Sandalwood Oil for the Chemoprevention of Skin Cancer: Mechanistic Insights, Anti-inflammatory, and In Vivo Anticancer Potential

Abstract

There is an increasing incidence of skin cancer across the world. The World Health Organization reports that the global incidence of melanoma will continue to rise with increasing depletion of the ozone layer and consequent UV irradiation. The natural product sandalwood oil from genus Santalum (Family Santalaceae) and its constituent alpha-santalol have been reported to exert chemopreventive effects against skin cancers as well as prostate, head and neck, and breast cancers. The anticancer effects are mediated via modulation of MAPK, AP-1, beta-catenin and PI3K/Akt pathways, upregulation of p21, and activation of caspases/PARP. Furthermore, sandalwood oil exerts anti-inflammatory activities via prostaglandin E2, IL-1beta, inhibition of NF-kappaB, and 5-lipoxygenase. Other therapeutic activities in eczema, psoriasis, radiation dermatitis, antifungal, etc. have also been reported. Sandalwood oil has acceptable safety and is well-tolerated. Taken together, given the chemopreventive potential of sandalwood oil, future clinical trials are warranted to investigate its use as an adjunct to chemotherapy or immunotherapy for skin cancers.