twitter

Saturday, 9 December 2017

Botanical Complementary and Alternative Medicine for Pruritus: a Systematic Review

Current Dermatology Reports December 2017, Volume 6, Issue 4, pp 248–255 | Cite as Authors Authors and affiliations Jonathan G. BonchakEmail authorShalini TharejaSuephy C. ChenCassandra L. Quave 1. 2. 3. Itch (E Lerner, Section Editor) First Online: 19 October 2017 2 Shares 10 Downloads Part of the following topical collections: Topical Collection on Itch Abstract Purpose of Review Complementary and alternative medicine (CAM) is widely used by patients who suffer from chronic pruritus, but there is little data on the efficacy or antipruritic mechanism of these interventions. This review assesses the current understanding of the clinical efficacy and purported mechanisms of CAM therapy for pruritic skin disease, and serves as a basis for further investigation into the pharmacological basis of plant-based CAM for pruritus and patient motivations in the adoption of these types of therapies. Recent Findings To assess the current state of the literature, we queried multiple databases for reports of botanical CAM therapies for pruritic skin conditions. Numerous in vitro and animal studies show positive results, but antipruritic effects in human trials are varied. Many of these topical and systemic therapies have demonstrated measurable impact on inflammatory pathways, including some that are known to be crucial in transmission of itch signaling. Summary CAM is a frequently utilized but somewhat poorly understood intervention for chronic pruritus, though our understanding of the impact of these therapies on pruritus has improved in recent years. Further studies into the mechanism and efficacy of CAM-based therapies for chronic pruritus, and patient attitudes towards these practices, are warranted. Keywords Pruritus Itch CAM Complementary Alternative Botanical Permissions Tables contained herein are original and not previously published elsewhere. This article is part of the Topical Collection on Itch Notes Compliance with Ethical Standards Conflict of Interest The authors declare that they have no conflict of interest. Human and Animal Rights and Informed Consent This article does not contain any studies with human or animal subjects performed by any of the authors. References Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance 1. Sirois FM. Motivations for consulting complementary and alternative medicine practitioners: a comparison of consumers from 1997–8 and 2005. BMC Complement Altern Med. 2008;8:16. CrossRefPubMedPubMedCentralGoogle Scholar 2. Testerman J, Patient K. Motivations for using complementary and alternative medicine. Complement Health Pract Rev. 2004;9:81–92. CrossRefGoogle Scholar 3. Caspi O, Koithan M, Criddle MW. Alternative medicine or ‘alternative’ patients: a qualitative study of patient-oriented decision-making processes with respect to complementary and alternative medicine. Med Decis Mak. 2004;24:64–79. CrossRefGoogle Scholar 4. •• Clarke TC, Black LI, Stussman BJ, Barnes PM, Nahin RL. Trends in the use of complementary health approaches among adults: United States, 2002-2012. Natl Health Stat Rep. 2015;79:1–16. This report assesses the current state of CAM therapies in the USA. It highlights key sociodemographic data associated with CAM usage. Google Scholar 5. Black LI, Clarke TC, Barnes PM, Stussman BJ, Nahin RL. Use of complementary health approaches among children aged 4-17 years in the United States: National Health Interview Survey, 2007-2012. Natl Health Stat Rep. 2015;78:1–19. Google Scholar 6. Nahin RL, Barnes PM, Stussman BJ. Expenditures on Complementary Health Approaches: United States, 2012. Natl Health Stat Rep. 2016;95:1–11. Google Scholar 7. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Rep. 2008;12:1–23. Google Scholar 8. Fuhrmann T, Smith N, Tausk F. Use of complementary and alternative medicine among adults with skin disease: updated results from a national survey. J Am Acad Dermatol. 2010;63:1000–5. CrossRefPubMedGoogle Scholar 9. • Kalaaji AN, et al. Use of complementary and alternative medicine by patients seen at the dermatology department of a tertiary care center. Complement Ther Clin Pract. 2012;18:49–53. This is one of the few detailed reports evaluating patterns of CAM usage specifically for dermatologic conditions. CrossRefPubMedGoogle Scholar 10. Oldendick R, et al. Population-based survey of complementary and alternative medicine usage, patient satisfaction, and physician involvement. South Carolina Complementary Medicine Program Baseline Research Team. South Med J. 2000;93:375–81. CrossRefPubMedGoogle Scholar 11. Matterne U, Apfelbacher C, Vogelgsang L, Loerbroks A, Weisshaar E. Incidence and determinants of chronic pruritus: a population-based cohort study. Acta Derm Venereol. 2013;93:532–7. CrossRefPubMedGoogle Scholar 12. Rea JN, Newhouse ML, Halil T. Skin disease in Lambeth. A community study of prevalence and use of medical care. J Epidemiol Community Health. 1976;30:107–14. CrossRefGoogle Scholar 13. Dalgard F, Lien L, Dalen I. Itch in the community: associations with psychosocial factors among adults. J Eur Acad Dermatol Venereol. 2007;21(9):1215–1219. https://doi.org/10.1111/j.1468-3083.2007.02234.x. 14. Matterne U, Strassner T, Apfelbacher C, Diepgen T, Weisshaar E. Measuring the prevalence of chronic itch in the general population: development and validation of a questionnaire for use in large-scale studies. Acta Derm Venereol. 2009;89:250–6. CrossRefPubMedGoogle Scholar 15. Matterne U, et al. Prevalence, correlates and characteristics of chronic pruritus: a population-based cross-sectional study. Acta Derm Venereol. 2011;91:674–9. CrossRefPubMedGoogle Scholar 16. Shive M, Linos E, Berger T, Wehner M, Chren M-M. Itch as a patient-reported symptom in ambulatory care visits in the United States. J Am Acad Dermatol. 2013;69:550–6. CrossRefPubMedPubMedCentralGoogle Scholar 17. Carr CW, Veledar E, Chen SC. Factors mediating the impact of chronic pruritus on quality of life. JAMA Dermatol. 2014;150:613–20. CrossRefPubMedGoogle Scholar 18. Yosipovitch G, et al. A questionnaire for the assessment of pruritus: validation in uremic patients. Acta Derm Venereol. 2001;81:108–11. CrossRefPubMedGoogle Scholar 19. Kini SP, DeLong LK, Veledar E, McKenzie-Brown AM, Schaufele M, Chen SC. The impact of pruritus on quality of life: the skin equivalent of pain. Arch Dermatol. 2011;147(10):1153–1156. https://doi.org/10.1001/archdermatol.2011.178 20. Halvorsen J, Dalgard F, Thoresen M, Bjertness E, Lien L. Itch and pain in adolescents are associated with suicidal ideation: a population-based cross-sectional study. Acta Derm Venereol. 2012;92:543–6. CrossRefPubMedGoogle Scholar 21. Chase MW. An update of the Angiosperm Phylogeny Group classification for the orders and families of flowering plants: APG IV. Bot J Linn Soc. 2016;181:1–20. CrossRefGoogle Scholar 22. MycoBank. Available at: www.mycobank.org. 23. Boudreau MD, Beland FA. An evaluation of the biological and toxicological properties of Aloe barbadensis (Miller), Aloe vera. J Environ Sci Health Part C. 2006;24:103–54. CrossRefGoogle Scholar 24. Corazza M, Borghi A, Lauriola MM, Virgili A. Use of topical herbal remedies and cosmetics: a questionnaire-based investigation in dermatology out-patients. J Eur Acad Dermatol Venereol. 2009;23:1298–303. CrossRefPubMedGoogle Scholar 25. Shin E, et al. Dietary aloe improves insulin sensitivity via the suppression of obesity-induced inflammation in obese mice. Immune Netw. 2011;11:59. CrossRefPubMedPubMedCentralGoogle Scholar 26. Yagi A, et al. Antioxidant, free radical scavenging and anti-inflammatory effects of aloesin derivatives in Aloe vera. Planta Med. 2002;68:957–60. CrossRefPubMedGoogle Scholar 27. Finberg MJ, Muntingh GL, van Rensburg CEJ. A comparison of the leaf gel extracts of Aloe ferox and Aloe vera in the topical treatment of atopic dermatitis in Balb/c mice. Inflammopharmacology. 2015;23:337–41. CrossRefPubMedGoogle Scholar 28. Choonhakarn C, Busaracome P, Sripanidkulchai B, Sarakarn P. A prospective, randomized clinical trial comparing topical aloe vera with 0.1% triamcinolone acetonide in mild to moderate plaque psoriasis. J Eur Acad Dermatol Venereol. 2010;24:168–72. CrossRefPubMedGoogle Scholar 29. Paulsen E, Korsholm L, Brandrup F. A double-blind, placebo-controlled study of a commercial Aloe vera gel in the treatment of slight to moderate psoriasis vulgaris. J Eur Acad Dermatol Venereol. 2005;19:326–31. CrossRefPubMedGoogle Scholar 30. Kim S, et al. Inhibitory effects of (-)-α-bisabolol on LPS-induced inflammatory response in RAW264.7 macrophages. Food Chem Toxicol. 2011;49:2580–5. CrossRefPubMedGoogle Scholar 31. Maurya AK, et al. α-(-)-bisabolol reduces pro-inflammatory cytokine production and ameliorates skin inflammation. Curr Pharm Biotechnol. 2014;15:173–81. CrossRefPubMedGoogle Scholar 32. Chandrashekhar VM, et al. Anti-allergic activity of German chamomile (Matricaria recutita L.) in mast cell mediated allergy model. J Ethnopharmacol. 2011;137:336–40. CrossRefPubMedGoogle Scholar 33. Kobayashi Y, Nakano Y, Inayama K, Sakai A, Kamiya T. Dietary intake of the flower extracts of German chamomile (Matricaria recutita L.) inhibited compound 48/80-induced itch-scratch responses in mice. Phytomedicine. 2003;10:657–64. CrossRefPubMedGoogle Scholar 34. Kobayashi Y, Takahashi R, Ogino F. Antipruritic effect of the single oral administration of German chamomile flower extract and its combined effect with antiallergic agents in ddY mice. J Ethnopharmacol. 2005;101:308–12. CrossRefPubMedGoogle Scholar 35. Lee S-H, Heo Y, Kim Y-C. Effect of German chamomile oil application on alleviating atopic dermatitis-like immune alterations in mice. J Vet Sci. 2010;11:35–41. CrossRefPubMedPubMedCentralGoogle Scholar 36. •• Mounessa JS, Siegel JA, Dunnick CA, Dellavalle RP. The role of cannabinoids in dermatology. J Am Acad Dermatol. 2017;77:188–90. This report summarizes the impact of cannabinoids on various cuatneous physiological processes, and discusses how cannabinoid-based therapies may be leveraged to treat skin disease. CrossRefPubMedGoogle Scholar 37. van der Stelt M, et al. Anandamide acts as an intracellular messenger amplifying Ca2+ influx via TRPV1 channels. EMBO J. 2005;24:3026–37. CrossRefPubMedPubMedCentralGoogle Scholar 38. Haruna T, et al. S-777469, a novel cannabinoid type 2 receptor agonist, suppresses itch-associated scratching behavior in rodents through inhibition of itch signal transmission. Pharmacology. 2015;95:95–103. CrossRefPubMedGoogle Scholar 39. Tosun NC, Gunduz O, Ulugol A. Attenuation of serotonin-induced itch responses by inhibition of endocannabinoid degradative enzymes, fatty acid amide hydrolase and monoacylglycerol lipase. J Neural Transm. 2014;3:363–7. https://doi.org/10.1007/s00702-014-1251-x. Google Scholar 40. Gaffal E, et al. Cannabinoid 1 receptors in keratinocytes modulate proinflammatory chemokine secretion and attenuate contact allergic inflammation. J Immunol. 2013;190:4929–36. CrossRefPubMedGoogle Scholar 41. Kusakabe KI, et al. Selective CB2 agonists with anti-pruritic activity: discovery of potent and orally available bicyclic 2-pyridones. Bioorg Med Chem. 2013;21:3154–63. CrossRefPubMedGoogle Scholar 42. Facci L, et al. Mast cells express a peripheral cannabinoid receptor with differential sensitivity to anandamide and palmitoylethanolamide. Proc Natl Acad Sci U S A. 1995;92:3376–80. CrossRefPubMedPubMedCentralGoogle Scholar 43. Karsak M, et al. Attenuation of allergic contact dermatitis through the endocannabinoid system. Science. 2007;316:1494–7. CrossRefPubMedGoogle Scholar 44. Szepietowski JC, Reich A, Szepietowski T. Emollients with endocannabinoids in the treatment of uremic pruritus: discussion of the therapeutic options. Ther Apher Dial. 2005;9:277–9. CrossRefPubMedGoogle Scholar 45. Ständer S, Reinhardt HW, Luger TA. Topical cannabinoid agonists. An effective new possibility for treating chronic pruritus. Der Hautarzt; Zeitschrift für Dermatologie, Venerol und verwandte Gebiete. 2006;57:801–7. CrossRefGoogle Scholar 46. Neff GW, et al. Preliminary observation with dronabinol in patients with intractable pruritus secondary to cholestatic liver disease. Am J Gastroenterol. 2002;97:2117–9. CrossRefPubMedGoogle Scholar 47. Patel T, Ishiuji Y, Yosipovitch G. Menthol: a refreshing look at this ancient compound. J Am Acad Dermatol. 2007;57:873–8. CrossRefPubMedGoogle Scholar 48. Than JY-XL, Li L, Hasan R, Zhang X. Excitation and modulation of TRPA1, TRPV1, and TRPM8 channel-expressing sensory neurons by the pruritogen chloroquine. J Biol Chem. 2013;288:12818–27. CrossRefPubMedPubMedCentralGoogle Scholar 49. Misery L, Stander S. Menthol. In: Misery L, Stander S, eds. Pruritus. 1st ed. London: Springer; 2010:262–264. Google Scholar 50. Frölich M, Enk A, Diepgen TL, Weisshaar E. Successful treatment of therapy-resistant pruritus in lichen amyloidosis with menthol. Acta Derm Venereol. 2009;89:524–6. CrossRefPubMedGoogle Scholar 51. Marsakova L, Touska F, Krusek J, Vlachova V. Pore helix domain is critical to camphor sensitivity of transient receptor potential vanilloid 1 channel. Anesthesiology. 2012;116:903–17. CrossRefPubMedGoogle Scholar 52. Xu H. Camphor activates and strongly desensitizes the transient receptor potential vanilloid subtype 1 channel in a vanilloid-independent mechanism. J Neurosci. 2005;25:8924–37. CrossRefPubMedGoogle Scholar 53. Danial C, et al. Evaluation of treatments for pruritus in epidermolysis bullosa. Pediatr Dermatol. 2015;32:628–34. CrossRefPubMedGoogle Scholar 54. Haught JM, Jukic DM, English JC. Hydroxyethyl starch-induced pruritus relieved by a combination of menthol and camphor. J Am Acad Dermatol. 2008;59:151–3. CrossRefPubMedGoogle Scholar 55. Sur R, Nigam A, Grote D, Liebel F, Southall MD. Avenanthramides, polyphenols from oats, exhibit anti-inflammatory and anti-itch activity. Arch Dermatol Res. 2008;300:569–74. CrossRefPubMedGoogle Scholar 56. Matheson JD, Clayton J, Muller MJ. The reduction of itch during burn wound healing. J Burn Care Rehabil. 2001;22:76–81. discussion 75 CrossRefPubMedGoogle Scholar 57. Talsania N, Loffeld A, Orpin SD. Colloidal oatmeal lotion is an effective treatment for pruritus caused by erlotinib. Clin Exp Dermatol. 2008;33:108. PubMedGoogle Scholar 58. Alexandrescu DT, Vaillant JG, Dasanu CA. Effect of treatment with a colloidal oatmeal lotion on the acneform eruption induced by epidermal growth factor receptor and multiple tyrosine-kinase inhibitors. Clin Exp Dermatol. 2007;32:71–4. PubMedGoogle Scholar 59. Fowler JF, Nebus J, Wallo W, Eichenfield LF. Colloidal oatmeal formulations as adjunct treatments in atopic dermatitis. J Drugs Dermatol. 2012;11:804–7. PubMedGoogle Scholar 60. Antiga E, Bonciolini V, Volpi W, Del Bianco E, Caproni M. Oral curcumin (Meriva) is effective as an adjuvant treatment and is able to reduce IL-22 serum levels in patients with psoriasis vulgaris. Biomed Res Int. 2015;2015:1–7. CrossRefGoogle Scholar 61. Pakfetrat M, Basiri F, Malekmakan L, Roozbeh J. Effects of turmeric on uremic pruritus in end stage renal disease patients: a double-blind randomized clinical trial. J Nephrol. 2014;27:203–7. CrossRefPubMedGoogle Scholar 62. Panahi Y, Sahebkar A, Parvin S, Saadat A. A randomized controlled trial on the anti-inflammatory effects of curcumin in patients with chronic sulphur mustard-induced cutaneous complications. Ann Clin Biochem. 2012;49:580–8. CrossRefPubMedGoogle Scholar 63. Panahi Y, et al. Improvement of sulphur mustard-induced chronic pruritus, quality of life and antioxidant status by curcumin: results of a randomised, double-blind, placebo-controlled trial. Br J Nutr. 2012;108:1272–9. CrossRefPubMedGoogle Scholar 64. Moon P-D, Jeong H-J, Kim H-M. Down-regulation of thymic stromal lymphopoietin by curcumin. Pharmacol Rep. 2013;65:525–31. CrossRefPubMedGoogle Scholar 65. Lysy J, et al. Topical capsaicin--a novel and effective treatment for idiopathic intractable pruritus ani: a randomised, placebo controlled, crossover study. Gut. 2003;52:1323–6. CrossRefPubMedPubMedCentralGoogle Scholar 66. Makhlough A, Ala S, Haj-Heydari Z, Kashi Z, Bari A. Topical capsaicin therapy for uremic pruritus in patients on hemodialysis. Iran J Kidney Dis. 2010;4:137–40. PubMedGoogle Scholar 67. Weisshaar E, Dunker N, Gollnick H. Topical capsaicin therapy in humans with hemodialysis-related pruritus. Neurosci Lett. 2003;345:192–4. CrossRefPubMedGoogle Scholar 68. Ständer S, Luger T, Metze D. Treatment of prurigo nodularis with topical capsaicin. J Am Acad Dermatol. 2001;44:471–8. CrossRefPubMedGoogle Scholar 69. Neess CM, et al. Treatment of pruritus by capsaicin in a patient with pityriasis rubra pilaris receiving RE-PUVA therapy. Clin Exp Dermatol. 2000;25:209–11. CrossRefPubMedGoogle Scholar 70. Akhavan Amjadi M, Mojab F, Kamranpour SB. The effect of peppermint oil on symptomatic treatment of pruritus in pregnant women. Iran J Pharm Res IJPR. 2012;11:1073–7. PubMedGoogle Scholar 71. Antiga E, Bonciolini V, Volpi W, Del Bianco E, Caproni M. Oral curcumin (Meriva) is effective as an adjuvant treatment and is able to reduce IL-22 serum levels in patients with psoriasis vulgaris. Biomed Res Int. 2015;2015:283634. CrossRefPubMedPubMedCentralGoogle Scholar 72. Russo EB. Cannabis in India. In: Mechoulam R, ed. Cannabinoids as Therapeutics. 1st ed. Basel: Birkhäuser Basel; 2005:1-22. Google Scholar 73. Bulkley LD. Neurotic eczema. J Am Med Assoc. 1898;30:891. Google Scholar 74. Parke WE. Cannabis indica. Med Surg Rep. 1895;72:140. Google Scholar 75. Wilson SR, Bautista DM. Role of transient receptor potential channels in acute and chronic itch. In: Carstens E, Akiyama T, eds. Itch Mech Treat. 1st ed. Boca Raton: CRC Press; 2014. Google Scholar 76. Misery L, et al. Successful Treatment of refractory neuropathic pruritus with capsaicin 8% patch: a bicentric retrospective study with long-term follow-up. Acta Derm Venereol. 2015;95:864–5. CrossRefPubMedGoogle Scholar 77. Zeidler C, et al. Capsaicin 8% cutaneous patch: a promising treatment for brachioradial pruritus? Br J Dermatol. 2015;172:1669–71. CrossRefPubMedGoogle Scholar 78. Disease P. Topical capsaicin — a novel and effective treatment for idiopathic intractable pruritus ani: a randomised, placebo controlled, crossover study. Gut. 2003;52:1323–7. CrossRefGoogle Scholar 79. Weisshaar E, Ziethen B, Gollnick H. Lack of efficacy of topical capsaicin in serotonin-induced itch. Skin Pharmacol Appl Ski Physiol. 2000;13:1–8. CrossRefGoogle Scholar 80. Gupta S. Chamomile: a herbal medicine of the past with a bright future (Review). Mol Med Rep. 2010;3:895–901. CrossRefPubMedPubMedCentralGoogle Scholar 81. Prasad S, Aggarwal BB. Turmeric, the Golden Spice: From traditional medicine to modern medicine. In: Benzie I, Wachtel-Galor S, eds. Herbal Medicine: Biomolecular and Clinical Aspects. 2nd ed. Boca Raton: CRC Press; 2011. Google Scholar 82. Luthra PM, Singh R, Chandra R. Therapeutic uses of Curcuma longa (turmeric). Indian J Clin Biochem. 2001;16:153–60. CrossRefPubMedPubMedCentralGoogle Scholar 83. Velayudhan K, Sikshit N, Abdul M. Ethnobotany of turmeric. Indian J Tradit Knowl. 2012;11(4):607–614. Google Scholar 84. Prasad DV. ethno-medicine and indigenous therapeutic practices of the Nicobarese Of Katchal Island. J Andaman Sci. 2013;18:96–101. Google Scholar 85. Elmariah SB, Lerner EA. The missing link between itch and inflammation in atopic dermatitis. Cell. 2013;155:267–9. CrossRefPubMedPubMedCentralGoogle Scholar Copyright information © Springer Science+Business Media, LLC 2017