People are more often choosing herbal remedies to treat their chronic rosacea.
"Increasingly, our patients are using products both externally and internally that are not pharmacologic," says Jessica Wu, M.D., founder and president of Dr. Jessica Wu Cosmeceuticals. Dr.Wu The good news is that many sufferers of the chronic disease are finding relief from the anti-inflammatory properties in herbs. The not-so-good-news is that for some patients, certain herbs can worsen their condition.
In addition, patients don't always tell their physicians about the complimentary medications they are using so they can be monitored.
"So whether or not we specifically question our patients about the products they are using, they are using them because they are seeing nutritionists, herbalists and Chinese medicine practitioners who are prescribing topical and oral supplements that might positively or negatively affect their rosacea. It really behooves us as physicians to be familiar with some of the more common herbal ingredients because some of them may either help or hinder their rosacea," Dr. Wu tells Dermatology Times.
Experts estimate that the use of herbal products increased 380 percent between 1990 and 1997. With this kind of consumer interest, it's imperative that dermatologists be aware of what herbal remedies patients are using and then be able to advise them about the benefits as well as any downsides.
The most effective and frequently used herbal compounds for relief of rosacea are feverfew, green tea, licorice, lavender, oatmeal, chamomile, tea tree oil and camphor and most recently, MimyX (Stiefel).
Feverfew (Tanacetum parthenium)A recent study found that 45 days of treatment with 1 percent feverfew PFE (parthenolide-free extract) Aveeno Daily Moisturizer Ultracalming, improved mild inflammatory acne by halting the release of inflammatory markers from stimulated lymphocytes.
It also reduced neutrophil chemotaxis, thus making it a practical treatment for rosacea.
Green tea (Camellia sinensis)
The derivatives of green tea have amazing anticarcinogenic properties, as well as the potential to reduce inflammation and provide antioxidants.
All of these properties are especially beneficial for people with rosacea since intrinsic sun sensitivity is a staple of the disease. Green tea may also reduce reactions to ultraviolet light as well as the visual signs and symptoms of rosacea. An added plus is that green tea has been known to decrease skin barrier disruptions, a common side effect in persons suffering with the disease.
Licorice (glycyrrhizin)Two recent studies have shown good results in patients using glycyrrhizinic acid to improve dermatitis.
In one study, 2 percent glycyrrhizinic acid gel significantly decreased erythema, edema and itching. A second study found that licochalcone A provided a potent anti-inflammatory action on a variety of skin cells that are responsible for skin irritation.
OatmealColloidal oatmeal is known to reduce dry skin through its moisturizing qualities and it also serves as a protectant.
The proteins and polysaccharides attach to the skin to provide a protective shield, while proteins build a barrier against acids and bases.
Chamomile (Matricaria recutita and Chamaemelum nobile)
The active constituents of chamomile — terpenoids and flavonoids — have been confirmed in studies to have anti-inflammatory and soothing effects.
Camphor oil (Cinnamonum camphora)
Camphor oil has recently been evaluated for its effectiveness in treating demodicoses that often occur with rosacea.
Patients should be warned that camphor oil can irritate the skin.
Tea tree oil (Melaleuca alternifolia)
Tea tree oil has grown more popular as an antimicrobial agent because of its anti-inflammatory properties.
Use caution with tea tree oil however, due to its link to several side effects including allergic contact dermatitis, systemic contact dermatitis, erythema and systemic hypersensitivity reactions, which can worsen rosacea.
MimyX
It's a topical, non-steroidal prescription cream approved for topical dermatitis.
It is an olive oil-based product and its efficacy is based on repairing and restoring the skin's barrier function.
Synergy of herbs, prescriptions
"While the use of medicinal herbs is increasing, it's important to remember that several variables can impact the composition, concentration and bio-availability of the herbal composite," Dr. Wu says.
"Nonetheless, many people may still get good relief from herbal remedies. In addition, prescription medications can work nicely with herbal treatments to give the patient even better results and maintain them for the longest possible time."
Dermatologists need to ask their patients about their use of all medications including herbs, vitamins and supplements, according to Dr. Wu.
"I suggest taking an extra five or 10 minutes to find out what your patients are using on their skin in addition to what you're prescribing for them."
Dr. Wu says that more research in the future will help patients with rosacea. She is planning clinical studies on skincare products containing herbal and botanical ingredients, as well as research on the affects of acupuncture and peripheral blood flow as it relates to rosacea.
Disclosure: Dr. Wu is on the Medical Advisory Board for Johnson and Johnson Consumer products and is Founder and President of Dr. Jessica Wu Cosmeceuticals.
