Potential of Trachyspermum ammi (ajwain) Gel for Treatment of Facial Acne vulgaris: a Pilot Study with Skin Biophysical Profile Assessment and Red Fluorescence Photography

Document Type: Original paper

Authors

1 International Campus, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.

2 Department of Iranian Traditional Medicine, School of Iranian Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran.

3 Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran

4 International Campus, School Of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

5 Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran.

6 Department of Pharmacognosy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Medicinal Plants Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Background and objectives: Acne vulgaris is one of the most common dermatologic conditions. The available anti-acne treatments are not satisfactory and safe. In this regard, searching for new treatments, especially natural materials with reasonable side effects and satisfactory effectiveness, could be promising. The aim of the present study was to explore the safety and efficacy of a topical formulation containing Trachyspermum ammi (ajwain) fruits essential oil in patients with facial acne. Methods: The essential oil of the fruits was extracted by hydrodistillation method and formulated as a 1% gel. In this open-labeled, uncontrolled clinical trial, 20 patients with mild to moderate acne received topical ajwain gel twice daily for 8 weeks. The outcomes of acne lesion count, red fluorescence parameters and biophysical skin profiles were evaluated at baseline, 4th and 8th weeks. Any adverse reaction was recorded during the study.  Results: All patients completed the study. Two months after treatment, the mean reduction in the total (8.2±3.36; P=0.000) and non-inflammatory (7.3±4.53; p=0.000) lesions was statistically significant. Furthermore, a significant reduction in the size and quantity of red fluorescence spots was also observed. Biophysical skin profile measurements revealed a significant reduction in erythema (p=0.033) and sebum (p=0.026) and a significant increase in pH (p=0.005). No serious adverse events were reported. Conclusion: The results of this pilot study provided a basis for the effectiveness of topical ajwain gel for the treatment of mild to moderate facial acne. Conducting further double blind clinical trials are necessary to confirm the efficacy and safety of the product.
 

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[1] Chaudhary SS, Tariq M, Zaman R, Imtiyaz S. The in vitro anti-acne activity of two unani drugs. Anc Sci Life. 2013; 33(1): 35-38.
[2] Kraft J, Freiman A. Management of acne. Can Med Assoc J. 2011; 183(7): 430-435.
[3] Barnes LE, Levender MM, Fleischer AB, Feldman SR. Quality of life measures for acne patients. Dermatol Clin. 2012; 30(2): 293-300.
[4] 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(6): 742-746.
[5] Kosmadaki M, Katsambas A. Topical treatments for acne. Clin Dermatol. 2017; 35(2): 173-178.
[6] Goh CL, Noppakun N, Micali G, Azizan NZ, Boonchai W, Chan Y, Etnawati K, Gulmatico-Flores Z, Foong H, Kubba R, Paz-Lao P, Lee YY, Loo S, Modi F, Nguyen TH, Pham TL, Shih YH, Sitohang IB, Wong SN. Meeting the challenges of acne treatment in Asian patients: a review of the role of dermocosmetics as adjunctive therapy. J Cutan Aesthet Surg. 2016; 9(2): 85-92.
[7] Yang JH, Yoon JY, Kwon HH, Min S, Moon J, Suh DH. Seeking new acne treatment from natural products, devices and synthetic drug discovery. Dermatoendocrinol. 2017; Article ID: 1356520.
[8] Solórzano-Santos F, Miranda-Novales MG. Essential oils from aromatic herbs as antimicrobial agents. Curr Opin Biotech. 2012; 23(2): 136-141.
[9] Yarnell E, Abascal K. Herbal medicine for acne vulgaris. Altern Complement Ther. 2006; 12(6): 303-309.
[10] Rezaeizadeh H, Alizadeh M, Naseri M, Ardakani M. The traditional Iranian medicine point of view on health and disease. Iran J Pub Health. 2009; 38(1): 169-172.
[11] Shirbeigi L, Oveidzadeh L, Jafari Z, Fard MS. Acne etiology and treatments in traditional Persian medicine. Int J Mol Sci. 2016; 41(S3): 19.
[12] Zarshenas MM, Moein M, Mohammadi Samani S, Petramfar P. An overview on ajwain (Trachyspermum ammi) pharmacological effects; modern and traditional. J Neurosci R. 2013; 14(1): 98-105.
[13] Avicenna. Canon of medicine. New Delhi: S. Waris Nawab, Senior Press Superintendent, Jamia Hamdard Printing press, 1998.
[14] Thangam C, Dhananjayan R. Antiinflammatory potential of the seeds of Carum copticum Linn. Indian J Pharmacol. 2003; 35(6): 388-391.
[15] Umar S, Asif M, Sajad M, Ansari MM, Hussain U, Ahmad W, Siddiqui SA, Ahmad S, Khan HA. Anti-inflammatory and antioxidant activity of Trachyspermum ammi seeds in collagen induced arthritis in rats. Int J Drug Dev Res. 2012; 4(1): 210-219.
[16] Saxena S, Agarwal D, Saxena R, Rathore S. Analysis of anti-oxidant properties of ajwain (Trachyspermum ammi L) seed extract. Int J Seed Spices. 2012; 2(1): 50-55.
[17] Singh A, Ahmad A. Antioxidant activity of essential oil extracted by SC-CO2 from seeds of Trachyspermum ammi. Medicines. 2017; Article ID: 28930268.
[18] Prashanth M, Revanasiddappa H, Rai K, Raveesha K, Jayalakshmi B. Antioxidant and antibacterial activity of ajwain seed extract against antibiotic resistant bacteria and activity enhancement by the addition of metal salts. J Pharm Res. 2012; 5(4): 1952-1956.
[19] Chatterjee S, Goswami N, Bhatnagar P. Estimation of phenolic components and in vitro antioxidant activity of fennel (Foeniculum vulgare) and ajwain (Trachyspermum ammi) seeds. Adv Biores. 2012; 3(2): 109-118.
[20] Chatterjee S, Goswami N, Kothari N. Evaluation of antioxidant activity of essential oil from ajwain (Trachyspermum ammi) seeds. Int J Green Pharm. 2013; 7(2): 140-144.
[21] Bajpai VK, Agrawal P. Studies on phytochemicals, antioxidant, free radical scavenging and lipid peroxidation inhibitory effects of Trachyspermum ammi seeds. Indian J Pharm Educ. 2015; 49(1): 58-65.
[22] Mood BS, Shafeghat M, Metanat M, Saeidi S, Sepehri N. The inhibitory effect of ajowan essential oil on bacterial growth. Int J Infect. 2014; Article ID: 9394.
[23] Manayi A, Vazirian M, Omidpanah S, Hosseinkhani F, Hasseli A. Chemical composition and antibacterial activity of essential oil of Trachyspermum ammi. Planta Med. 2014; 80(16): P2B60.
[24] Adams RP, Sparkman OD. Review of identification of essential oil components by gas chromatography/mass spectrometry. J Am Soc Mass Spectrom. 2007; 18(4): 803-806.
[25] Tisserand R, Young R. Essential oil safety: a guide for health care professionals. 2nd ed. London: Elsevier Health Sciences, 2013.
[26] Hayashi N, Akamatsu H, Kawashima M. Establishment of grading criteria for acne severity. J Dermatol. 2008; 35(5): 255-260.
[27] Tahir CM. Pathogenesis of acne vulgaris: simplified. J Pak Assoc Dermatol. 2016; 20(2): 93-97.
[28] Kapoor S, Saraf S. Topical herbal therapies an alternative and complementary choice to combat acne. Res J Med Plant. 2011; 5(6): 650-659.
[29] Youn SW, Kim JH, Lee JE, Kim SO, Park KC. The facial red fluorescence of ultraviolet photography: is this color due to Propionibacterium acnes or the unknown content of secreted sebum? Skin Res Technol. 2009; 15(2): 230-236.
[30] Bojar RA, Holland KT. Acne and Propionibacterium acnes. Clin Dermatol. 2004; 22(5): 375-379.
[31] Sarici G, Cinar S, Armutcu F, Altınyazar C, Koca R, Tekin N. Oxidative stress in acne vulgaris. J Eur Acad Dermatol Venereol. 2010; 24(7): 763-777.
[32] Shrivastava V, Shrivastava G, Sharma R, Mahajan N, Sharma V, Bhardwaj U. Anti-microbial potential of ajwain (Trachyspermum copticum): an immense medical spice. J Pharm Res. 2012; 5(7): 3837-3840.
[33] Hassanshahian M, Bayat Z, Saeidi S, Shiri Y. Antimicrobial activity of Trachyspermum ammi essential oil against human bacterial. Int J Adv Biol Biomed Res. 2014; 2(1): 18-24.
[34] Hassan W, Noreen H, Rehman S, Gul S. Antimicrobial efficacies, antioxidant activity and nutritional potentials of Trachyspermum ammi. Vitam Miner. 2016; 5(3): 1-5.
[35] Awan UA, Andleeb S, Kiyani A, Zafar A, Shafique I, Riaz N, Azahr MT, Uddin H. Antibacterial screening of traditional herbal plants and standard antibiotics against some human bacterial pathogens. Pak J Pharm Sci. 2013; 26(6): 1109-1116.
[36] Vitali LA, Beghelli D, Nya PCB, Bistoni O, Cappellacci L, Damiano S, Vitali LA, Beghelli D, Biapa Nya PC, Bistoni O, Cappellacci L, Damiano S, Lupidi G, Maggi F, Orsomando G, Papa F, Petrelli D, Petrelli R, Quassinti L, Sorci L, Majd Zadeh M, Bramucci M. Diverse biological effects of the essential oil from Iranian Trachyspermum ammi. Arab J Chem. 2016; 9(6): 775-786.
[37] Raman A, Weir U, Bloomfield S. Antimicrobial effects of tea‐tree oil and its major components on Staphylococcus aureus, Staph. epidermidis and Propionibacterium acnes. Lett Appl Microbiol. 1995; 21(4): 242-245.
[38] Kavoosi G, Tafsiry A, Ebdam AA, Rowshan V. Evaluation of antioxidant and antimicrobial activities of essential oils from Carum copticum seed and Ferula assafoetida latex. J Food Sci. 2013; 78(2): 356-361.
[39] Abtahi M, Mohammadi Z, Hatef B, Amini M, khorrami M, Aghanoori MR. Antifungal effect of flavonoid extract of Trachyspermum Ammi plant on the gene expression of pro-inflammatory cytokines such as IL-18 and TNF-α in articular chondrocyte cells. Biosci Biotech Res Asia. 2015; 12(3): 2081-2087.
[40] Abtahi MS, Mohammadi Z, Hatef B. Antifungal effect of flavonoid extract of Trachyspermum ammi plant on the gene expression of pro-inflammatory cytokines such as IL-18 and TNF-α in articular THP-1 monocyte/macrophages cells. Biosci Biotech Res Asia. 2015; 12(2): 1341-1342.
[41] Alavinezhad A, Boskabady MH. Antiinflammatory, antioxidant, and immunological effects of Carum copticum L. and some of its constituents. Phytother Res. 2014; 28(12): 1739-1748.
[42] Schmid-Wendtner MH, Korting HC. The pH of the skin surface and its impact on the barrier function. Skin Pharmacol Physiol. 2006; 19(6): 296-302.
[43] Malhi HK, Tu J, Riley TV, Kumarasinghe SP, Hammer KA. Tea tree oil gel for mild to moderate acne; a 12 week uncontrolled, open‐label phase II pilot study. Australas J Dermatol. 2017; 58(3): 205-210.
[44] Ghovvati M, Afshari GK, Nasrollahi SA, Firooz A, Samadi A, Karimi M, Talebi Z, Kolahdooz S, Vazirian M. Efficacy of topical cinnamon gel for the treatment of facial acne vulgaris: A preliminary study. Biomed Res Ther. 2019; 6(1): 2958-2965.