Abstract
Botanical extracts and single compounds are increasingly used in cosmetics but also in over-the-counter drugs and food supplements. The focus of the present review is on controlled clinical trials with botanicals in the treatment of acne, inflammatory skin diseases, skin infections, UV-induced skin damage, skin cancer, alopecia, vitiligo, and wounds. Studies with botanical cosmetics and drugs are discussed, as well as studies with botanical food supplements. Experimental research on botanicals was considered to a limited extent when it seemed promising for clinical use in the near future.
In acne therapy, Mahonia, tea tree oil, and Saccharomyces may have the potential to become standard treatments. Mahonia, Hypericum, Glycyrrhiza and some traditional Chinese medicines appear promising for atopic dermatitis. Some plant-derived substances like dithranol and methoxsalen (8-methoxypsoralen) [in combination with UVA] are already accepted as standard treatments in psoriasis; Mahonia and Capsicum (capsaicin) are the next candidates suggested by present evidence. Oral administration and topical application of antioxidant plant extracts (green and black tea, carotenoids, coffee, and many flavonoids from fruits and vegetables) can protect skin from UV-induced erythema, early aging, and irradiation-induced cancer. Hair loss and vitiligo are also traditional fields of application for botanicals.
According to the number and quality of clinical trials with botanicals, the best evidence exists for the treatment of inflammatory skin diseases, i.e. atopic dermatitis and psoriasis. However, many more controlled clinical studies are needed to determine the efficacy and risks of plant-derived products in dermatology. Safety aspects, especially related to sensitization and photodermatitis, have to be taken into account. Therefore, clinicians should not only be informed of the beneficial effects but also the specific adverse effects of botanicals used for dermatologic disorders and cosmetic purposes.
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References
Mantle D, Gok MA, Lennard TW. Adverse and beneficial effects of plant extracts on skin and skin disorders. Adverse Drug React Toxicol Rev 2001 Jun; 20 (2): 89–103
Choi CM, Berson DS. Cosmeceuticals. Semin Cutan Med Surg 2006 Sep; 25 (3): 163–8
Thornfeldt C. Cosmeceuticals containing herbs: fact, fiction, and future. Dermatol Surg 2005 Jul; 31 (7 Pt 2): 873–80; discussion 80
Blumenthal M, Gruenwald J, Hall T, et al. The complete German Commission E monographs: therapeutic guide to herbal medicine. Boston (MA): Integrative Medicine Communications, 1998
Centre for Evidence Based Medicine. Oxford Centre for Evidence-based Medicine. Levels of evidence (March 2009) [online]. Available from URL: http://www.cebm.net/index.aspx?o=1025#levels [Accessed 2010 Mar 26]
Kraft K. Erkrankungen der Haut (II). Weitere Ekzemformen, Akne und Pruritus. [Diseases of the skin (II). Other eczema types, acne and pruritus]. Z Phytotherapie 2007; 28 (3): 129–33
Peirce A, Fargis P, Scordato E. The American Pharmaceutical Association practical guide to natural medicines. New York (NY): Stonesong Press Inc., 1999
Bedi MK, Shenefelt PD. Herbal therapy in dermatology. Arch Dermatol 2002 Feb; 138 (2): 232–42
Wuttke W, Jarry H, Christoffel V, et al. Chaste tree (Vitex agnus-castus): pharmacology and clinical indications. Phytomedicine 2003 May; 10 (4): 348–57
Jain A, Basal E. Inhibition of Propionibacterium acnes-induced mediators of inflammation by Indian herbs. Phytomedicine 2003 Jan; 10 (1): 34–8
Nam C, Kim S, Sim Y, et al. Anti-acne effects of Oriental herb extracts: a novel screeningmethod to select anti-acne agents. Skin Pharmacol Appl Skin Physiol 2003 Mar-Apr; 16 (2): 84–90
Weckesser S, Engel K, Simon-Haarhaus B, et al. Screening of plant extracts for antimicrobial activity against bacteria and yeasts with dermatological relevance. Phytomedicine 2007 Aug; 14 (7-8): 508–16
Orafidiya LO, Agbanie EO, Oyedele AO, et al. Preliminary clinical tests on topical preparations of Ocimum gratissimum L. leaf essential oil for the treatment of acne vulgaris. Clin Drug Investig 2002; 22 (5): 313–9
Slobodnikova L, Kost’alova D, Labudova D, et al. Antimicrobial activity of Mahonia aquifolium crude extract and its major isolated alkaloids. Phytother Res 2004 Aug; 18 (8): 674–6
Seki T, Morohashi M. Effect of some alkaloids, flavonoids and triterpenoids, contents of Japanese-Chinese traditional herbal medicines, on the lipogenesis of sebaceous glands. Skin Pharmacol 1993; 6 (1): 56–60
Choi BH, Ahn IS, Kim YH, et al. Berberine reduces the expression of adipogenic enzymes and inflammatory molecules of 3T3-L1 adipocyte. Exp Mol Med 2006 Dec 31; 38 (6): 599–605
Koh KJ, Pearce AL, Marshman G, et al. Tea tree oil reduces histamineinduced skin inflammation. Br J Dermatol 2002 Dec; 147 (6): 1212–7
Bassett IB, Pannowitz DL, Barnetson RS. A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. Med J Aust 1990 Oct; 153 (8): 455–8
Enshaieh S, Jooya A, Siadat AH, et al. The efficacy of 5% topical tea tree oil gel in mild to moderate acne vulgaris: a randomized, double-blind placebocontrolled study. Indian J Dermatol Venereol Leprol 2007 Jan-Feb; 73 (1): 22–5
Schempp CM, Schopf E, Simon JC. Plant-induced toxic and allergic dermatitis (phytodermatitis). Hautarzt 2002 Feb; 53 (2): 93–7
van Dijken JP, van Tuijl A, Luttik MA, et al. Novel pathway for alcoholic fermentation of delta-gluconolactone in the yeast Saccharomyces bulderi. J Bacteriol 2002 Feb; 184 (3): 672–8
Hunt MJ, Barnetson RS. A comparative study of gluconolactone versus benzoyl peroxide in the treatment of acne. Australas J Dermatol 1992; 33 (3): 131–4
Kraft K. Diseases of the skin: I. Psoriasis and atopic eczema. Z Phytotherapie 2007; 28 (2): 76–8
Schilcher H, Kammerer S. Leitfaden phytotherapie. Munich, Jena: Urban and Fischer, 2000
Patzelt-Wenczler R, Ponce-Poschl E. Proof of efficacy of Kamillosan® cream in atopic eczema. Eur J Med Res 2000 Apr 19; 5 (4): 171–5
Korting HC, Schafer-Korting M, Klovekorn W, et al. Comparative efficacy of hamamelis distillate and hydrocortisone cream in atopic eczema. Eur J Clin Pharmacol 1995; 48 (6): 461–5
Schempp CM, Hezel S, Simon JC. Topical treatment of atopic dermatitis with Hypericum cream: a randomised, placebo-controlled, double-blind half-side comparison study. Hautarzt 2003 Mar; 54 (3): 248–53
Higaki S, Kitagawa T, Morohashi M, et al. Efficacy of Shiunko for the treatment of atopic dermatitis. J Int Med Res 1999 May-Jun; 27 (3): 143–7
Thumm EJ, Stoss M, Bayerl C. Randomized trial to study efficacy of a 20% and 10% Hippophą rhamnoides containing cream used by patients with mild to intermediate atopic dermatitis. Akt Dermatol 2000; 26: 285–90
Stern T, Bayerl C. Black seed oil ointment: a new approach for the treatment of atopic dermatitis? Akt Dermatol 2002; 28: 74–9
Takwale A, Tan E, Agarwal S, et al. Efficacy and tolerability of borage oil in adults and children with atopic eczema: randomised, double blind, placebo controlled, parallel group trial. BMJ 2003 Dec 13; 327 (7428): 1385–9
Donsky H, Clarke D. Relieva, a Mahonia aquifolium extract for the treatment of adult patients with atopic dermatitis. Am J Ther 2007 Sep-Oct; 14 (5): 442–6
Abeck D, Klövekorn W, Danesch U. Behandlung des atopischen Ekzems bei Kindern mit einer pflanzlichen Heilsalbe: Ergebnisse einer offenen Studie mit Ekzevowen ® derma [in German]. Akt Dermatol 2005; 31: 523–6
Klovekorn W, Tepe A, Danesch U. A randomized, double-blind, vehiclecontrolled, half-side comparison with a herbal ointment containing Mahonia aquifolium, Viola tricolor and Centella asiatica for the treatment of mild-to-moderate atopic dermatitis. Int J Clin Pharmacol Ther 2007 Nov; 45 (11): 583–91
Saeedi M, Morteza-Semnani K, Ghoreishi MR. The treatment of atopic dermatitis with licorice gel. J Dermatolog Treat 2003 Sep; 14 (3): 153–7
Abramovits W, Boguniewicz M. A multicenter, randomized, vehicle-controlled clinical study to examine the efficacy and safety of MAS063DP (Atopiclair) in the management of mild to moderate atopic dermatitis in adults. J Drugs Dermatol 2006 Mar; 5 (3): 236–44
Abramovits W, Gover MD, Gupta AK. Atopiclair nonsteroidal cream. Skinmed 2005 Nov-Dec; 4 (6): 369
Belloni G, Pinelli S, Veraldi S. A randomised, double-blind, vehicle-controlled study to evaluate the efficacy and safety of MAS063D (Atopiclair) in the treatment of mild to moderate atopic dermatitis. Eur J Dermatol 2005 Jan-Feb; 15 (1): 31–6
Boguniewicz M, Zeichner JA, Eichenfield LF, et al. MAS063DP is effective monotherapy for mild to moderate atopic dermatitis in infants and children: a multicenter, randomized, vehicle-controlled study. J Pediatr 2008 Jun; 152 (6): 854–9
Uehara M, Sugiura H, Sakurai K. A trial of oolong tea in the management of recalcitrant atopic dermatitis. Arch Dermatol 2001 Jan; 137 (1): 42–3
Kobayashi H, Mizuno N, Teramae H, et al. Diet and Japanese herbal medicine for recalcitrant atopic dermatitis: efficacy and safety. Drugs Exp Clin Res 2004; 30 (5-6): 197–202
Kobayashi H, Mizuno N, Teramae H, et al. The effects of Hochu-ekki-to in patients with atopic dermatitis resistant to conventional treatment. Int J Tissue React 2004; 26 (3-4): 113–7
Hon KL, Leung TF, Ng PC, et al. Efficacy and tolerability of a Chinese herbal medicine concoction for treatment of atopic dermatitis: a randomized, double-blind, placebo-controlled study. Br J Dermatol 2007 Aug; 157 (2): 357–63
Sheehan MP, Rustin MH, Atherton DJ, et al. Efficacy of traditional Chinese herbal therapy in adult atopic dermatitis. Lancet 1992 Jul 4; 340 (8810): 13–7
Shapira MY, Raphaelovich Y, Gilad L, et al. Treatment of atopic dermatitis with herbal combination of Eleutherococcus, Achillea millefolium, and Lamium album has no advantage over placebo: a double blind, placebocontrolled, randomized trial. J Am Acad Dermatol 2005 Apr; 52 (4): 691–3
Gloor M, Reichling J, Wasik B, et al. Antiseptic effect of a topical dermatological formulation that contains Hamamelis distillate and urea. Forsch Komplementarmed Klass Naturheilkd 2002 Jun; 9 (3): 153–9
Schempp CM, Pelz K, Wittmer A, et al. Antibacterial activity of hyperforin from St John’s wort, against multiresistant Staphylococcus aureus and gram-positive bacteria [letter]. Lancet 1999 Jun 19; 353 (9170): 2129
Schempp CM, Winghofer B, Ludtke R, et al. Topical application of St John’s wort (Hypericum perforatum L.) and of its metabolite hyperforin inhibits the allostimulatory capacity of epidermal cells. Br J Dermatol 2000 May; 142 (5): 979–84
Inoue H, Mori T, Shibata S, et al. Modulation by glycyrrhetinic acid derivatives of TPA-induced mouse ear oedema. Br J Pharmacol 1989 Jan; 96 (1): 204–10
Sheehan MP, Stevens H, Ostlere LS, et al. Follow-up of adult patients with atopic eczema treated with Chinese herbal therapy for 1 year. Clin Exp Dermatol 1995 Mar; 20 (2): 136–40
van de Kerkhof PC, van der Valk PG, Swinkels OQ, et al. A comparison of twice-daily calcipotriol ointment with once-daily short-contact dithranol cream therapy: a randomized controlled trial of supervised treatment of psoriasis vulgaris in a day-care setting. Br J Dermatol 2006 Oct; 155 (4): 800–7
Augustin M, Hoch Y. Phytotherapie bei Hautkrankheiten: Grundlagen–Praxis–Studien. München: Elsevier GmbH, 2004
Amornpinyokeit N, Asawanonda P. 8-Methoxypsoralen cream plus targeted narrowband ultraviolet B for psoriasis. Photodermatol Photoimmunol Photomed 2006 Dec; 22 (6): 285–9
Vongthongsri R, Konschitzky R, Seeber A, et al. Randomized, double-blind comparison of 1mg/L versus 5 mg/L methoxsalen bath-PUVA therapy for chronic plaque-type psoriasis. J Am Acad Dermatol 2006 Oct; 55 (4): 627–31
Gulliver WP, Donsky HJ. A report on three recent clinical trials using Mahonia aquifolium 10% topical cream and a review of the worldwide clinical experience with Mahonia aquifolium for the treatment of plaque psoriasis. Am J Ther 2005 Sep-Oct; 12 (5): 398–406
Bernstein S, Donsky H, Gulliver W, et al. Treatment of mild to moderate psoriasis with Relieva, a Mahonia aquifolium extract: a double-blind, placebo-controlled study. Am J Ther 2006 Mar-Apr; 13 (2): 121–6
Stucker M, Memmel U, Hoffmann M, et al. Vitamin B(12) cream containing avocado oil in the therapy of plaque psoriasis. Dermatology 2001; 203 (2): 141–7
Ellis CN, Berberian B, Sulica VI, et al. A double-blind evaluation of topical capsaicin in pruritic psoriasis. J Am Acad Dermatol 1993 Sep; 29 (3): 438–42
Bernstein JE, Parish LC, Rapaport M, et al. Effects of topically applied capsaicin on moderate and severe psoriasis vulgaris. J Am Acad Dermatol 1986 Sep; 15 (3): 504–7
Syed TA, Ahmad SA, Holt AH, et al. Management of psoriasis with Aloe vera extract in a hydrophilic cream: a placebo-controlled, double-blind study. Trop Med Int Health 1996 Aug; 1 (4): 505–9
Paulsen E, Korsholm L, Brandrup F. A double-blind, placebo-controlled study of a commercial aloe vera gel in the treatment of slight to moderate psoriasis vulgaris. J Eur Acad Dermatol Venereol 2005 May; 19 (3): 326–31
Brown AC, Koett J, Johnson DW, et al. Effectiveness of kukui nut oil as a topical treatment for psoriasis. Int J Dermatol 2005 Aug; 44 (8): 684–7
Zhou N, Bai YP, Man XH, et al. Effect of new Pulian ointment in treating psoriasis of blood-heat syndrome: a randomized controlled trial. Chin J Integr Med 2009 Dec; 15 (6): 409–14
Lin YK, Wong WR, Su Pang JH. Successful treatment of recalcitrant psoriasis with Indigo naturalis ointment. Clin Exp Dermatol 2007 Jan; 32 (1): 99–100
Lin YK, Chang CJ, Chang YC, et al. Clinical assessment of patients with recalcitrant psoriasis in a randomized, observer-blind, vehicle-controlled trial using indigo naturalis. Arch Dermatol 2008 Nov; 144 (11): 1457–64
Grover JK, Yadav SP. Pharmacological actions and potential uses of Momordica charantia: a review. J Ethnopharmacol 2004 Jul; 93 (1): 123–32
Tse TW. Use of common Chinese herbs in the treatment of psoriasis. Clin Exp Dermatol 2003 Sep; 28 (5): 469–75
Tse WP, Cheng CH, Che CT, et al. Induction of apoptosis underlies the Radix Rubiae-mediated anti-proliferative action on human epidermal keratinocytes: implications for psoriasis treatment. Int J Mol Med 2007 Nov; 20 (5): 663–72
Cox SD, Mann CM, Markham JL, et al. The mode of antimicrobial action of the essential oil of Melaleuca alternifolia (tea tree oil). J Appl Microbiol 2000 Jan; 88 (1): 170–5
Lo Cantore P, Iacobellis NS, De Marco A, et al. Antibacterial activity of Coriandrum sativum L. and Foeniculum vulgare Miller Var. vulgare (Miller) essential oils. J Agric Food Chem 2004 Dec 29; 52 (26): 7862–6
Elgayyar M, Draughon FA, Golden DA, et al. Antimicrobial activity of essential oils from plants against selected pathogenic and saprophytic microorganisms. J Food Prot 2001 Jul; 64 (7): 1019–24
Delaquis PJ, Stanich K, Girard B, et al. Antimicrobial activity of individual and mixed fractions of dill, cilantro, coriander and eucalyptus essential oils. Int J Food Microbiol 2002 Mar 25; 74 (1-2): 101–9
Singh G, Kapoor IP, Pandey SK, et al. Studies on essential oils: part 10; antibacterial activity of volatile oils of some spices. Phytother Res 2002 Nov; 16 (7): 680–2
Kubo I, Fujita K, Kubo A, et al. Antibacterial activity of coriander volatile compounds against Salmonella choleraesuis. J Agric Food Chem 2004 Jun 2; 52 (11): 3329–32
Reuter J, Huyke C, Casetti F, et al. Anti-inflammatory potential of a lipolotion containing coriander oil in the ultraviolet erythema test. J Dtsch Dermatol Ges 2008 Oct; 6 (10): 847–51
Higaki S, Morimatsu S, Morohashi M, et al. Susceptibility of Propionibacterium acnes, Staphylococcus aureus and Staphylococcus epidermidis to 10 Kampo formulations. J Int Med Res 1997 Nov-Dec; 25 (6): 318–24
Shahi SK, Shukla AC, Bajaj AK, et al. Broad spectrum herbal therapy against superficial fungal infections. Skin Pharmacol Appl Skin Physiol 2000 Jan-Feb; 13 (1): 60–4
Ledezma E, De Sousa L, Jorquera A, et al. Efficacy of ajoene, an organosulphur derived from garlic, in the short-term therapy of tinea pedis. Mycoses 1996 Sep-Oct; 39 (9-10): 393–5
Koytchev R, Alken RG, Dundarov S. Balm mint extract (Lo-701) for topical treatment of recurring herpes labialis. Phytomedicine 1999 Oct; 6 (4): 225–30
Xie FM, Zeng K, Chen ZL, et al. Treatment of recurrent condyloma acuminatum with solid lipid nanoparticle gel containing podophyllotoxin: a randomized double-blinded, controlled clinical trial. Nan Fang Yi Ke Da Xue Xue Bao 2007 May; 27 (5): 657–9
Stockfleth E, Beti H, Orasan R, et al. Topical Polyphenon E in the treatment of external genital and perianal warts: a randomized controlled trial. Br J Dermatol 2008 Jun; 158 (6): 1329–38
Tatti S, Stockfleth E, Beutner KR, et al. Polyphenon E®: a new treatment for external anogenital warts. Br J Dermatol 2010; 162: 176–84
Baliga MS, Katiyar SK. Chemoprevention of photocarcinogenesis by selected dietary botanicals. Photochem Photobiol Sci 2006 Feb; 5 (2): 243–53
Yaar M, Gilchrest BA. Photoageing: mechanism, prevention and therapy. Br J Dermatol 2007 Nov; 157 (5): 874–87
Afaq F, Mukhtar H. Botanical antioxidants in the prevention of photocarcinogenesis and photoaging. Exp Dermatol 2006 Sep; 15 (9): 678–84
Gonzalez S, Pathak MA, Cuevas J, et al. Topical or oral administration with an extract of Polypodium leucotomos prevents acute sunburn and psoraleninduced phototoxic reactions as well as depletion of Langerhans cells in human skin. Photodermatol Photoimmunol Photomed 1997 Feb-Apr; 13 (1-2): 50–60
Middelkamp-Hup MA, Pathak MA, Parrado C, et al. Orally administered Polypodium leucotomos extract decreases psoralen-UVA-induced phototoxicity, pigmentation, and damage of human skin. J Am Acad Dermatol 2004 Jan; 50 (1): 41–9
Middelkamp-Hup MA, Pathak MA, Parrado C, et al. Oral Polypodium leucotomos extract decreases ultraviolet-induced damage of human skin. J Am Acad Dermatol 2004 Dec; 51 (6): 910–8
Capote R, Alonso-Lebrero JL, Garcia F, et al. Polypodium leucotomos extract inhibits trans-urocanic acid photoisomerization and photodecomposition. J Photochem Photobiol B 2006 Mar 1; 82 (3): 173–9
Reuter J, Jocher A, Hornstein S, et al. Sage extract rich in phenolic diterpenes inhibits ultraviolet-induced erythema in vivo. Planta Med 2007 Sep; 73 (11): 1190–1
Hughes-Formella BJ, Filbry A, Gassmueller J, et al. Anti-inflammatory efficacy of topical preparations with 10% hamamelis distillate in a UV erythema test. Skin Pharmacol Appl Skin Physiol 2002 Mar-Apr; 15 (2): 125–32
Heinrich U, Gartner C, Wiebusch M, et al. Supplementation with betacarotene or a similar amount of mixed carotenoids protects humans from UV-induced erythema. J Nutr 2003 Jan; 133 (1): 98–101
Aust O, Stahl W, Sies H, et al. Supplementation with tomato-based products increases lycopene, phytofluene, and phytoene levels in human serum and protects against UV-light-induced erythema. Int J Vitam Nutr Res 2005 Jan; 75 (1): 54–60
Katiyar SK, Ahmad N, Mukhtar H. Green tea and skin. Arch Dermatol 2000 Aug; 136 (8): 989–94sss
Zhao JF, Zhang YJ, Jin XH, et al. Green tea protects against psoralen plus ultraviolet A-induced photochemical damage to skin. J Invest Dermatol 1999 Dec; 113 (6): 1070–5
Cooper R, Morre DJ, Morre DM. Medicinal benefits of green tea: part II. Review of anticancer properties. J Altern Complement Med 2005 Aug; 11 (4): 639–52
Cooper R, Morre DJ, Morre DM. Medicinal benefits of green tea: part I. Review of noncancer health benefits. J Altern Complement Med 2005 Jun; 11 (3): 521–8
Camouse MM, Hanneman KK, Conrad EP, et al. Protective effects of tea polyphenols and caffeine. Expert Rev Anticancer Ther 2005 Dec; 5 (6): 1061–8
Nomura M, Ma WY, Huang C, et al. Inhibition of ultraviolet B-induced AP-1 activation by theaflavins from black tea. Mol Carcinog 2000 Jul; 28 (3): 148–55
Leung LK, Su Y, Chen R, et al. Theaflavins in black tea and catechins in green tea are equally effective antioxidants. J Nutr 2001 Sep; 131 (9): 2248–51
Baumann LS. Less-known botanical cosmeceuticals. Dermatol Ther 2007 Sep-Oct; 20 (5): 330–42
Farris P. Idebenone, green tea, and coffeeberry extract: new and innovative antioxidants. Dermatol Ther 2007 Sep-Oct; 20 (5): 322–9
Heinrich U, Neukam K, Tronnier H, et al. Long-term ingestion of high flavanol cocoa provides photoprotection against UV-induced erythema and improves skin condition in women. J Nutr 2006 Jun; 136 (6): 1565–9
Katiyar SK. Silymarin and skin cancer prevention: anti-inflammatory, antioxidant and immunomodulatory effects. Int J Oncol 2005 Jan; 26 (1): 169–76
Huang MT, Ho CT, Wang ZY, et al. Inhibition of skin tumorigenesis by rosemary and its constituents carnosol and ursolic acid. Cancer Res 1994 Feb 1; 54 (3): 701–8
Mitamura T, Matsuno T, Sakamoto S, et al. Effects of a new clerodane diterpenoid isolated from propolis on chemically induced skin tumors in mice. Anticancer Res 1996 Sep-Oct; 16 (5A): 2669–72
Xiaoguang C, Hongyan L, Xiaohong L, et al. Cancer chemopreventive and therapeutic activities of red ginseng. J Ethnopharmacol 1998 Feb; 60 (1): 71–8
Wei H, Saladi R, Lu Y, et al. Isoflavone genistein: photoprotection and clinical implications in dermatology. J Nutr 2003 Nov; 133 (11 Suppl. 1): 3811S–9S
Syed DN, Malik A, Hadi N, et al. Photochemopreventive effect of pomegranate fruit extract on UVA-mediated activation of cellular pathways in normal human epidermal keratinocytes. Photochem Photobiol 2006 Mar-Apr; 82 (2): 398–405
Zaid MA, Afaq F, Syed DN, et al. Inhibition of UVB-mediated oxidative stress and markers of photoaging in immortalized HaCaT keratinocytes by pomegranate polyphenol extract POMx. Photochem Photobiol 2007 Jul-Aug; 83 (4): 882–8
Laszczyk M, Jager S, Simon-Haarhaus B, et al. Physical, chemical and pharmacological characterization of a new oleogel-forming triterpene extract from the outer bark of birch (betulae cortex). Planta Med 2006 Dec; 72 (15): 1389–95
Huyke C, Laszczyk M, Scheffler A, et al. Treatment of actinic keratoses with birch bark extract: a pilot study. J Dtsch Dermatol Ges 2006 Feb; 4 (2): 132–6
Huyke C, Reuter J, Rödig M, et al. Treatment of actinic keratoses with a novel betulin-based oleogel: a prospective, randomized, comparative pilot study. J Dtsch Dermatol Ges 2009 Feb; 7 (2): 128–33
Siller G, Gebauer K, Welburn P, et al. PEP005 (ingenolmebutate) gel, a novel agent for the treatment of actinic keratosis: results of a randomized, doubleblind, vehicle-controlled, multicentre, phase IIa study. Australas J Dermatol 2009 Feb; 50 (1): 16–22
Anderson L, Schmieder GJ, Werschler WP, et al. Randomized, double-blind, double-dummy, vehicle-controlled study of ingenol mebutate gel 0.025% and 0.05% for actinic keratosis. J Am Acad Dermatol 2009 Jun; 60 (6): 934–43
Sharquie KE, Al-Obaidi HK. Onion juice (Allium cepa L.), a new topical treatment for alopecia areata. J Dermatol 2002 Jun; 29 (6): 343–6
Prager N, Bickett K, French N, et al. A randomized, double-blind, placebocontrolled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. J Altern Complement Med 2002 Apr; 8 (2): 143–52
Gerber GS, Zagaja GP, Bales GT, et al. Saw palmetto (Serenoa repens) in men with lower urinary tract symptoms: effects on urodynamic parameters and voiding symptoms. Urology 1998; 51: 1003–7
Lee MM, Lin SS, Wrensch MR, et al. Alternative therapies used by women with breast cancer in four ethnic populations. J Nat Cancer Inst 2000; 92: 42–7
Parrish JA, Fitzpatrick TB, Tanenbaum L, et al. Photochemotherapy of psoriasis with oral methoxsalen and longwave ultraviolet. N Engl J Med 1974 Dec; 291 (23): 1207–11
Yones SS, Palmer RA, Garibaldinos TM, et al. Randomized double-blind trial of treatment of vitiligo: efficacy of psoralen-UV-A therapy vs. narrowband-UV-B therapy. Arch Dermatol 2007 May; 143 (5): 578–84
Middelkamp-Hup MA, Bos JD, Rius-Diaz F, et al. Treatment of vitiligo vulgaris with narrow-band UVB and oral Polypodium leucotomos extract: a randomized double-blind placebo-controlled study. J Eur Acad Dermatol Venereol 2007 Aug; 21 (7): 942–50
Liu ZJ, Xiang YP. Clinical observation on treatment of vitiligo with xiaobai mixture. Zhongguo Zhong Xi Yi Jie He Za Zhi 2003 Aug; 23 (8): 596–8
Szczurko O, Boon HS. A systematic review of natural health product treatment for vitiligo. BMC Dermatol 2008; 8: 2, doi:10.1186/1471-5945-5945-8-2
Parsad D, Pandhi R, Juneja A. Effectiveness of oral Ginkgo biloba in treating limited, slowly spreading vitiligo. Clin ExpDermatol 2003 May; 28 (3): 285–7
Kraft K. Erkrankungen der Haut (II): Wunden und Stumpfe Traumen. Z Phytotherapie 2007; 28 (4): 178–80
Cordova CA, Siqueira IR, Netto CA, et al. Protective properties of butanolic extract of the Calendula officinalis L. (marigold) against lipid peroxidation of rat liver microsomes and action as free radical scavenger. Redox Rep 2002; 7 (2): 95–102
Bisset NG, Wichtl M. Herbal drugs and phytopharmaceuticals. 2nd ed. Boca Raton (FL): CRC Press, 2001
Pommier P, Gomez F, Sunyach MP, et al. Phase III randomized trial of Calendula officinalis compared with trolamine for the prevention of acute dermatitis during irradiation for breast cancer. J Clin Oncol 2004 Apr 15; 22 (8): 1447–53
ESCOP. Monographs on the medicinal uses of plant drugs: Arnicae flos. European Scientific Cooperative on Phytotherapy. Stuttgart (NY): Georg Thieme Verlag, 1997
Willuhn G. Arnica flowers; pharmacology, toxicology and analysis of the sesquiterpene lactones: their main active substances. In: Lawson LD, Bauer R, editors. Phytomedicines of Europe chemistry and biological activity. ACS Symposium Series 691. Washington, DC: American Chemical Society, 1998: 118–32
Lyss G, Knorre A, Schmidt TJ, et al. The anti-inflammatory sesquiterpene lactone helenalin inhibits the transcription factor NF-kappaB by directly targeting p65. J Biol Chem 1998 Dec 11; 273 (50): 33508–16
Garcia-Pineres AJ, Castro V, Mora G, et al. Cysteine 38 in p65/NF-kappaB plays a crucial role in DNA binding inhibition by sesquiterpene lactones. J Biol Chem 2001 Oct 26; 276 (43): 39713–20
Brock FB. Additiver Effekt venentypischer Hydrotherapie nach Kneipp und lokaler Arnika-Anwendung bei Patienten mit chronisch-venöser Insuffizienz: Synergismus naturheilkundlicher Therapien. Erfahrungsheilkunde 2001; 11: 357–63
Avijgan M. Phytotherapy: an alternative treatment for non-healing ulcers. J Wound Care 2004 Apr; 13 (4): 157–8
Somboonwong J, Thanamittramanee S, Jariyapongskul A, et al. Therapeutic effects of Aloe vera on cutaneous microcirculation and wound healing in second degree burn model in rats. J Med Assoc Thai 2000 Apr; 83 (4): 417–25
Maenthaisong R, Chaiyakunapruk N, Niruntraporn S, et al. The efficacy of aloe vera used for burn wound healing: a systematic review. Burns 2007 Sep; 33 (6): 713–8
Majumdar M, Nayeem N, Kamath JV, et al. Evaluation of Tectona grandis leaves for wound healing activity. Pak J Pharm Sci 2007 Apr; 20 (2): 120–4
Nayak S, Nalabothu P, Sandiford S, et al. Evaluation of wound healing activity of Allamanda cathartica. L. and Laurus nobilis. L. extracts on rats. BMC Complement Altern Med 2006; 6: 12, doi:10.1186/1472-6882-6-12
Manjunatha BK, Vidya SM, Krishna V, et al. Comparative evaluation of wound healing potency of Vitex trifolia L. and Vitex altissima L. Phytother Res 2007 May; 21 (5): 457–61
Nayak BS, Pinto Pereira LM. Catharanthus roseus flower extract has woundhealing activity in Sprague Dawley rats. BMC Complement Altern Med 2006; 6: 41, doi:10.1186/1472-6882-6-41
Shetty BS, Udupa SL, Udupa AL, et al. Effect of Centella asiatica L (Umbelliferae) on normal and dexamethasone-suppressed wound healing in Wistar Albino rats. Int J Low Extrem Wounds 2006 Sep; 5 (3): 137–43
Udupa SL, Shetty S, Udupa AL, et al. Effect of Ocimum sanctum Linn. on normal and dexamethasone suppressed wound healing. Indian J Exp Biol 2006 Jan; 44 (1): 49–54
Panchatcharam M, Miriyala S, Gayathri VS, et al. Curcumin improves wound healing by modulating collagen and decreasing reactive oxygen species. Mol Cell Biochem 2006 Oct; 290 (1-2): 87–96
Blazso G, Gabor M, Schonlau F, et al. Pycnogenol accelerates wound healing and reduces scar formation. Phytother Res 2004 Jul; 18 (7): 579–81
Aberer W. Contact allergy and medicinal herbs. J Dtsch Dermatol Ges 2008 Jan; 6 (1): 15–24
Thomson KF, Wilkinson SM. Allergic contact dermatitis to plant extracts in patients with cosmetic dermatitis. Br J Dermatol 2000; 1: 84–8
Wilken K, Schempp CM. Toxic phytodermatitis caused by Euphorbia helioscopia L. (sun spurge). Hautarzt 2005; 10: 955–7
Schempp CM, Sonntag M, Schopf E, et al. Dermatitis bullosa striata pratensis caused by Dictamnus albus L. (burning bush). Hautarzt 1996; 9: 708–10
Schempp CM, Schopf E, Simon JC. Bullous phototoxic contact dermatitis caused by Ruta graveolens L. (garden rue), Rutaceae: case report and review of literature. Hautarzt 1999; 6: 432–4
McGovern TW, Barkley TM. Botanical briefs: giant hogweed, Heracleum mantegazzianum. Cutis 2000; 65: 71–2
Vale PT. Prevention of phytophotodermatitis from celery [letter]. Contact Dermatitis 1993; 29: 108
Hausen BM. Identification of the allergens of Arnica montana L [letter]. Contact Dermatitis 1978; 5: 308
Paulsen E. Contact sensitization from Compositae-containing herbal remedies and cosmetics. Contact Dermatitis 2002; 4: 189–98
Reider N, Komericki P, Hausen BM, et al. The seamy side of natural medicines: contact sensitization to arnica (Arnica montana L.) and marigold (Calendula officinalis L.). Contact Dermatitis 2001; 5: 269–72
Lass C, Vocanson M, Martin S, et al. Anti-inflammatory and immune regulatory mechanisms prevent contact hypersensitivity to Arnica montana L. Exp Dermatology 2008 Oct; 17 (10): 849–57
Jocher A, Nist G, Weiss J, et al. Allergenic potential of arnica-containing formulations in arnica-allergic subjects. Contact Dermatitis 2009; 61: 304–6
Matura M, Goossens A, Bordalo O, et al. Oxidized citrus oil (R-limonene): a frequent skin sensitizer in Europe. J Am Acad Dermatol 2002; 5: 709–14
Hausen BM, Reichling J, Harkenthal M. Degradation products of monoterpenes are the sensitizing agents in tea tree oil. Am J Contact Dermat 1999; 2: 68–77
Henley DV, Lipson N, Korach KS, et al. Prepubertal gynecomastia linked to lavender and tea tree oils. N Engl J Med 2007; 5: 479–85
Ernst E. Adverse effects of herbal drugs in dermatology. Br J Dermatol 2000; 5: 923–9
Wanner M, Avram M. An evidence-based assessment of treatments of cellulite. J Drugs Dermatol 2008 Apr; 7 (4): 341–5
Rawlings AV. Cellulite and its treatment. Int J Cosmet Sci 2006 Jun; 28 (3): 175–90
Bertin C, Zunino H, Pittet JC, et al. A double-blind evaluation of the activity of an anti-cellulite product containing retinol, caffeine, and ruscogenine by a combination of several non-invasive methods. J Cosmet Sci 2001 Jul; 52 (4): 199–210
Hexsel D, Orlandi C, Zechmeister do Prado D. Botanical extracts used in the treatment of cellulite. Dermatol Surg 2005 Jul; 31 (7): 866–72
Wu J. Treatment of rosacea with herbal ingredients. J Drugs Dermatol 2006 Jan; 5 (1): 29–32
Acknowledgments
We thank Dr Ute Wölfle for the critical reading of the manuscript. No sources of funding were used to assist in the preparation of this review. Christoph M. Schempp has conducted studies for pharmaceutical companies manufacturing botanical products: Birken, Cassella-Med, Kneipp, Riemser, Tom’s of Maine, WALA, Weleda. He is also involved in patents on botanical extracts from H.perforatum, Reseda luteola, and Usnea barbata. The other authors have no conflicts of interest that are directly relevant to the content of this review.
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Reuter, J., Merfort, I. & Schempp, C.M. Botanicals in Dermatology. Am J Clin Dermatol 11, 247–267 (2010). https://doi.org/10.2165/11533220-000000000-00000
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DOI: https://doi.org/10.2165/11533220-000000000-00000