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Are Topical Herbal Medicines for Atopic Eczema Effective?

In addition to the many effective medications for atopic eczema, many patients also choose to try complementary or alternative medicines (CAMs) to manage atopic eczema (AE). A previous systematic review of oral CAM found that there was currently no evidence of efficacy for AE, and a Cochrane protocol was registered with the aim to review all randomized controlled trials (RCTs) of several forms of CAMs (including phytotherapy) and complementary techniques. This systematic review sought to evaluate the current evidence for the efficacy and safety of topical herbal preparations in AE. The study focused on controlled trials of topical herbal preparations (whether randomized or not), with an overall aim to provide clarity to prescribers and patients, and identify opportunities for future research.

Using search terms such as ‘atopic eczema/atopic dermatitis’ together with ‘topical herbal’, ‘topical application’, ‘topical administration’, authors identified eight publications that met the inclusion and exclusion criteria. The studies span research from the last 25 years, but despite this lengthy period, objective evidence regarding the use of topical plant extracts still remains unclear. Six of the eight studies displayed superiority of treatment over placebo, but only two were considered to have a low risk of bias across all domains. The eight included studies were mostly pilot studies and had methodological flaws, or were single trials.

Two preparations – Hypericum perforatum extracts and licorice gel 2% – showed promise, but due to the methodological concerns, there is insufficient evidence of efficacy. One other study of evening primrose oil also had positive outcomes, but a failure to control for patients use of other topical medications led to a high risk of bias. However, based on the review, the authors state that further trials with larger patient cohorts and longer follow-up to assess efficacy and record adverse effects may be warranted for Hypericum perforatum extracts, 2% licorice gel and evening primrose oil.


Byline: Martha L. Sikes, MS, RPh, PA-C

Posted: April 10, 2017

Source: Wiley Online Library
Adapted from the original article.

[Image: Shutterstock]

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