arch Dis Child Educ Pract Ed. 2014;99(4):135–7. An efficient overview of the most recent evidence-based acne guidelines for pediatrics.

    Article  PubMed  Google Scholar 

  33. Carson CF, Hammer KA, Riley TV. Melaleuca alternifolia (tea tree) oil: a review of antimicrobial and other medicinal properties. Clin Microbiol Rev. 2006;19(1):50–62.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  34. Enshaieh S, Jooya A, Siadat AH, Iraji F. The efficacy of 5 % topical tea tree oil gel in mild to moderate acne vulgaris: a randomized, double-blind placebo-controlled study. Indian J Dermatol Venereol Leprol. 2007;73(1):22–5.

    Article  PubMed  Google Scholar 

  35. Bassett IB, Pannowitz DL, Barnetson RS. A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. Med J Aust. 1990;153(8):455–8.

    CAS  PubMed  Google Scholar 

  36. Jack AR, Norris PL, Storrs FJ. Allergic contact dermatitis to plant extracts in cosmetics. Semin Cutan Med Surg. 2013;32(3):140–6.

    PubMed  Google Scholar 

  37. Grange PA, Raingeaud J, Calvez V, Dupin N. Nicotinamide inhibits Propionibacterium acnes-induced IL-8 production in keratinocytes through the NF-kappaB and MAPK pathways. J Dermatol Sci. 2009;56(2):106–12.

    Article  CAS  PubMed  Google Scholar 

  38. Niren NM, Torok HM. The Nicomide Improvement in Clinical Outcomes Study (NICOS): results of an 8-week trial. Cutis. 2006;77(1 Suppl):17–28.

    PubMed  Google Scholar 

  39. Shalita AR, Smith JG, Parish LC, Sofman MS, Chalker DK. Topical nicotinamide compared with clindamycin gel in the treatment of inflammatory acne vulgaris. Int J Dermatol. 1995;34(6):434–7.

    Article  CAS  PubMed  Google Scholar 

  40. Dreno B, Moyse D, Alirezai M, et al. Multicenter randomized comparative double-blind controlled clinical trial of the safety and efficacy of zinc gluconate versus minocycline hydrochloride in the treatment of inflammatory acne vulgaris. Dermatology. 2001;203(2):135–40.

    Article  CAS  PubMed  Google Scholar 

  41. Weimar VM, Puhl SC, Smith WH, TenBroeke JE. Zinc sulfate in acne vulgaris. Arch Dermatol. 1978;114(12):1776–8.

    Article  CAS  PubMed  Google Scholar 

  42. Sardana K, Chugh S, Garg VK. The role of zinc in acne and prevention of resistance: have we missed the “base” effect? Int J Dermatol. 2014;53(1):125–7.

    Article  PubMed  Google Scholar 

  43. Sardana K, Garg VK. An observational study of methionine-bound zinc with antioxidants for mild to moderate acne vulgaris. Dermatol Ther. 2010;23(4):411–8.

    Article  PubMed  Google Scholar 

  44. Boull C, Groth D. Update: treatment of cutaneous viral warts in children. Pediatr Dermatol. 2011;28(3):217–29.

    Article  PubMed  Google Scholar 

  45. Tomson N, Sterling J, Ahmed I, Hague J, Berth-Jones J. Human papillomavirus typing of warts and response to cryotherapy. J Eur Acad Dermatol Venereol. 2011;25(9):1108–11.

    Article  CAS  PubMed  Google Scholar 

  46. Kwok CS, Gibbs S, Bennett C, Holland R, Abbott R. Topical treatments for cutaneous warts. Cochrane database Syst Rev. 2012;9(9):CD001781. A deep and through review of wart treatments that includes alternatives as well.

  47. Kuropatnicki AK, Szliszka E, Krol W. Historical aspects of propolis research in modern times. Evid Based Complement Alternat Med. 2013;2013:964149.

    PubMed Central  PubMed  Google Scholar 

  48. Sforcin J. Propolis and the immune system: a review. J Ethnopharmacol. 2007;113(1):1–14.

    Article  CAS  PubMed  Google Scholar 

  49. Lazarczyk M, Pons C, Mendoza J-A, Cassonnet P, Jacob Y, Favre M. Regulation of cellular zinc balance as a potential mechanism of EVER-mediated protection against pathogenesis by cutaneous oncogenic human papillomaviruses. J Exp Med. 2008;205(1):35–42.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  50. Mun J-H, Kim S-H, Jung D-S, et al. Oral zinc sulfate treatment for viral warts: an open-label study. J Dermatol. 2011;38(6):541–5.

    Article  CAS  PubMed  Google Scholar 

  51. Yaghoobi R, Sadighha A, Baktash D. Evaluation of oral zinc sulfate effect on recalcitrant multiple viral warts: a randomized placebo-controlled clinical trial. J Am Acad Dermatol. 2009;60(4):706–8.

    Article  PubMed  Google Scholar 

  52. Khattar JA, Musharrafieh UM, Tamim H, Hamadeh GN. Topical zinc oxide vs. salicylic acid-lactic acid combination in the treatment of warts. Int J Dermatol. 2007;46(4):427–30.

    Article  CAS  PubMed  Google Scholar 

  53. Lio PA. Commentary on “Topical treatments for cutaneous warts”. Evidence-Based Child Heal A Cochrane Rev J. 2011;6(5):1695–6.

    Article  Google Scholar 

  54. Sharquie KE, Khorsheed AA, Al-Nuaimy AA. Topical zinc sulphate solution for treatment of viral warts. Saudi Med J. 2007;28(9):1418–21.

    PubMed  Google Scholar 

  55. Hjorth N, Roed-Petersen J. Occupational protein contact dermatitis in food handlers. Contact Dermatitis. 1976;2(1):28–42.

    Article  CAS  PubMed  Google Scholar 

  56. Harris JC, Cottrell SL, Plummer S, Lloyd D. Antimicrobial properties of Allium sativum (garlic). Appl Microbiol Biotechnol. 2001;57(3):282–6.

    Article  CAS  PubMed  Google Scholar 

  57. Silverberg NB. Garlic cloves for verruca vulgaris. Pediatr Dermatol. 2002;19(2):183.

    Article  PubMed  Google Scholar 

  58. Dehghani F, Merat A, Panjehshahin MR, Handjani F. Healing effect of garlic extract on warts and corns. Int J Dermatol. 2005;44(7):612–5.

    Article  PubMed  Google Scholar 

  59. Filobbos G, Chapman T, Gesakis K. Iatrogenic burns from garlic. J Burn Care Res. 2009;33(1):e21.

    Article  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

MA Strom declares no conflicts of interest.

PA Lio has received personal fees from Anacor Pharmaceuticals, Galderma Laboratories, Johnson & Johnson, Mission Pharmacal, and Pierre Fabre Dermatologie; grants from Atopic Dermatitis Foundation and Pierre Fabre Dermatologie; and non-financial support from National Eczema Association.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. Northwestern University Feinberg School of Medicine, 1455 N. Milwaukee Avenue, Chicago, IL, 60622, USA

    Mark A. Strom & Peter A. Lio

Authors
  1. Mark A. Strom
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter A. Lio
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter A. Lio.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Strom, M.A., Lio, P.A. Alternative Medicine in Pediatric Dermatology: What Is the Evidence?. Curr Derm Rep 3, 165–170 (2014). https://doi.org/10.1007/s13671-014-0086-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13671-014-0086-x

Keywords

Search

Navigation