St. John’s Wort Cream Provides Eczema Relief
Applying a cream containing St. John’s wort (Hypericum perforatum) may be beneficial for people suffering from mild to moderate eczema (atopic dermatitis), reports a study in Phytomedicine (2003;10 Suppl 4:31–7).
Referred to as “the itch that rashes,” eczema is a chronic inflammatory skin disorder characterized by itching that leads to rashes. Rashes may occur as patches, small bumps, and larger areas called plaques. Eczema is most commonly seen on the face, neck, the insides of the elbows, behind the knees, and on the hands and feet. Persistent scratching causes the skin to become red and scaly, with oozing and crusting of irritated areas. Scratching can also lead to skin loss (excoriation), skin infections, and skin thickening.
Eczema usually develops in the first year of life; 60% of cases are diagnosed before the age of one year. Two-thirds of people with eczema have either a personal or family history of asthma, hay fever, or allergies that affect the nasal passages (allergic rhinitis). Eczema can be worsened by allergies, stress, hormones, infections, and time of year (eczema is often worst in the dry winter months). Malfunctions in the immune system have been implicated in its development.
Treatments for eczema are aimed at decreasing inflammation and preventing infections. Corticosteroid creams help relieve itching, and newer medications (e.g., tacrolimus ointment [Protopic™]) target the immune system to help control inflammation. Side effects of steroid-containing creams may include skin thinning and longer healing times. When used near the eyes, they can cause cataracts and glaucoma. Tacrolimus ointment is associated with fewer side effects than corticosteroids; however, it may cause a temporary burning, stinging, or itching sensation, and increased sensitivity to sunlight (photosensitivity).
St. John’s wort has been used historically for the topical treatment of bruises and mild burns, and to speed wound healing. Hyperforin is a constituent of the herb that has been found to have antibacterial activity.
The current study investigated the effect of a cream containing an extract of St. John’s wort on the symptoms of eczema. Eighteen people aged 12 to 59 years with mild to moderate eczema completed the trial. The participants applied a cream containing 5% of an extract of St. John’s wort (standardized to 1.5% hyperforin) to affected areas on one side of the body and a placebo cream to affected areas on the other side. The treatments were applied two times per day for four weeks. The intensity of eczema was measured based on the total area of skin affected, redness, crusting, excoriation, scaling, and skin thickening. The presence of a common cause of skin infections, the bacterium Staphylococcus aureus, was also measured, and skin tolerance and cosmetic acceptability of the two creams were compared.
Application of the St. John’s wort cream resulted in a statistically significant improvement in the intensity of eczema compared with the placebo cream. S. aureus concentrations were also lower on the side of the body treated with the St. John’s wort cream than on the placebo side. Both the St. John’s wort and placebo creams were well tolerated and most participants described their cosmetic acceptability as “good” or “excellent.”
This is the first study to demonstrate a substantial benefit of an herbal preparation for the treatment of eczema. The positive results of this preliminary study should lead to larger trials comparing the effect of topical corticosteroids with extracts of St. John’s wort.
Kimberly Beauchamp, ND, received her bachelor’s degree from the University of Rhode Island and her Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. She is a co-founder and practicing physician at South County Naturopaths, Inc., in Wakefield, RI. Dr. Beauchamp teaches holistic medicine classes and provides consultations focusing on detoxification and whole-foods nutrition.
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