Abstract
Topical traditional Chinese medicine- (TTCM-) related contact dermatitis is not uncommon but ignored. Patch and photopatch tests using 6 individual herbal ingredients and Bai-Zhi-Kao (BZK; 白 芷 膏), a skin-lightening TTCM preparation, were conducted on 30 participants. Twenty-five subjects showed at least 1 positive reaction, including 6 (20.0%) participants who reacted to BZK. The majority reacted to Radix Ampelopsis japonica (Bai-Lian; 白 蘞) (60.0%), whereas few reacted to Rhizoma Bletilla striata (Bai-Ji; 白 芨) (16.7%), Rhizoma Atractylodis macrocephalae (Bai-Zhu; 白 朮) (10.0%), Radix Angelicae dahuricae (Bai-Zhi; 白 芷) (3.3%), and Herba asari (Xi-Xin; 細 辛) (3.3%). In the photopatch test, 3 participants (10.0%) reacted positively to BZK and 10 to ≥1 constituent; however, all reacted to Radix Angelicae dahuricae (26.7%), Radix Ampelopsis japonica (13.3%), and Rhizoma Bletilla striata (3.3%). In contrast, no subjects showed positive reactions to Sclerotium Poria cocos (Bai-Fu-Ling; 白 茯 苓). Thus, BZK and its constituents might present potential latent risk of contact dermatitis owing to the possible presence of Radix Ampelopsis japonica and Radix Angelicae dahuricae. Furthermore, TTCMs, particularly cosmetic products, must be used carefully, with ample warning of potential contact dermatitis risk.
Highlights
During the last few decades, cosmetics derived from or partially composed of topical traditional Chinese medicines (TTCMs) have been widely used in skin care, despite the lack of parallel human clinical trials [1,2,3]
Research has revealed that allergic dermatitis and irritant contact dermatitis are the most common adverse events associated with TTCMs [4, 5]
Studies on TTCMs and other herbal medicine allergies are problematic because of the limited number of commercially available standardised patch test substances and the danger of active sensitisation when testing with botanical medicines, their constituent parts or individual extracts
Summary
During the last few decades, cosmetics derived from or partially composed of topical traditional Chinese medicines (TTCMs) have been widely used in skin care, despite the lack of parallel human clinical trials [1,2,3]. Many variants of traditional Chinese medical formulas contain complex combinations of individual ingredients from multiple herbal plant constituents (in both crude and galenic extracted forms), limiting the scope of clinical investigation [6]. Studies on TTCMs and other herbal medicine allergies are problematic because of the limited number of commercially available standardised patch test substances and the danger of active sensitisation when testing with botanical medicines, their constituent parts or individual extracts.
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