The effect of Unani antiacne formulation (Zimade Muhasa) on acne vulgaris: A single-blind, randomized, controlled clinical trial
Keywords:
Acne vulgaris, Unani compound formulation, GEA Score, Zimade MuhasaAbstract
Objective To evaluate clinically the efficacy of Zimade Muhasa, a Unani anti acne formulation, for Busoore labaniya (Acne vulgaris) against 5% benzoyl peroxide. Methods The randomized, single-blind, standard controlled trial of 6 weeks evaluated the efficacy and tolerability of Unani topical antiacne formulation against standard control i.e. 5% benzoyl peroxide in 48 patients of either sex on the basis of Global Evaluation of Acne Scale (GEA Scale) along with arbitrary scale for assessment of effect over postinflammatory hyperpigmentation, scarring and fairness. In addition quality of life was assessed according to Cardiff Acne Disability Index (CADI) questionnaire. The alterations in improvement and possible complications were regularly assessed. Results After 6 weeks of treatment, compared with baseline both the treatment preparations decreased the acne lesions (P<0.001). Further, the test formulation improved postinflammatory hyperpigmentation (P<0.001), scarring (P=0.025) and complexion (P=0.001). There was significant (P<0.001) improvement in the quality of life in treatment groups at the end of study. Conclusion The test formulation was well-tolerated and equivalent to 5% benzoyl peroxide in alleviating acne lesions. Test formulation was also more effectual concerning the effects over scars, post inflammatory hyperpigmentation and fairness. This formulation can be used safely to treat active acne as well as in patients with post acne scarring. The clinical relevance may be clarified by longer duration treatment.References
McKee P, Calonje E, Granter S. Pathology of the Skin with Clinical Correlations, 3rd edn. China: Elsevier Mosby; 2005. P. 1116-9.
Fabbrocini G, Annunziata MC, Arco VD, et al. Acne scars: pathogenesis, classification and treatment. Dermatol Res Pract. 2010;1-13.
Rosso JQD. A 6% benzoyl peroxide foaming cloth cleanser used in the treatment of acne vulgaris. aesthetic characteristics, patient preference considerations and impact on compliance with treatment. J Clin Aesthet Dermatol. 2009;2;26-9.
Do JE, Cho SM, In SI et al. Psychosocial aspects of acne vulgaris; a community – based study with Korean adolescents. A community- based study with Korean adolescents. Ann Dermatol. 2009;21:125-9.
Weedon D. Weedon’s Skin Pathology, 3rd edn. China: Churchill Livingstone Elsevier, 2010: P. 399-402.
Rathi SK. Acne vulgaris treatment: The current scenario. Indian J Dermatol. 2011;56:7-13.
Nahin RL, Barnes PM, Stussman BJ, Bloom B. Costs of complementary and Alternative Medicine (CAM) and Frequency of Visits to CAM Practitioners: United States, 2007. Natl Health Stat Reports. 2009;18:1-14.
Durusoy C, Gulec AT, Durukan E, Bakar C. Complementary and alternative medicine use among patients with acne vulgaris or melasma in dermatology clinic: a questionnaire survey. Turk J Dermatol. 2010;4:14-7.
Orafidiya LO, Agbani EO, Oyedele AO et al. Preliminary clinical tests on topical preparations of Ocimum gratissimum Linn leaf essential oil for the treatment of acne vulgaris. Clin Drug Investig. 2002;22:313-9.
Thappa DM, Dogra J. Nodulocystic acne: oral gugulipid versus tetracycline. J Dermatol. 1994;21:729-31.
Hajheydari Z, Saeedi M, Morteza Semnani K, Soltani A. Effect of Aloe vera topical gel with tretinoin in the treatment of mild to moderate acne vulgaris: a randomized, double blind, prospective trial. J Dermatolog Treat. 2014;25:123-9.
Fouladi RF. Aquous extract of dried fruit of Berberis vulgaris L. in acne vulgaris, a clinical trial. J Diet Suppl. 2012;9:253-61.
Enshaieh S, Jooya A, Siadat AH, Iraji F. The efficacy of 5% topical tree tea oil in mild to moderate acne vulgaris: A randomized, double - blind placebo - controlled study. Indian J Dermatol Leprol. 2007;73:22-5.
Hadi Al Harchan NAA. Treatment of Acne Vulgaris with Nigella sativa oil lotion. Iraqi Postgrad Med J. 2010;9:140-4.
Said HM, ed. Hamdard Pharmacopeia of Eastern Medicine. 2nd edn. Delhi: Sri satguru Publications, 1997: P. 193.
Dreno B, Poli F, Pawin H, Beylot C, Faure M. Development and evaluation of a Global Acne Severity Scale (GEA Scale) suitable for France and Europe. J Eur Acad Dermatol Venereol. 2011;25;43-8.
Bowe WP, Patel N, Logan AC. Acne vulgaris: the role of oxidative stress and the potential therapeutic value of local and systemic antioxidants. J Drugs Dermatol. 2012;11:742-6.
Ibn Sina, ed. Al Qanoon fil Tib. New Delhi: Idara Kitab ul Shifa; 2010. P. 1420.
Ghani N, ed. Khazainul Advia. New Delhi: Idara Kitabul Shifa; 2010. P. 1163-64,305-6,1330-34,799-800,1320-21.
Abdul Hakeem HM, ed. Bustan ul Muffridat Jadeed. Delhi: Idara Kitab us Shifa, 2002: pp 106, 336-7,506-7,591,598-91.
Kumar N, Kant R, Sinaga M, Yimame B, Belachew T. Preliminary phytochemical screening and in vitro antibacterial evaluation of the leaf and root extract of Azadirachta indica Plant. Int J Pharma Frontier Res. 2012;2:32-41.
Blakrishnan KP, Narayanaswamy N, Subba P, Poornima EH. Antibacterial activity of certain medicinal plants against acne inducing bacteria. Int J Pharma Bio Sci. 2011;2:476-81.
Dinda A, Das D, Ghosh G, Kumar S. Analgesic and anti inflammatory activity of hydro-alcoholic extract of Azadirachta Indica Leaf. Pharmacologyonline. 2011;3:477-84.
Patel P, Bhalodia Y, Gohil T, Malavia S, Devmurari V. In- vitro antioxidant activity of Azadirachta Indica leaves. J Advances Pharmacy Healthcare Res. 2011;1:22-7.
Vidya V, Srinivasan D, Sengottuvelu S. Wound healing potential of Melia azedarach L leaves in alloxan induced diabetic rats. Global J Res Med Plants Indigen Med. 2012;1:265-71.
Kamlesh W, Lakhotiya CL, Umekar MJ. Skin renewal effect of different extracts of leaves of Azadirachta indica. Int J Pharma Tech Research. 2009;1:1350-3.
Salem ZM, Aly H, Gohar Y, El-Sayed. Biological activity of extracts from Morus alba L., Albizzia lebbeck L. Benth., and Casuarina glauca Sieber against the growth of some pathogenic bacteria. Int J Agri Food Res. 2013;2:9-22.
Saha A, Ahmed M. The analgesic and anti-inflammatory activities of the extract of Albizia Lebbeck in animal model. Pak I Pharm Sci. 2009;22:74-7.
Pathak NL, Patel NJ, Kasture SB et al. Free radical scavengering activity of Albizia lebbeck methanolic extract in arthritic rats. Int J Pharma Res Develop Online. 2010;1:1-8.
Chadhary M, Sharma AK, Kumar R et al. Comparative immunomodulator activity of leaves and bark of Albizia Lebbeck (Linn.). Int J Res Dev Pharm L Sci. 2012;1:25-7.
Anam EM. Anti-inflammatory activity of compounds isolated from the aerial parts of Abrus precatorius (Fabaceae). Phytomedicine. 2001;8:24-7.
Bobaralla V, Varahalarao V. Abrus Precatorius L. Seed extracts antimicrobial properties against clinically important bacteria. Int J Pharm Rech Res. 2009;1:1115-8.
Alagesaboopathi C, Sivakumar R. Studies on wound healing activity of red and black coloured seed, white coloured seed extracts of Abrus precatorius L. Int J Pharma Bio Sci. 2011;2:302-12.
Pal RS, Ariharasivakumar G, Girhepunje K, Upadhyay A. In- vitro antioxidative activity of phenolic and flavonoid compounds extracted from seeds of Abrus Precatorius. Int J Pharma Sci. 2009;1:136-40.
Tilwari A, Shukla NP, Pathirissery UM. Immunomodulatory activity of the aquous extract of seeds of Abrus precatorius Linn. (Jequirity) in mice. Iran J Immunol. 2011;8:96-103.
Ibrahim SRM, Mohamed GA, Al Musayelp NM. New constituents from the Rhizomes of Egyptian Iris germanica L. Molecules. 2012;17:2587-98.
Aghar SF, Habib ur Rehman, Choudahry MI, Attaur Rahman. Gas chromatography- mass soectometry (GC-MS) analysis of petroleum ether extract (oil) and bio- essays of crude extract of Iris germanica. Int J Genet Molec Biol. 2011;3:95-100.
Nazir N, Koul S, Qurishi MA et al. Immunomodulatory activity of Isoflavones isolated from iris germanica (Iridaceae) on T- lymphocytes and cytokines. Phytother Res. 2009;23:428-33.
Ibn Baitar. Al Jamia Mufradatil Advia wal Aghzia (Urdu translation).Vol-1, 3, 4. New Delhi: CCRUM, Ministry of Health and Family Welfare, Govt. of India; 2000. P. 177-79, 324, 357-63.
Kabeeruddin HM. Ilm ul Advia Nafeesi. New Delhi: Eijaz Publishing House; 2007. P. 329, 300,149-50.
Khan A, ed. Muhit I Azam. Vol-1. New Delhi: CCRUM, Ministry of Health and Family Welfare; 2012. P. 188-190,500-503.
Ibn Hubl, ed. Kitab Al Mukhtarat fil tib. Vol-2, 4. New Delhi; CCRUM. Ministry of Health and Family Welfare, Govt. of India; 2005. P. 53-54,188-189,32.
Weerapreeyakul N, Seebundit K, Prayong P. Antioxidative and tyrosinase inhibitory activities of indigenous plants. KKU Sci J. 2012;40:572-83.
