Abstract
The present in vitro and randomized, double‐blind, placebo‐controlled trial aims to determine the efficacy and safety of nine Mediterranean antiacne medicinal plants. The antimicrobial, antisebum, and anti-inflammatory activities of the plant extracts were evaluated in cells from the immortalized human keratinocytes (HaCaT) and human monocytic cell line (THP-1) as well as in a double-blind, randomized, and placebo‐controlled trial. Most of the extracts showed no significant cytotoxic effects on HaCaT cells up to 250 μg/ml. Inula helenium (IH) and Saponaria officinalis (SO) inhibited sebum production at 90 μg/ml and 30 μg/ml, respectively. The inhibition effect of SO on the growth of Cutibacterium acnes was 1.2 times higher than that of chloramphenicol. IH and SO extracts significantly inhibited the lipopolysaccharide- (LPS-) induced IL-6 and TNF-α production in THP-1 cells reaching the control levels of untreated cells at a concentration of 250 μg/ml. SO, IH, and Solanum nigrum (SN) extracts inhibited the nitric oxide (NO) production in a dose-dependent manner. Based on these results, an antiacne herbal cream (AHC) was prepared from different portions of extracts from SO, IH, and SN, and its efficacy was evaluated in a double-blind, randomized, and controlled efficacy study with 41 acne patients, ages 18–24, who were asked to apply AHC (n = 27) or a placebo (n = 14) two to three times daily for six weeks. Results obtained indicate that the AHC has unique synergistic effects that halt sebum production, combined with highly antiseptic and anti-inflammatory activity, in which 54.95% (t = 19.37 P < 0.001) of acne inflammatory and noninflammatory lesions disappeared after two weeks, 85.3%, after five weeks (t = 14.19 P < 0.001), and 91.4%, at the end of the sixth week of application (t = 5.7 P < 0.001). In conclusion, SO, IH, and SN as single extracts and in combination as AHC showed significant antimicrobial, antisebum, and anti-inflammatory activities in vitro and in a double-blind, randomized, and controlled antiacne efficacy. Therefore, AHC represents an interesting alternative treatment for acne.
Highlights
Acne, known as acne vulgaris, is a chronic inflammatory disease, predominantly affecting teenagers and young adults.e currently used acne treatments target its pathogenetic mechanisms. ese include keratinocyte hyperproliferation, seborrhea, colonization of follicular ducts by Cutibacterium acnes (C. acnes), and local inflammation [1,2,3]
Separate extracts from Cappris spinose (CS), Solanum nigrum (SN), Ferula hermonis (FH), Eruca sativa (ES), Hypericum triquetrifolium (HT), Inula helenium (IH), Linum pubescens (LP), Urtica dioica (UD), roots of Saponaria officinalis (SO), and seeds of Nigella sativa (NS) were prepared by adding 100 g of airdried powder of each plant to one liter of 50% ethanol in distilled water and boiled for 10 minutes. e extracts were filtered through a filter paper and frozen at −70°C until use in the following experiments. e plants were collected from the Galilee region and Hermon Mountain during the periods of March and August. ey were authenticated by Prof
We evaluated the antiacne effects of nine medicinal plants from the western region of the Mediterranean where large portions of the population rely on them for treatment of various skin diseases [12]. e majority of the plants evaluated in this study are known to have antimicrobial activity against different microorganisms and anti-inflammatory effect [21]
Summary
Known as acne vulgaris, is a chronic inflammatory disease, predominantly affecting teenagers and young adults.e currently used acne treatments target its pathogenetic mechanisms. ese include keratinocyte hyperproliferation, seborrhea, colonization of follicular ducts by Cutibacterium acnes (C. acnes), and local inflammation [1,2,3]. For. Evidence-Based Complementary and Alternative Medicine example, C. acnes may be controlled by modulating specific aspects of the immune system [1, 3,4,5,6], and inhibition of 5αR-I or ∆5-3β-HSD by drugs can target sebaceous gland function [7]. Evidence-Based Complementary and Alternative Medicine example, C. acnes may be controlled by modulating specific aspects of the immune system [1, 3,4,5,6], and inhibition of 5αR-I or ∆5-3β-HSD by drugs can target sebaceous gland function [7] Such approaches, do not allow for the free use of physiological agents in the treatment of acne, as these approaches have multiple effects and other target organs [8].
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