Bot Med Term 2: Dermatitis - Skin Rash PDF

BOT MED TERM 2 DERMATITIS – SKIN RASH WRITTEN BY DR. FIONA SMULDERS ND LEARNING OUTCOMES 1. Describe the botanical treatment strategy for the topical treatment of skin inflammation and irritation. 2. Identify herbal actions that would be most beneficial for dermatitis. 3. List herbs...

BOT MED TERM 2 DERMATITIS – SKIN RASH WRITTEN BY DR. FIONA SMULDERS ND LEARNING OUTCOMES 1. Describe the botanical treatment strategy for the topical treatment of skin inflammation and irritation. 2. Identify herbal actions that would be most beneficial for dermatitis. 3. List herbs that would be indicated in dermatitis. 4. Recognize safety concerns regarding the use of the herbs discussed in today’s lecture. 5. Formulate a topical herbal remedy to alleviate skin inflammation and irritation. DERMATITIS General term that describes a common skin irritation Can be caused by virus, bacteria, fungus, irritant, or allergen etiologies Most common types of dermatitis: Atopic dermatitis Contact dermatitis Seborrheic dermatitis Cradle cap Diaper rash GENERAL SIGNS & SYMPTOMS Pruritus Dry skin Erythema Bumps or raised patches BOTANICAL TREATMENT STRATEGIES 1. Identify and treat the cause 2. Prevent/treat infection 3. Soothe irritation 4. Reduce pruritus 5. Prevent spreading and/or recurrence HERBAL ACTIONS (TOPICAL) Emollients Anti-pruritics Vulneraries Lymphatics Antimicrobials / Astringents Antiseptics Connective tissue tonics Anti-inflammatories MATERIA MEDICA DERMATITIS - RASH MATERIA MEDICA – TOPICAL CONSIDERATIONS FOR SKIN RASH Aloe barbadensis Hamamelis virginiana Arnica montana* Matricaria recutita Avena sativa Plantago spp Calendula officinalis Stellaria media Centella asiatica Symphytum officinale Glycyrrhiza glabra Urtica dioica CALENDULA OFFICINALIS (MARIGOLD / CALENDULA) Image retrieved from https://zettlhomeopathy.ca CALENDULA OFFICINALIS Common name: Calendula / Marigold Family: Asteraceae Part used: Flowerheads & petals Main Actions: Antimicrobial, lymphatic, antiseptic, anti-inflammatory, vulnerary, demulcent/emollient Main Constituents: Flavonoids (isohamnetin & quercetin) & carotenoids (xanthophylls) Saponins, polysaccharides, VO, mucilage & resins CALENDULA OFFICINALIS Pharmacology: One of the best remedies for local skin problems: rash, eczema, psoriasis, abrasions, etc Stimulates drainage of enlarged and inflamed lymph nodes Polysaccharides and volatile oils have immuno- stimulatory activity Vulnerary activity are due to xanthophylls, mucilage and volatile oils, which stimulate granulation tissue Resins display antifungal activity CALENDULA OFFICINALIS Pharmacy Infusion & tincture for internal use Topical: creams, ointments, poultices, suppositories & fresh plant succus applied BID or PRN Safety Generally a safe herb, great in first aid kits for various skin-healing needs. Caution: Asteraceae family allergy CENTELLA ASIATICA (GOTU KOLA) CENTELLA ASIATICA Common name: Gotu kola Family: Apiaceae Part used: Aerial Main Actions: Anti-inflammatory, CT builder, vulnerary, adaptogen, nervine tonic Main Constituents: Saponins (asiaticoside, madecassoside, brahmoside) Flavonoids (quercetin & kaempferol) Allantoin, VO, alkaloids, phytosterols CENTELLA ASIATICA Pharmacology: Speeds up skin collagen formation and angiogenesis Increases antioxidant levels within the wound in early staged of tissue repair Anti-inflammatory action due to Inhibition of iNOS and COX-2, NF-κB activity, and the release of TNF-α, IL-1β, IL-6, and IgE Anti-allergy activity due to decreased mast cell infiltration and reduced the expression of various proinflammatory cytokines such as TNF-α, IL-4, IL-5, IL-6, IL-10, and IL-17 Asiaticosides increase vascularization of connective tissue and the formation of structural glycosaminoglycans (chondroitin sulfate, hyaluronic acid) Kyoung Sik Park, "Pharmacological Effects of Centella asiatica on Skin Diseases: Evidence and Possible Mechanisms", Evidence-Based Complementary and Alternative Medicine, vol. 2021, Article ID 5462633, 8 pages, 2021. https://doi.org/10.1155/2021/5462633 CENTELLA ASIATICA Pharmacy Infusion, tincture and standardized extracts for internal use Topical: creams, ointments and poultices applied BID or PRN Safety Toxicity associated with internal use: GIT upset, contact dermatitis, sedation, headaches Carcinogenic concerns with long-term topical use due to angiogenesis activity PLANTAGO LANCEOLATA & MAJOR (PLANTAIN / TOADSTOOL / RIBWORT) PLANTAGO LANCEOLATA & MAJOR Common name: Plantain, Toadstool, Ribwort Family: Plantaginaceae Parts used: Leaves Main Constituents: Mucilage, tannins, flavonoids (baicalein, hispidulin, scutallarein and plantaginin ), resins, alkaloids Allantoin, iridoid glycosides, saponins, minerals: Zn, K+, Mg, P Main Actions: Anti-microbial, lymphatic, anti-inflammatory, astringent, anti- hemorrhagic, emollient, vulnerary, connective tissue tonic, anti-pruritic PLANTAGO SPP Pharmacology: Leaves have been used as a wound healing remedy for centuries The mucilage from the leaves are emollient, vulnerary and anti- inflammatory Allantoin promotes cell proliferation and induces transition of fibroblasts into myofibroblasts to increase tensile strength of CT Phenolic acids and flavonoids inhibit COX and LOX Baicalein, hispidulin, scutallarein and plantaginin are free radical scavengers and inhibit lipid peroxidation Tannins display bacteriostatic and bacteriocidal effects Samuelsen, A. “The traditional uses, chemical constituents and biological activities of Plantago major L. A review”. J Ethnopharmacol. 2000 Jul; 71(1): 1–21/PMC7142308 PLANTAGO SPP Pharmacy: The macerated leaves or fresh juice of the plant are excellent, quick healing agents for cuts, wounds, and bruises Applied topically as a salve, lotion, compress or poultice BID or PRN Safety: Generally a safe herb High doses internally can have laxative effect MATRICARIA RECUTITA (GERMAN CHAMOMILE) MATRICARIA RECUTITA Common name: German Chamomile Family: Asteraceae Part used: Flower heads Main Actions: Anti-inflammatory, vulnerary, nervine sedative, emollient, antimicrobial Main Constituents: Volatile oils (bisabolol, azulene, chamazulene & matricin) Flavonoids (apigenin, luteolin, quercetin) Sesquiterpene lactones, salicylic acid, mucilage MATRICARIA RECUTITA Pharmacology: Flavonoids have anti-allergenic effects d/t inhibition of histamine release Volatile oils (alpha-bisabolol, chamazulene) and flavonoids demonstrate anti-inflammatory, wound-healing and antimicrobial activity Alpha-bisabolol has demonstrated promotion of granulation tissue in woulnd healing Anti-inflammatory activity is due in part to the inhibition of COX & LOX Topical chamomile is comparable with 0.25% hydrocortisone for dermatological conditions (Brown and Dattner 1998) Brown D.J., Dattner A.M. Phytotherapeutic approaches to common dermatological conditions. Arch Dermatol. 1998;1:15-7. MATRICARIA RECUTITA Pharmacy Infusion & tincture for internal use Topical: creams, ointments, baths, steams and poultices applied BID or PRN Safety Generally a safe herb, may cause contact dermatitis in cases of allergy or sensitivity Caution in Asteraceae allergy TOPICAL HERBAL PHARMACY FOR SKIN RASH Ointments (salves) – semi-solid base of oil and beeswax, fats soften at skin temperature making material available to the skin. Creates a protective barrier for the skin. See herbal salve recipe handout and video demo at end of lecture today Creams/lotions – suspensions of oil in water blended together. Often absorbed faster and more moistening for the skin. Example: 2/3 cup rosewater, 1/3 cup aloe vera gel, ¾ calendula oil, 1/3 cocoa butter, 1 tsp lanolin, 2 tbsp. liquid lecithin, ½ ounce beeswax, 6 drops tea tree EO, 6 drops lavender EO, Vitamin A/E HERBAL PHARMACY FOR SKIN RASH Poultices – solid herb in some form (mashed/blended/cut), placed directly on skin, held in place with cloth Example: blending or mashing fresh Plantago major and apply to affected area (may add a little water for consistency) Pastes – mixture of powder in a liquid base, keep herbs on the surface for a longer period of time, but contents are not well absorbed Example: 1 tsp Althea officinalis powder with Centella asiatica tincture. Mix until desired consistency Also: compress, bath, steam INTERNAL CONSIDERATIONS FOR DERMATITIS Herbal actions to consider for Herbal options with dermatological internal use: benefit Alteratives Arctium lappa Hepatics Galium aparine Lymphatics Glycyrrhiza glabra Anti-microbials Iris versicolor Adaptogens & nervine tonics / Rumex crispus relaxants Trifolium pratense Anti-inflammatories Urtica dioica To be discussed in greater detail in future lectures… SUMMARY Herbs can be used both topically and internally to treat skin conditions Herbs can be used topically to reduce inflammation, fight infection, speed skin healing and relieve itching and irritation There are a variety of ways herbs can be used topically. Choosing which preparation to use will depend on patient preference/compliance, herbs chosen, and consideration of level of absorption/moisturization required THANK YOU. A N D H AV E A LO V E LY D AY