hypericum and Erythema

Topical Acyclovir has moderate efficacy on recurrent HSV symptoms, requiring repeat applications for several days. Topical Dynamiclear, which requires only a single dose application, may provide a more effective and convenient treatment option for symptomatic management of HSV.. The study assessed the comparative efficacy and tolerability of a single use, topical formulation containing copper sulfate pentahydrate and Hypericum perforatum that is marketed as Dynamiclear™ to a topical 5% Acyclovir cream standard preparation and use.. A prospective, randomized, multi-centered, comparative, open-label clinical study was conducted. A total of 149 participants between 18 and 55 years of age with active HSV-1 and HSV-2 lesions were recruited for the 14-day clinical trial. Participants were randomized into two groups: A (n=61), those receiving the Dynamiclear formulation, and B (n=59), those receiving 5% Acyclovir. Efficacy parameters were assessed via physical examination at baseline (day 1), day 2, 3, 8, and 14. Laboratory safety tests were conducted at baseline and on day 14.. Use of the Dynamiclear formulation was found to have no significant adverse effects and was well tolerated by participants. All hematological and biochemical markers were within normal range for the Dynamiclear group. Statistically, odds for being affected by burning and stinging sensation were 1.9 times greater in the Acyclovir group in comparison to the Dynamiclear group. Similarly, the odds of being affected by symptoms of acute pain, erythema and vesiculation were 1.8, 2.4, and 4.4 times higher in the Acyclovir group in comparison to the Dynamiclear group.. The Dynamiclear formulation was well tolerated, and efficacy was demonstrated in a number of measured parameters, which are helpful in the symptomatic management of HSV-1 and HSV-2 lesions in adult patients. Remarkably, the effects seen from this product came from a single application.

Topics: Acyclovir; Administration, Topical; Adolescent; Adult; Copper Sulfate; Erythema; Female; Herpes Simplex; Herpesvirus 1, Human; Herpesvirus 2, Human; Humans; Hypericum; Male; Middle Aged; Plant Extracts; Prospective Studies; Treatment Outcome; Young Adult

Hyperforin, a major constituent of St. John's Wort (Hypericum perforatum, HP), provides anti-inflammatory, anti-tumor, and anti-bacterial properties. Previous studies have shown anti-oxidative properties of St. John's Wort extracts; however, its free radical scavenging activity in skin cells or skin has not been assessed in detail so far. Therefore, the free radical scavenging activity of hyperforin was tested in the H(2)DCFDA-assay in vitro in HaCaT keratinocytes irradiated with solar simulated radiation. Hyperforin (EC(50) 0.7 μM corresponding to 0.42 μg/ml) was much more effective compared to Trolox (EC(50) 12 μg/ml) and N-acetylcysteine (EC(50) 847 μg/ml) without showing phototoxicity. The radical protection factor of a cream containing 1.5%w/w of a hyperforin-rich HP extract was determined to be 200 × 10(14) radicals/mg, indicating a high radical scavenging activity. The cream was further applied ex vivo on porcine ear skin and significantly reduced radical formation after infrared irradiation. Finally, the UV-protective effect of the HP cream was tested on 20 volunteers in a randomized, double-blind, vehicle-controlled study. HP cream significantly reduced UVB-induced erythema as opposed to the vehicle. Occlusive application of HP cream on non-irradiated test sites did not cause any skin irritation. Taken together, these results demonstrate that hyperforin is a powerful free radical scavenger.

Topics: Administration, Topical; Adult; Animals; Anti-Inflammatory Agents; Antioxidants; Double-Blind Method; Erythema; Female; Free Radical Scavengers; Humans; Hypericum; Inflammation; Keratinocytes; Male; Middle Aged; Phloroglucinol; Plant Extracts; Skin; Swine; Terpenes; Ultraviolet Rays; Young Adult

Dry and atopic skin requires skin care with lipid-rich emollients and moisturizing bath or shower oils. However, it has been shown recently that some bath oils may even impair the skin barrier.. To investigate the skin-irritating potential of a new bath oil containing a lipophilic St. John's wort (Hypericum perforatum) extract.. In this single-center, randomized, double-blind, prospective study, 3 bath oils together with positive and negative controls were applied under occlusion on test areas on the volar forearms of 18 volunteers (visit 1). After 24 h, the tapes were removed, and the test areas were evaluated by a visual score and the instrumental measurement of skin erythema and transepidermal water loss (TEWL) using a Mexameter and a Tewameter (visit 2). The test substances were applied a second time, and the measurements were performed after another 24 h (visit 3).. The positive control, 1% vol/vol sodium lauryl sulfate (SLS), caused a significant increase in skin erythema and TEWL. In contrast, distilled water as a negative control did not influence these parameters. The new bath oil containing St. John's wort extract and 1 of the other 2 commercial products were not different from the water control. The third bath oil displayed a skin-irritating effect similar to SLS.. The results of this study confirm the different skin-irritating potential of bath oils and demonstrate good skin tolerance of the new bath oil containing St. John's wort extract.

Topics: Adult; Baths; Double-Blind Method; Erythema; Female; Forearm; Humans; Hypericum; Male; Middle Aged; Plant Extracts; Plant Oils; Prospective Studies; Skin Irritancy Tests; Water Loss, Insensible; Young Adult

The naphthodiantrones hypericin and pseudohypericin, ingredients of hypericum extracts, are known as potent photosensitizers that may cause phototoxic effects in grazing animals after excessive ingestion of hypericum species and in some cases in higher concentrations of hypericum extracts oder pure hypericin in humans as well. Therefore, the objective of the present studies was to investigate the effect of two different hypericum extracts (STW 3, STW 3-VI) on photosensitivity with respect to minimal erythema dose (MED) after 14 days treatment. Both open, multiple-dose, one-phase studies were conducted in 20 healthy men, receiving one tablet per day. MED values were determined prior to hypericum extract administration (baseline) and after 14 days treatment using an erythem tester emitting a light very similar to sun light (main emission spectrum: 285-350 nm). Skin reactions with respect to MED were evaluated 12 h, 24 h (primary endpoint), 48 h and 7 days after irradiation. All volunteers reached steady-state of hypericin/pseudohypericin plasma concentrations before study day 14, when the irradiation under treatment conditions took place. In all subjects MED was measurable under baseline and under hypericum treatment conditions. With respect to the primary endpoint, in both studies, mean MED (24 h) were not significantly different between baseline and after 14 days hypericum treatment. However, individually photosensitivity of the skin could increase under treatment conditions, just as well photosensitivity could decrease or remain unchanged. There were no clinically relevant changes in the laboratory parameters, the vital signs, physical findings and other observations related to safety during the examinations. In one study (STW 3), two adverse events were reported, both described as hypersensitivity to light in mild Intensity. The two studies showed that treatment with the two hypericum extracts under steady state and under prescribed conditions were safe medications without significant increases of photosensitivity.

Topics: Adolescent; Adult; Anthracenes; Erythema; Humans; Hypericum; Hypersensitivity; Light; Male; Middle Aged; Perylene; Plant Extracts; Skin

Hypericin from St John's wort (Hypericum perforatum L.) is a photosensitizing agent that may cause a severe photodermatitis when higher amounts of St John's wort are ingested by animals. Although Hypericum extracts are widely used in the treatment of depressive disorders, only a little information on the photosensitizing capacity of St John's wort in humans is available. In the present prospective randomized study we investigated the effect of the Hypericum extract LI 160 on skin sensitivity to ultraviolet B (UVB), ultraviolet A (UVA), visible light (VIS) and solar simulated radiation (SIM). Seventy two volunteers of skin types II and III were included and were divided into six groups, each consisting of 12 volunteers. In the single-dose study the volunteers (n = 48) received 6 or 12 coated tablets (5400 or 10 800 microgram hypericin). In the steady-state study the volunteers (n = 24) received an initial dose of 6 tablets (5400 microgram hypericin), and subsequently 3 x 1 tablets (2700 microgram hypericin) per day for 7 days. Phototesting was performed on the volar forearms prior to medication and 6 h after the last administration of Hypericum extract. The erythema-index and melanin-index were evaluated photometrically using a mexameter. After both single-dose and steady-state administration, no significant influence on the erythema-index or melanin-index could be detected, with the exception of a marginal influence on UVB induced pigmentation (p = 0.0471) in the single-dose study. The results do not provide evidence for a phototoxic potential of the Hypericum extract LI 160 in humans when administered orally in typical clinical doses up to 1800 mg daily. This is in accordance with previous pharmacokinetic studies that found hypericin serum and skin levels after oral ingestion of Hypericum extract always to be lower than the assumed phototoxic hypericin threshold level of 1000 ng/mL.

Topics: Administration, Oral; Adolescent; Adult; Drug Administration Schedule; Erythema; Female; Humans; Hypericum; Hyperpigmentation; Male; Middle Aged; Photosensitizing Agents; Phytotherapy; Plant Extracts; Prospective Studies; Reference Values; Sunlight; Ultraviolet Rays

Topics: Animals; Anthracenes; Data Interpretation, Statistical; Erythema; Humans; Hypericum; Perylene; Plants, Medicinal; Prospective Studies; Radiation-Sensitizing Agents; Skin; Sunlight; Time Factors; Ultraviolet Rays

St. John's wort (Hypericum perforatum) is a tradional folk remedy that is used for the topical treatment of superficial wounds, scars and burns. A characteristic metabolite of St. John's wort is the photodynamic active plant pigment hypericin. It is known that hypericin may cause a severe photodermatitis called hypericism when higher amounts of St. John's wort are ingested orally. To date, no reports on the photosensitizing capacity of topical application of St. John's wort are available. Here, we investigated the effects of Hypericum oil (hypericin 110 microg/mL) and Hypericum ointment (hypericin 30 microg/mL) on skin sensitivity to solar simulated radiation. Sixteen volunteers of the skin types II and III were tested on their volar forearms with solar simulated radiation for photosensitizing effects of Hypericum oil (n=8) and Hypericum ointment (n=8). The minimal erythema dose (MED) was determined by visual assessment, and skin erythema was evaluated photometrically. With the visual erythema score, no change of the MED could be detected after application of either Hypericum oil or Hypericum ointment (P>0.05). With the more sensitive photometric measurement, an increase of the erythema-index after treatment with the Hypericum oil could be detected (P< or =0.01). The results do not provide evidence for a severe phototoxic potential of Hypericum oil and Hypericum ointment, detectable by the clinically relevant visual erythema score. However, the trend towards increased photosensitivity detected with the more sensitive photometric measurement could become relevant in fair-skinned individuals, in diseased skin or after extended solar irradiation.

Topics: Administration, Cutaneous; Adolescent; Adult; Anthracenes; Erythema; Female; Forearm; Humans; Hypericum; Male; Middle Aged; Ointments; Perylene; Photosensitizing Agents; Plant Extracts; Plant Oils; Plants, Medicinal; Prospective Studies; Radiation-Sensitizing Agents; Reference Values; Skin; Sunlight

Oleum Hyperici, the oil extract of St. John's Wort (SJW), is one of the oldest folk remedies, traditionally used in the topical treatment of wounds, bruises, ulcers, cuts, burns, hemorrhoids and also as an antiseptic. Considering the advantageous characteristics of emulsion applications, in the present study we have formulated three O/W creams containing 15% (w/v) of SJW oil extract as an active ingredient. The aim was to estimate dermatological application of the prepared creams for the abovementioned indications. The extracts were prepared according to the prescriptions from traditional medicine, however with different vegetable oils used as an extractant, namely: Olive, palm and sunflower oil. The investigated O/W creams demonstrated significant antiinflammatory effects in an in vivo double-blind randomized study, using a sodium lauryl sulphate test. Both skin parameters assessed in the study (electrical capacitance and erythema index), were restored to the baseline value after a seven-day treatment with the tested creams. Almost all investigated SJW oil extracts and corresponding creams displayed the same antimicrobial activity against the most of the investigated microorganisms with obtained minimal inhibitory concentrations values of 1,280 µg/mL, 2,560 µg/mL or >2,560 µg/mL.

Topics: Anti-Infective Agents; Anti-Inflammatory Agents; Chemistry, Pharmaceutical; Drug Compounding; Drug Stability; Electric Capacitance; Erythema; Humans; Hypericum; Microbial Sensitivity Tests; Plant Extracts; Plant Oils; Skin

St John's wort (SJW) is widely used as a treatment for depression. A phototoxic reaction, due to its content of hypericin, can occur in animals and in cell culture, and has been reported in humans. Hypericin displays absorption within the ultraviolet (UV) A1 spectrum and there may therefore be a potential for phototoxicity if taken during high-dose UVA1 therapy.. To assess the phototoxicity risk of SJW ingestion.. Eleven adult volunteers of skin types I and II were exposed to a geometric dose series of UVA1 irradiation from a high-output source (Dermalight Ultra 1; Dr Hönle, Martinsreid, Germany; irradiance 70-77 mW cm(-2)) on the photoprotected lower back skin at eight 1.5-cm(2) test areas. Irradiation was carried out at baseline and after 10 days of SJW extract 1020 mg (equivalent to 3000 microg of hypericin) daily. Four, 8, 24 and 48 h after each exposure, the minimal erythema dose (MED) and the presence or absence of pigmentation were recorded visually and erythema was assessed objectively with an erythema meter.. The median MED and D(0.025), an objective measure of MED, were lower at all time-points after SJW ingestion. The visual erythemal peak (lowest median MED), which was seen at 8 h postirradiation, was lower after SJW (median 14 J cm(-2), range 10-56) than at baseline (median 20 J cm(-2), range 14-56) (P = 0.047). Similarly, the median D(0.025) at 8 h postirradiation was lower after SJW (median 22.0 J cm(-2), range 15.2-53.9) than at baseline (median 33.7 J cm(-2), range 22.9-136.0) (P = 0.014). The MED and D(0.025) were also significantly different at the 48-h and 4-h time-points, respectively. Significance was not reached at the 24-h time-point. Median intensity of postirradiation erythema increased at all time-points after ingestion of SJW. Despite these differences, the maximum slope of the dose-response curve was not increased after SJW ingestion.. These data suggest that SJW extract has the potential to lower the erythemal threshold to UVA1 irradiation in a significant proportion of individuals and highlight the importance of ascertaining a full drug history, including herbal remedies, before initiating UVA1 phototherapy.

Topics: Adult; Anthracenes; Antidepressive Agents; Dose-Response Relationship, Radiation; Erythema; Humans; Hypericum; Middle Aged; Perylene; Phytotherapy; Plant Extracts; Radiation Injuries; Radiotherapy Dosage; Severity of Illness Index; Ultraviolet Therapy

Exposure to sunlight may cause sunburn, skin cancer or phototoxic reactions to certain drugs such as Hypericum extract. All these are ultraviolet B (UVB)-mediated reactions which may be modulated by individual genetic susceptibility. UVB exposure results in oxidative stress. Many products of oxidative stress are detoxified by glutathione-S-transferases mu 1 (GSTM1) and theta 1 (GSTT1). Deletion polymorphisms (genotype *0/*0) of GSTM1 and GSTT1 occur in 50% and 20% of Caucasians, respectively. By affecting the individual ability to detoxify oxidative stress-related products, they may influence the severity of the cutaneous photoreaction.. Minimal erythema doses (MED) of UVB irradiation on the skin were determined in 110 subjects who were selected according to their GSTT1 genotype (28 GSTT1*0/*0, 54 GSTT1*A/*0, and 28 GSTT1*A/*A). Genotypes were detected with novel polymerase chain reaction (PCR) assays that allow the differentiation between homozygous and heterozygous GSTT1 and GSTM1 deletions.. In the absence of GSTT1 enzyme, the susceptibility of individuals to UVB-induced inflammatory skin reactions increased significantly (p = 0.02, ANCOVA). 'Gene-equivalents' were calculated from the number of functional GSTM1 and GSTT1 alleles as a measure of the gene-dose. UVB sensitivity correlated with gene dose up to a threshold above which additional GSTT1 or GSTM1 alleles did not provide additional protection. Volunteers who were homozygously deficient in GSTT1 and GSTM1 were most sensitive to UVB. Interestingly, individuals with high GSTM1 gene-doses showed increased photosensitization after administration of Hypericum extract (St. John's wort).. Individuals harboring the *0/*0 genotype of GSTT1 and/or GSTM1 showed enhanced UVB-induced cutaneous damage. Moreover, GST genotypes modulated Hypericum-induced photosensitization.

Topics: Adolescent; Adult; Analysis of Variance; Erythema; Female; Genotype; Glutathione Transferase; Humans; Hypericum; Male; Middle Aged; Polymorphism, Genetic; Statistics, Nonparametric; Sunburn