Phytochemical and Botanical Therapies for Rosacea: A Systematic Review
Whitney A. Fisk
Department of Dermatology, University of California—Davis, Sacramento, CA, USA
These authors contributed equally in this manuscript.Search for more papers by this authorHadar A. Lev-Tov
Department of Dermatology, Albert Einstein College of Medicine, Bronx, NY, USA
These authors contributed equally in this manuscript.Search for more papers by this authorAshley K. Clark
School of Medicine, University of California—Davis, Sacramento, CA, USA
Search for more papers by this authorCorresponding Author
Raja K. Sivamani
Department of Dermatology, University of California—Davis, Sacramento, CA, USA
Correspondence to: Raja Sivamani, MD MS CAT, Department of Dermatology, University of California—Davis, 3301 C Street, Suite 1400, Sacramento, CA, USA.
E-mail: [email protected]
Search for more papers by this authorWhitney A. Fisk
Department of Dermatology, University of California—Davis, Sacramento, CA, USA
These authors contributed equally in this manuscript.Search for more papers by this authorHadar A. Lev-Tov
Department of Dermatology, Albert Einstein College of Medicine, Bronx, NY, USA
These authors contributed equally in this manuscript.Search for more papers by this authorAshley K. Clark
School of Medicine, University of California—Davis, Sacramento, CA, USA
Search for more papers by this authorCorresponding Author
Raja K. Sivamani
Department of Dermatology, University of California—Davis, Sacramento, CA, USA
Correspondence to: Raja Sivamani, MD MS CAT, Department of Dermatology, University of California—Davis, 3301 C Street, Suite 1400, Sacramento, CA, USA.
E-mail: [email protected]
Search for more papers by this authorAbstract
Botanical and cosmeceutical therapies are commonly used to treat symptoms of rosacea such as facial erythema, papules/pustule counts, and telangiectasia. These products may contain plant extracts, phytochemicals, and herbal formulations. The objective of this study was to review clinical studies evaluating the use of botanical agents for the treatment of rosacea. MEDLINE and Embase databases were searched for clinical studies evaluating botanical therapies for rosacea. Major results were summarized, and study methodology was analyzed. Several botanical therapies may be promising for rosacea symptoms, but few studies are methodologically rigorous. Several plant extract and phytochemicals effectively improved facial erythema and papule/pustule counts caused by rosacea. Many studies are not methodologically rigorous. Further research is critical, as many botanicals have been evaluated in only one study. Botanical agents may reduce facial erythema and effectively improve papule/pustule counts associated with rosacea. Although promising, further research in the area is imperative. Copyright © 2015 John Wiley & Sons, Ltd.
References
- Akamatsu H, Asada M, Komura J, Asada Y, Niwa Y. 1992. Effect of doxycycline on the generation of reactive oxygen species: a possible mechanism of action of acne therapy with doxycycline. Acta Derm Venereol 72(3): 178–179.
- Aroni K, Tsagroni E, Kavantzas N, Patsouris E, Ioannidis E. 2008. A study of the pathogenesis of rosacea: how angiogenesis and mast cells may participate in a complex multifactorial process. Arch Dermatol Res 300(3): 125–131.
- Arts IC, Hollman PC. 2005. Polyphenols and disease risk in epidemiologic studies. Am J Clin Nutr 81(1 Suppl): 317s–325s.
- Bae YI, Yun SJ, Lee JB, et al. 2009. Clinical evaluation of 168 Korean patients with rosacea: the sun exposure correlates with the erythematotelangiectatic subtype. Ann Dermatol 21(3): 243–249.
- Bakar O, Demircay Z, Yuksel M, Haklar G, Sanisoglu Y. 2007. The effect of azithromycin on reactive oxygen species in rosacea. Clin Exp Dermatol 32(2): 197–200.
- Bamford JT, Gessert CE, Renier CM. 2004. Measurement of the severity of rosacea. J Am Acad Dermatol 51(5): 697–703.
- Berardesca E, Cameli N, Cavallotti C, et al. 2008. Combined effects of silymarin and methylsulfonylmethane in the management of rosacea: clinical and instrumental evaluation. J Cosmet Dermatol 7(1): 8–14.
- Berman B, Zell D. 2005. Subantimicrobial dose doxycycline: a unique treatment for rosacea. Cutis 75(4 Suppl): 19–24.
- Berman B, Perez OA, Zell D. 2007. Update on rosacea and anti-inflammatory-dose doxycycline. Drugs Today (Barc) 43(1): 27–34.
- Böhm D, Schwanitz P, Stock Gissendanner S, Schmid-Ott G, Schulz W. 2014. Symptom severity and psychological sequelae in rosacea: results of a survey. Psychol Health Med 19(5): 586–586.
- Broniarczyk-Dyla G, Prusinska-Bratos M, Kmiec ML. 2011. Assessment of the influence of licochalcone on selected functional skin parameters in patients with impaired vasomotor disorders and rosacea. Postepy Dermatol Alergol 28(4): 241–254.
- Chiu P-C, Chan C-C, Lin H-M, Chiu H-C. 2007. The clinical anti-aging effects of topical kinetin and niacinamide in Asians: a randomized, double-blind, placebo-controlled, split-face comparative trial. J Cosmet Dermatol 6(4): 243–249.
- Chon SY, Doan HQ, Mays RM, et al. 2012. Antibiotic overuse and resistance in dermatology. Dermatol Ther 25(1): 55–69.
- Dahl MV, Katz HI, Krueger GG, et al. 1998. Topical metronidazole maintains remissions of rosacea. Arch Dermatol 134(6): 679–683.
- Del Rosso JQ. 2009. Anti-inflammatory dose doxycycline in the treatment of rosacea. J Drugs Dermatol 8(7): 664–668.
- Del Rosso JQ. 2012. Advances in understanding and managing rosacea: part 1: connecting the dots between pathophysiological mechanisms and common clinical features of rosacea with emphasis on vascular changes and facial erythema. J Clin Aesthet Dermatol 5(3): 16–25.
- Del Rosso JQ, Webster GF, Jackson M, et al. 2007. Two randomized phase III clinical trials evaluating anti-inflammatory dose doxycycline (40-mg doxycycline, USP capsules) administered once daily for treatment of rosacea. J Am Acad Dermatol 56(5): 791–802.
- Domingo DS, Camouse MM, Hsia AH, et al. 2010. Anti-angiogenic effects of epigallocatechin-3-gallate in human skin. Int J Clin Exp Pathol 3(7): 705–709.
- Draelos ZD, Ertel K, Berge C. 2005. Niacinamide-containing facial moisturizer improves skin barrier and benefits subjects with rosacea. Cutis 76(2): 135–141.
- Elmets CA, Singh D, Tubesing K, et al. 2001. Cutaneous photoprotection from ultraviolet injury by green tea polyphenols. J Am Acad Dermatol 44(3): 425–432.
- Emer J, Waldorf H, Berson D. 2011. Botanicals and anti-inflammatories: natural ingredients for rosacea. Semin Cutan Med Surg 30(3): 148–155.
- Erdogan F, Yurtsever P, Aksoy D, Eskioglu F. 1998. Efficacy of low-dose isotretinoin in patients with treatment-resistant rosacea. Arch Dermatol 134(7): 884–885.
- Fallen RS, Gooderham M. 2012. Rosacea: update on management and emerging therapies. Skin Therapy Lett 17(10): 1–4.
- Farage MA, Katsarou A, Maibach HI. 2006. Sensory, clinical and physiological factors in sensitive skin: a review. Contact Dermatitis 55(1): 1–14.
- Ferrari A, Diehl C. 2012. Evaluation of the efficacy and tolerance of a topical gel with 4% quassia extract in the treatment of rosacea. J Clin Pharmacol 52(1): 84–88.
- Fowler J Jr, Jackson M, Moore A, et al. 2013. Efficacy and safety of once-daily topical brimonidine tartrate gel 0.5% for the treatment of moderate to severe facial erythema of rosacea: results of two randomized, double-blind, and vehicle-controlled pivotal studies. J Drugs Dermatol 12(6): 650–656.
- Georgala S, Katoulis AC, Kylafis GD, et al. 2001. Increased density of Demodex folliculorum and evidence of delayed hypersensitivity reaction in subjects with papulopustular rosacea. J Eur Acad Dermatol Venereol 15(5): 441–444.
- Gomaa AH, Yaar M, Eyada MM, Bhawan J. 2007. Lymphangiogenesis and angiogenesis in non-phymatous rosacea. J Cutan Pathol 34(10): 748–753.
- Grazyna BD, Magdalena PB, Kmiec ML. 2012. The evaluation of action of flavonoid creams in regression of erythema and improvement of the skin barrier in patients with rosacea. Przegl Dermatol 99(4): 357–358.
- Hsiao G, Shen MY, Lin KH, et al. 2003. Inhibitory activity of kinetin on free radical formation of activated platelets in vitro and on thrombus formation in vivo. Eur J Pharmacol 465(3): 281–287.
- Jones D. 2004. Reactive oxygen species and rosacea. Cutis 74(3 Suppl): 17–20, 32–14.
- Katiyar SK. 2003. Skin photoprotection by green tea: antioxidant and immunomodulatory effects. Curr Drug Targets Immune Endocr Metabol Disord 3(3): 234–242.
- Katiyar SK, Elmets CA. 2001. Green tea polyphenolic antioxidants and skin photoprotection (Review). Int J Oncol 18(6): 1307–1313.
- Katiyar SK, Korman NJ, Mukhtar H, Agarwal R. 1997. Protective effects of silymarin against photocarcinogenesis in a mouse skin model. J Natl Cancer Inst 89(8): 556–566.
- Katiyar SK, Perez A, Mukhtar H. 2000. Green tea polyphenol treatment to human skin prevents formation of ultraviolet light B-induced pyrimidine dimers in DNA. Clin Cancer Res 6(10): 3864–3869.
- Katiyar S, Elmets CA, Katiyar SK. 2007. Green tea and skin cancer: photoimmunology, angiogenesis and DNA repair. J Nutr Biochem 18(5): 287–296.
- Korting HC, Schollmann C. 2009. Current topical and systemic approaches to treatment of rosacea. J Eur Acad Dermatol Venereol 23(8): 876–882.
- Layton A, Thiboutot D. 2013. Emerging therapies in rosacea. J Am Acad Dermatol 69(6 Suppl 1): S57–S65.
- Lowe NJ. 2003. Use of topical metronidazole in moderate to severe rosacea. Adv Ther 20(4): 177–190.
- McAleer MA, Powell FC. 2008. Complementary and alternative medicine usage in rosacea. Br J Dermatol 158(5): 1139–1141.
- Murphy G. 2004. Ultraviolet light and rosacea. Cutis 74(3 Suppl): 13–16, 32–14.
- Neumann E, Frithz A. 1998. Capillaropathy and capillaroneogenesis in the pathogenesis of rosacea. Int J Dermatol 37(4): 263–266.
- Ni Raghallaigh S, Bender K, Lacey N, Brennan L, Powell FC. 2012. The fatty acid profile of the skin surface lipid layer in papulopustular rosacea. Br J Dermatol 166(2): 279–287.
- Nield GL, Ippersiel R. 2002. Open evaluation of silymarin cream in the management of facial redness associated with rosacea. Cosmet Dermatol 15(8): 15–17.
- Niren NM, Torok HM. 2006. The Nicomide Improvement in Clinical Outcomes Study (NICOS): results of an 8-week trial. Cutis 77(1 Suppl): 17–28.
- Pelle MT, Crawford GH, James WD. 2004. Rosacea: II. Therapy. J Am Acad Dermatol 51(4): 499–512; quiz 513–494.
- Raab S, Oresajo C, Yatskayer M, Draelos Z. 2012. Clinical evaluation of the effectiveness and tolerance of a facial lotion on subjects with rosacea. J Am Acad Dermatol 66(4): AB45.
- Reinholz M, Ruzicka T, Schauber J. 2012. Cathelicidin LL-37: an antimicrobial peptide with a role in inflammatory skin disease. Ann Dermatol 24(2): 126–135.
- Rigopoulos D, Kalogeromitros D, Gregoriou S, et al. 2005. Randomized placebo-controlled trial of a flavonoid-rich plant extract-based cream in the treatment of rosacea. J Eur Acad Dermatol Venereol 19(5): 564–568.
- Shalita AR, Smith JG, Parish LC, Sofman MS, Chalker DK. 1995. Topical nicotinamide compared with clindamycin gel in the treatment of inflammatory acne vulgaris. Int J Dermatol 34(6): 434–437.
- Sharma VK, Sethuraman G. 2007. Parthenium dermatitis. Dermatitis 18(4): 183–190.
- Stahl W, Sies H. 2007. Carotenoids and flavonoids contribute to nutritional protection against skin damage from sunlight. Mol Biotechnol 37(1): 26–30.
- Steinhoff M, Schauber J, Leyden JJ. 2013. New insights into rosacea pathophysiology: a review of recent findings. J Am Acad Dermatol 69(6 Suppl 1): S15–S26.
- Surjana D, Damian DL. 2011. Nicotinamide in dermatology and photoprotection. Skinmed 9(6): 360–365.
- Tan J, Berg M. 2013. Rosacea: current state of epidemiology. J Am Acad Dermatol 69(6 Suppl 1): S27–S35.
- Weber TM, Ceilley RI, Buerger A, et al. 2006. Skin tolerance, efficacy, and quality of life of patients with red facial skin using a skin care regimen containing Licochalcone A. J Cosmet Dermatol 5(3): 227–232.
- Wilkin J, Dahl M, Detmar M, et al. 2002. Standard classification of rosacea: report of the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea. J Am Acad Dermatol 46(4): 584–587.
- Wilkin J, Dahl M, Detmar M, et al. 2004. Standard grading system for rosacea: report of the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea. J Am Acad Dermatol 50(6): 907–912.
- Wu JJ, Weinstein GD, Kricorian GJ, Kormeili T, McCullough JL. 2007. Topical kinetin 0.1% lotion for improving the signs and symptoms of rosacea. Clin Exp Dermatol 32(6): 693–695.
- Yu TG, Zheng YZ, Zhu JT, Guo W. 2006. Effect of treatment of rosacea in females by Chibixiao recipe in combination with minocycline and spironolactone. Chin J Integr Med 12(4): 277–280.