티트리 오일 (내복 주의)
Tea Tree Oil (Internal)
📚 관련 논문 (27편)
1. Biomed Pharmacother. 2021 Oct;142:111992. doi: 10.1016/j.biopha.2021.111992. Epub 2021 Aug 5. Advantages of using toothpaste containing propolis and plant oils for gingivitis prevention and oral cavity hygiene in cleft lip/palate patients. Machorowska-Pieniążek A(1), Morawiec T(2), Olek M(3),
2. BMJ Clin Evid. 2011 Jan 17;2011:0923. MRSA colonisation (eradicating colonisation in people without active/invasive infection). Bradley SF(1). Author information: (1)Internal Medicine, Divisions of Infectious Diseases and Geriatric Medicine, University of Michigan Medical School, Ann Arbor,
1. J Clin Med. 2025 Feb 28;14(5):1641. doi: 10.3390/jcm14051641. Evaluation of the Effectiveness of a Mouthwash Containing Spilanthol and Cannabidiol on Improving Oral Health in Patients with Gingivitis-Clinical Trial. Kiełbratowski M(1), Kuśka-Kiełbratowska A(2), Mertas A(3), Bobela E(3), Wiench R(2), Kępa M(4), Trzcionka A(1), Korkosz R(1), Tanasiewicz M(1). Author information: (1)Department of Conservative Dentistry with Endodontics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland. (2)Department of Periodontal Diseases and Oral Mucosa Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland. (3)Department of Microbiology and Immunology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland. (4)Department of Microbiology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, 41-200 Sosnowiec, Poland. Background/Objectives: Plaque-associated gingivitis is widely regarded as a local inflammatory condition initiated by the accumulation of a non-specific dental biofilm in the interaction with the host immune system. The initial symptom noticed by the patient is bleeding gums. The use of mouthwash can serve to supplement mechanotherapy. However, there is an increasing interest in mouthwashes comprising natural ingredients, including cannabidiol (CBD) and spilanthol. The objective of this study was to evaluate the effect of an oral rinse containing spilanthol and CBD oil compared to a rinse containing tea tree oil on the oral microbiota and the values of selected oral status indicators in patients with gingivitis. Methods: The study included 40 patients treated with a rinse containing tea tree oil (TTO)/TTO + spilanthol + CBD for a period of 42 days. Patients rinsed their mouth twice daily for 30 s. The patients' oral microbiome was assessed before and after treatment, and bleeding on probing (BOP) and approximal plaque index (API) were assessed. The study was double-blind. Results: API and BOP were reduced in all groups, both the test and control. The most significant decrease in baseline BOP-1 scores was observed in test groups A and D (p = 0.005062 and p = 0.005062, respectively). A significant difference in API improvement was observed between the initial and final visits in the test (A, D) and control (B, C) groups (p = 0.012516, p = 0.005062, p = 0.004028, p = 0.003172, respectively). Conclusions: Firstly, the use of a mouthwash containing cannabidiol (CBD) and spilanthol was demonstrated to be efficacious in the maintenance of oral microbiota homeostasis. Secondly, the combination of TTO with spilanthol and CBD in the rinse was shown to result in a more significant reduction in selected oral health parameters (BOP and API) and anti-inflammatory effects when compared to a rinse with TTO alone. It should be noted that this is a pilot study and will continue. DOI: 10.3390/jcm14051641 PMCID: PMC11899771 PMID: 40095592 Conflict of interest statement: The authors declare no conflicts of interest.
2. Semin Cutan Med Surg. 2016 Jun;35(2):87-95. doi: 10.12788/j.sder.2016.026. Over-the-counter treatments for acne and rosacea. Rosamilia LL(1). Author information: (1)Geisinger Health System, Department of Dermatology - Scenery Park, State College, Pennsylvania, USA. llrosamilia@geisinger.edu. Acne and rosacea are common inflammatory processes historically classified in the same disease category, but evolving understanding of their disparate pathophysiology and exacerbating factors have generated an enormous armamentarium of therapeutic possibilities. Patients seek over-the-counter therapies first when managing cutaneous disease; therefore, this review defines ingredients considered to be effective over-the-counter acne and rosacea products, their mechanisms, and safe formulations, including botanical components, oral supplements, and other anecdotal options in this vast skin care domain. ©2016 Frontline Medical Communications. DOI: 10.12788/j.sder.2016.026 PMID: 27416314 [Indexed for MEDLINE]
3. J Strength Cond Res. 2012 Jun;26(6):1680-7. doi: 10.1519/JSC.0b013e318236d081. Effects of 2-nitrooxy ethyl 2-amino 3-methylbutanoate gel on resistance exercise performance and blood nitrate/nitrite in resistance trained men. Bloomer RJ(1), Alleman RJ Jr, Cantrell GS, Farney TM, Schilling BK. Author information: (1)Cardiorespiratory/Metabolic Laboratory, The University of Memphis, Memphis, Tennessee, USA. rbloomer@memphis.edu Nitric oxide dietary supplements are popular within the sport community. Our recent work involving the oral intake of 2-nitrooxy ethyl 2-amino 3-methylbutanoate demonstrated an approximately 6.7% increase in circulating nitrate/nitrite. However, no measures of exercise performance were obtained. The present study used a topical form of this molecule to determine the impact on exercise performance and blood nitrate/nitrite. Fourteen resistance trained men (24 ± 1 years old) reported to the laboratory on 2 occasions to undergo exercise testing, which consisted of arm curl isometric force and muscular endurance (3 sets to fatigue using 80, 65, and 50% of 1 repetition maximum [1RM]: total of 9 sets). The gel (2-nitrooxy ethyl 2-amino 3-methylbutanoate; mixed in tea tree oil) or placebo (tea tree oil) was applied topically by the subjects for 7 days before each test day, with 7-10 days separating the randomly ordered conditions. Blood samples, arm circumference, and perceived "muscle pump" were taken before and immediately after exercise on both test days. The heart rate and perceived exertion were measured after each set. No statistically significant differences were noted between conditions for performance variables (p > 0.05). However, when using a load of 50% of 1RM, 6.2% more repetitions were performed when using the gel as compared with when using the placebo; 19.9% more repetitions were performed by 8 subjects noted to be "responders" to gel treatment. Blood lactate and muscle pump significantly increased with exercise (p < 0.0001) but were not different between conditions (p > 0.05). Minimal change was noted in nitrate/nitrite, and the heart rate and perceived exertion were nearly identical between conditions (p > 0.05). These findings indicate that 2-nitrooxy ethyl 2-amino 3-methylbutanoate gel has a modest (6.2%), nonstatistically significant effect on exercise performance, in particular when using a load of 50% 1RM-with greater benefit noted in selected individuals. Studies inclusive of a larger sample size are needed to extend these initial findings. DOI: 10.1519/JSC.0b013e318236d081 PMID: 21921823 [Indexed for MEDLINE]
4. Am J Clin Dermatol. 2010;11(4):247-67. doi: 10.2165/11533220-000000000-00000. Botanicals in dermatology: an evidence-based review. Reuter J(1), Merfort I, Schempp CM. Author information: (1)Competence Center Skintegral, Department of Dermatology, University Medical Center Freiburg, Freiburg, Germany. Botanical extracts and single compounds are increasingly used in cosmetics but also in over-the-counter drugs and food supplements. The focus of the present review is on controlled clinical trials with botanicals in the treatment of acne, inflammatory skin diseases, skin infections, UV-induced skin damage, skin cancer, alopecia, vitiligo, and wounds. Studies with botanical cosmetics and drugs are discussed, as well as studies with botanical food supplements. Experimental research on botanicals was considered to a limited extent when it seemed promising for clinical use in the near future. In acne therapy, Mahonia, tea tree oil, and Saccharomyces may have the potential to become standard treatments. Mahonia, Hypericum, Glycyrrhiza and some traditional Chinese medicines appear promising for atopic dermatitis. Some plant-derived substances like dithranol and methoxsalen (8-methoxypsoralen) [in combination with UVA] are already accepted as standard treatments in psoriasis; Mahonia and Capsicum (capsaicin) are the next candidates suggested by present evidence. Oral administration and topical application of antioxidant plant extracts (green and black tea, carotenoids, coffee, and many flavonoids from fruits and vegetables) can protect skin from UV-induced erythema, early aging, and irradiation-induced cancer. Hair loss and vitiligo are also traditional fields of application for botanicals. According to the number and quality of clinical trials with botanicals, the best evidence exists for the treatment of inflammatory skin diseases, i.e. atopic dermatitis and psoriasis. However, many more controlled clinical studies are needed to determine the efficacy and risks of plant-derived products in dermatology. Safety aspects, especially related to sensitization and photodermatitis, have to be taken into account. Therefore, clinicians should not only be informed of the beneficial effects but also the specific adverse effects of botanicals used for dermatologic disorders and cosmetic purposes. DOI: 10.2165/11533220-000000000-00000 PMID: 20509719 [Indexed for MEDLINE]
5. Am J Clin Dermatol. 2002;3(5):341-8. doi: 10.2165/00128071-200203050-00006. Complementary/alternative medicine in dermatology: evidence-assessed efficacy of two diseases and two treatments. Ernst E(1), Pittler MH, Stevinson C. Author information: (1)Department of Complementary Medicine, School of Sport and Health Sciences, University of Exeter, UK. E.Ernst@ex.ac.uk The objective of this article is to provide a brief, but critical, overview of the evidence related to complementary/alternative medicine (CAM) use, and to offer valid and useful information for dermatologists in clinical practice. Systematic literature searches were conducted on these databases: Medline, EMBASE, The Cochrane Library, CISCOM and AMED (until October 2000). Where appropriate, the evaluation of the published literature was based on systematic reviews and randomized controlled trials. After scanning the literature it was decided to focus on a selection of two conditions (atopic dermatitis and chronic venous insufficiency) and two treatment modalities (aloe vera gel and tea tree oil). Data for the life-time prevalence of CAM use by patients with dermatological disease ranges between 35 to 69%. The most popular modalities include herablism and (other) dietary supplements, while atopic dermatitis is one of the conditions most frequently treated with CAM. For patients with atopic dermatitis the evidence relates to autogenic training, hypnotherapy, diet, herbal medicine, and dietary supplements. Compelling evidence of effectiveness exists for none of these therapies. However, some promising data have been reported for those with a psychological component: autogenic training, biofeedback and hypnotherapy. For chronic venous insufficiency there is relatively convincing evidence for the effectiveness of oral horse chestnut seed extract. The data for aloe vera gel and tea tree oil indicate that for neither is there compelling evidence of effectiveness. The use of CAM treatments is not free of risk; direct and indirect risks associated with CAM must be considered. DOI: 10.2165/00128071-200203050-00006 PMID: 12069640 [Indexed for MEDLINE]
6. Oral Health Prev Dent. 2024 Jun 12;22:211-222. doi: 10.3290/j.ohpd.b5458585. The Effect of Local Application of Tea Tree Oil Adjunctive to Daily Oral Maintenance and Nonsurgical Periodontal Treatment: A Systematic Review and Meta-Analysis of Randomised Controlled Studies. Zhang C, Liu B, Hu J, Zhao L, Zhao H. PURPOSE: To evaluate the efficacy of the adjunctive use of tea tree oil (TTO) for dental plaque control and nonsurgical periodontal treatment (NSPT). MATERIALS AND METHODS: Three electronic databases were searched from 2003. The reference lists of the included articles and relevant reviews were also manually searched. Randomised controlled trials reporting the clinical outcomes of the topical use of TTO as an adjunct to daily oral hygiene or scaling and root planing (SRP) were included. Regarding the use of TTO as an adjunctive to daily oral hygiene, the primary outcome was plaque index (PI) reduction. Regarding the use of TTO as an adjunctive to SRP, probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain were the primary outcomes. The secondary outcomes were adverse events. RESULTS: Eleven studies were included for qualitative analysis, 9 studies were included for quantitative analysis, and 6 studies were included to examine the application of TTO mouthwash as an adjunctive to daily oral hygiene. In addition, three studies were included to analyse the subgingival use of TTO adjunctive to SRP at selected sites. The results indicated a nonsignificant improvement in PI reduction in the TTO mouthwash group compared with placebo. The incidence of adverse events was statistically significantly greater in the CHX group than in the TTO group. For subgingival use of TTO adjunctive to SRP, beneficial effects were observed in the TTO group compared with SRP alone in terms of PPD and CAL at both three and six months post-treatment. However, an unpleasant taste was reported in three out of four studies. CONCLUSION: There is a lack of strong evidence to support the beneficial effects of TTO. Studies with larger sample sizes and standardised evaluation criteria are needed to further demonstrate the clinical relevance of TTO. DOI: 10.3290/j.ohpd.b5458585 PMCID: PMC11619907 PMID: 38864380 [Indexed for MEDLINE]
7. Am J Ophthalmol. 2024 Aug;264:8-16. doi: 10.1016/j.ajo.2024.03.019. Epub 2024 Mar 19. Efficacy and Safety of Lotilaner Ophthalmic Solution (0.25%) for the Treatment of Demodex Blepharitis: A GRADE Assessed Systematic Review and Meta-Analysis of Observational & Experimental Studies. Talha M(1), Haris Ali M(1), Fatima E(2), Nadeem A(3), Ahmed A(3), Nashwan AJ(4). Author information: (1)Department of Medicine, Shaikh Khalifa Bin Zayed Al-Nahyan Medical and Dental College (M.T., M.H.A.), Lahore, Pakistan. (2)Department of Medicine, Services Institute of Medical Sciences (E.F.), Lahore, Pakistan. (3)Department of Medicine, Allama Iqbal Medical College (A.N., A.A.), Lahore, Pakistan. (4)Department of Nursing, Hamad Medical Corporation (A.J.N.), Doha, Qatar; Department of Public Health, College of Health Sciences, QU Health, Qatar University (A.J.N.), Doha, Qatar. Electronic address: anashwan@hamad.qa. PURPOSE: Several treatments have been in use for Demodex blepharitis, before the discovery of lotilaner, like tea tree oil and antibiotics; however, they either have irritable effects or systemic adverse effects, respectively. Lotilaner, a novel ectoparasiticide, has been proposed as a treatment for patients grappling with Demodex blepharitis. This review aims to assess the safety and efficacy of lotilaner in the treatment of Demodex blepharitis. DESIGN: Systematic review and meta-analysis. METHODS: An extensive search was conducted on PubMed, Cochrane Library, Scopus, and Google Scholar to find relevant literature till July 31, 2023 following the PRISMA guidelines. A total of 143 articles were retrieved by database searching, out of which 6 studies met the inclusion criteria and were included in the review. Four randomized controlled trials were included in the meta-analysis of mite eradication incidence. The review is registered with PROSPERO: CRD42023459997. RESULTS: Lotilaner is effective in eradicating Demodex mites in individuals suffering from Demodex blepharitis according to RR for the intervention versus the control group of 3.55 (95% confidence interval [CI]: 2.87-4.40, P < .00001, I2 = 0%). The meta-analysis of clinically meaningful collarette score revealed the summary RR for the intervention versus the control group was 3.15 (95% CI: 2.56-3.89, P < 0.00001, I2 = 27%). In conclusion, the results of the included studies were comparable and consistent. CONCLUSIONS: Our results indicated that lotilaner is an effective, well-tolerated, and promising drug in treating patients with Demodex blepharitis. Lotilaner administration and cost-effectiveness should now be contemplated for the study population as these constituents have a vital impact on its treatment success. Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.ajo.2024.03.019 PMID: 38513948 [Indexed for MEDLINE]
8. Cochrane Database Syst Rev. 2020 Jun 20;6(6):CD013333. doi: 10.1002/14651858.CD013333.pub2. Tea tree oil for Demodex blepharitis. Savla K(1), Le JT(2), Pucker AD(1). Author information: (1)School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, USA. (2)Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. Update of doi: 10.1002/14651858.CD013333. BACKGROUND: Demodex blepharitis is a chronic condition commonly associated with recalcitrant dry eye symptoms though many people with Demodex mites are asymptomatic. The primary cause of this condition in humans is two types of Demodex mites: Demodex folliculorum and Demodex brevis. There are varying reports of the prevalence of Demodex blepharitis among adults, and it affects both men and women equally. While Demodex mites are commonly treated with tea tree oil, the effectiveness of tea tree oil for treating Demodex blepharitis is not well documented. OBJECTIVES: To evaluate the effects of tea tree oil on ocular Demodex infestation in people with Demodex blepharitis. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2019, Issue 6); Ovid MEDLINE; Embase.com; PubMed; LILACS; ClinicalTrials.gov; and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We used no date or language restrictions in the electronic search for trials. We last searched the databases on 18 June 2019. SELECTION CRITERIA: We included randomized controlled trials (RCTs) that compared treatment with tea tree oil (or its components) versus another treatment or no treatment for people with Demodex blepharitis. DATA COLLECTION AND ANALYSIS: Two review authors independently screened the titles and abstracts and then full text of records to determine their eligibility. The review authors independently extracted data and assessed risk of bias using Covidence. A third review author resolved any conflicts at all stages. MAIN RESULTS: We included six RCTs (1124 eyes of 562 participants; 17 to 281 participants per study) from the US, Korea, China, Australia, Ireland, and Turkey. The RCTs compared some formulation of tea tree oil to another treatment or no treatment. Included participants were both men and women, ranging from 39 to 55 years of age. All RCTs were assessed at unclear or high risk of bias in one or more domains. We also identified two RCTs that are ongoing or awaiting publications. Data from three RCTs that reported a short-term mean change in the number of Demodex mites per eight eyelashes contributed to a meta-analysis. We are uncertain about the mean reduction for the groups that received the tea tree oil intervention (mean difference [MD] 0.70, 95% confidence interval [CI] 0.24 to 1.16) at four to six weeks as compared to other interventions. Only one RCT reported data for long-term changes, which found that the group that received intense pulse light as the treatment had complete eradication of Demodex mites at three months. We graded the certainty of the evidence for this outcome as very low. Three RCTs reported no evidence of a difference for participant reported symptoms measured on the Ocular Surface Disease Index (OSDI) between the tea tree oil group and the group receiving other forms of intervention. Mean differences in these studies ranged from -10.54 (95% CI - 24.19, 3.11) to 3.40 (95% CI -0.70 7.50). We did not conduct a meta-analysis for this outcome given substantial statistical heterogeneity and graded the certainty of the evidence as low. One RCT provided information concerning visual acuity but did not provide sufficient data for between-group comparisons. The authors noted that mean habitual LogMAR visual acuity for all study participants improved post-treatment (mean LogMAR 1.16, standard deviation 0.26 at 4 weeks). We graded the certainty of evidence for this outcome as low. No RCTs provided data on mean change in number of cylindrical dandruff or the proportion of participants experiencing conjunctival injection or experiencing meibomian gland dysfunction. Three RCTs provided information on adverse events. One reported no adverse events. The other two described a total of six participants randomized to treatment with tea tree oil who experienced ocular irritation or discomfort that resolved with re-educating the patient on application techniques and continuing use of the tea tree oil. We graded the certainty of the evidence for this outcome as very low. AUTHORS' CONCLUSIONS: The current review suggests that there is uncertainty related to the effectiveness of 5% to 50% tea tree oil for the short-term treatment of Demodex blepharitis; however, if used, lower concentrations may be preferable in the eye care arena to avoid induced ocular irritation. Future studies should be better controlled, assess outcomes at long term (e.g. 10 to 12 weeks or beyond), account for patient compliance, and study the effects of different tea tree oil concentrations. Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. DOI: 10.1002/14651858.CD013333.pub2 PMCID: PMC7388771 PMID: 32589270 [Indexed for MEDLINE] Conflict of interest statement: KS, JTL, and ADP have no financial interests in the subject matter of this systematic review. This Cochrane Review was prepared while JTL was a methodologist at the Johns Hopkins Bloomberg School of Public Health. The opinions expressed in this article are the author's own and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the US government.
9. Complement Ther Med. 2019 Dec;47:102224. doi: 10.1016/j.ctim.2019.102224. Epub 2019 Oct 24. Essential oils as topical anti-infective agents: A systematic review and meta-analysis. Deyno S(1), Mtewa AG(2), Abebe A(3), Hymete A(4), Makonnen E(5), Bazira J(6), Alele PE(7). Author information: (1)Department of Pharmacology, Mbarara University of Science and Technology, Mbarara, P.O.Box 1410, Uganda; Pharm-Biotechnology and Traditional Medicine (PHARMBIOTRAC) Center of Excellence, Mbarara University of Science and Technology, Mbarara, P.O.Box 1410, Uganda; Department of Pharmacology, School of Medicine, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia. Electronic address: dserawit@std.must.ac.ug. (2)Pharm-Biotechnology and Traditional Medicine (PHARMBIOTRAC) Center of Excellence, Mbarara University of Science and Technology, Mbarara, P.O.Box 1410, Uganda; Chemistry Section, Department of Applied Sciences, Malawi Institute of Technology, Malawi University of Science & Technology, Limbe, Malawi; Wellcome Centre for Anti-Infectives Research, Division of Biological Chemistry and Drug Discovery, School of Life Sciences, University of Dundee, DD1 5 EH, Scotland, United Kingdom. Electronic address: amtewa@must.ac.mw. (3)Traditional and Modern Drug Research Directorate, Ethiopian Public Health Research Institute, Ethiopia. Electronic address: abiyabg@yahoo.com. (4)Department of Pharmaceutical chemistry and Pharmacognosy, Addis Ababa University, Ethiopia. Electronic address: hymete@yahoo.com. (5)Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Ethiopia. Electronic address: eyasumakonnen@yahoo.com. (6)Department of Microbiology, Mbarara University of Science and Technology, Mbarara, P.O.Box 1410, Uganda. Electronic address: jbazira@must.ac.ug. (7)Department of Pharmacology, Mbarara University of Science and Technology, Mbarara, P.O.Box 1410, Uganda. Electronic address: paulalele@must.ac.ug. OBJECTIVE: This study summarized evidence on the efficacy and safety of essential oils (EOs) in the treatment of topical infections. DESIGN AND SETTING: Systematic review of clinical trials conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guideline. Electronic databases of the Cochrane, PubMed, EMBASE, Web of Science, and Scopus were searched from inception to November 2018. INTERVENTION: Essential oil of any type, standard treatment and placebo. MAIN OUTCOME MEASURES: Outcomes of the study include total acne count, acne severity index, reduction in total acne surface area, number of non-inflammatory acne lesions and inflammatory acne lesions, microbial cure rate, microbial decolonization rate, and new microbial emergence. RESULTS: Non-significant but higher proportion of MRSA was cleared in EOs group (69% [95%CI: 34%, 96%]) compared to routine care (45% [95%CI: 36%, 53%]). Essential oils significantly lowered level of new MRSA emergence (9% [95% CI: 5%, 14%], I2 = 86.59%) compared to routine care (53% [95%CI: 30%, 75%], I2 = 86.59%). Four of the five studies on acne treatment showed equal or superior efficacy of EOs and the remaining one showed inferior efficacy to a control. In treatment of topical fungal infections, efficacy of essential oils were non-inferior compared to a standard treatment but superior to a placebo. CONCLUSION: Essential oils could be considered as alternative treatment for acne, decolonization of MRSA, and topical fungal infections, yet the low quality and heterogeneity among the studies calls for further studies. Copyright © 2019 Elsevier Ltd. All rights reserved. DOI: 10.1016/j.ctim.2019.102224 PMID: 31780027 [Indexed for MEDLINE]
10. Ocul Surf. 2019 Oct;17(4):655-669. doi: 10.1016/j.jtos.2019.06.004. Epub 2019 Jun 20. Efficacy of treatments for Demodex blepharitis: A systematic review and meta-analysis. Navel V(1), Mulliez A(2), Benoist d'Azy C(3), Baker JS(4), Malecaze J(3), Chiambaretta F(3), Dutheil F(5). Author information: (1)University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Ophthalmology, F-63000, Clermont-Ferrand, France. Electronic address: vnavel@chu-clermontferrand.fr. (2)University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Biostatistics Unit, Clinical Research and Innovation Direction, F-63000, Clermont-Ferrand, France. (3)University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Ophthalmology, F-63000, Clermont-Ferrand, France. (4)University of the West of Scotland, Institute for Clinical Exercise and Health Science, Hamilton, United Kingdom. (5)University Hospital of Clermont-Ferrand, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Preventive and Occupational Medicine, Witty Fit, F-63000, Clermont-Ferrand, France; Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, 3065, Australia. PURPOSE: We conducted a systematic review and meta-analysis to evaluate the efficacy of different treatment for Demodex blepharitis. Parameters studied were mites count, improvement of symptoms and mites' eradication, stratified on type of treatments and mode of delivery of treatments (local or systemic). METHOD: The PubMed, Cochrane Library, Embase, ClinicalTrials.gov, Google scholar and Science Direct databases were searched for studies reporting an efficacy of treatments for Demodex blepharitis. RESULTS: We included 19 studies (14 observational and 5 randomized clinical trials), for a total of 934 patients, 1741 eyes, and 13 different treatments. For mites count, eradication rate, and symptoms improvement, meta-analysis included fifteen, fourteen and thirteen studies, respectively. The overall effect sizes for efficiency of all treatments, globally, were 1.68 (95CI 1.25 to 2.12), 0.45 (0.26-0.64), and 0.76 (0.59-0.90), respectively. Except usual lid hygiene for mites count, Children's Hospital of Eastern Ontario ointment (CHEO) for both eradication rate and symptoms, and CHEO, 2% metronidazole ointment, and systemic metronidazole for eradication rate, all treatments were efficient. Stratified meta-analysis did not show significant differences between local and systemic treatments (1.22, 0.83 to 1.60 vs 2.24, 1.30 to 3.18 for mites count; 0.37, 0.21 to 0.54 vs 0.56, 0.06 to 0.99 for eradication rate; and 0.77, 0.58 to 0.92 vs 0.67, 0.25 to 0.98 for symptoms improvement). CONCLUSION: We reported the efficiency of the different treatments of Demodex blepharitis. Because of less systemic side effects, local treatments seem promising molecules in the treatment of Demodex blepharitis. Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.jtos.2019.06.004 PMID: 31229586 [Indexed for MEDLINE]
11. J Nepal Health Res Counc. 2019 Jan 27;16(41):364-371. Evaluating Sanitization of Toothbrushes Using Various Decontamination Methods: A Meta-Analysis. Agrawal SK(1), Dahal S(1), Bhumika TV(2), Nair NS(3). Author information: (1)Department of Public Health Dentistry, BPKIHS, Dharan, Nepal. (2)Public Health Evidence South Asia, Manipal University, Karnataka, India. (3)Department of Statistics, and Director of Public Health Evidence South Asia Manipal University, Karnataka, India. Toothbrushes play an essential role in personal oral hygiene by effective plaque removal.However, they get heavily contaminated by bacteria, viruses, yeasts, and fungi which may originate from the oral cavity after every use as well as from the environment where they are stored. This systematic review was conducted to identify various decontamination interventions attempted scientifically and it summarizes the efficacy of each. Meta-analysis illustrated that the use of Ultra-violet rays and Microwave had a significant effect on reduction of the microbial count of a used toothbrush with a mean difference of -2.61 and CI (-4.66,-0.76) with I2=98%. When compared with non-active treatment group, the natural agents (garlic, green tree and tea-tree oil) proved to sterilize the toothbrushes effectively with mean difference of -483.34, CI (-914.79, -51.88) and I2=100%.In contrast, chlorhexidine showed the insignificant result with a mean difference of -347.55 and CI (-951.90, 256.80) with I2=100%. The evidence from this review suggests that decontaminating toothbrush reduces bacterial load. Toothbrushes exposed to radiation and natural agents proved to sanitize them effectively but chlorhexidine rendered insignificant results. Keywords: Chemical agent; disinfection; radiation; microbial load; natural agent; toothbrush. PMID: 30739916 [Indexed for MEDLINE]
12. Cochrane Database Syst Rev. 2017 May 17;5(5):CD004767. doi: 10.1002/14651858.CD004767.pub4. Interventions for cutaneous molluscum contagiosum. van der Wouden JC(1), van der Sande R(2), Kruithof EJ(1), Sollie A(3), van Suijlekom-Smit LW(4), Koning S(2). Author information: (1)Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, PO Box 7057, Amsterdam, Netherlands, 1007 MB. (2)Department of General Practice, Erasmus Medical Center, PO Box 2040, Room Ff303, Rotterdam, Netherlands, 3000 CA. (3)Maison Medical Bel Air, 154 Avenue Bel Air, Carpentras, France, 1084200. (4)Department of Paediatrics, Paediatric Rheumatology, Erasmus Medical Center - Sophia Children's Hospital, PO Box 2060, Rotterdam, Netherlands, 3000 CB. Update of Cochrane Database Syst Rev. 2009 Oct 07;(4):CD004767. doi: 10.1002/14651858.CD004767.pub3. BACKGROUND: Molluscum contagiosum is a common skin infection that is caused by a pox virus and occurs mainly in children. The infection usually resolves within months in people without immune deficiency, but treatment may be preferred for social and cosmetic reasons or to avoid spreading the infection. A clear evidence base supporting the various treatments is lacking.This is an update of a Cochrane Review first published in 2006, and updated previously in 2009. OBJECTIVES: To assess the effects of specific treatments and management strategies, including waiting for natural resolution, for cutaneous, non-genital molluscum contagiosum in people without immune deficiency. SEARCH METHODS: We updated our searches of the following databases to July 2016: the Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS. We searched six trial registers and checked the reference lists of included studies and review articles for further references to relevant randomised controlled trials. We contacted pharmaceutical companies and experts in the field to identify further relevant randomised controlled trials. SELECTION CRITERIA: Randomised controlled trials of any treatment of molluscum contagiosum in people without immune deficiency. We excluded trials on sexually transmitted molluscum contagiosum and in people with immune deficiency (including those with HIV infection). DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, assessed methodological quality, and extracted data from selected studies. We obtained missing data from study authors where possible. MAIN RESULTS: We found 11 new studies for this update, resulting in 22 included studies with a total of 1650 participants. The studies examined the effects of topical (20 studies) and systemic interventions (2 studies).Among the new included studies were the full trial reports of three large unpublished studies, brought to our attention by an expert in the field. They all provided moderate-quality evidence for a lack of effect of 5% imiquimod compared to vehicle (placebo) on short-term clinical cure (4 studies, 850 participants, 12 weeks after start of treatment, risk ratio (RR) 1.33, 95% confidence interval (CI) 0.92 to 1.93), medium-term clinical cure (2 studies, 702 participants, 18 weeks after start of treatment, RR 0.88, 95% CI 0.67 to 1.14), and long-term clinical cure (2 studies, 702 participants, 28 weeks after start of treatment, RR 0.97, 95% CI 0.79 to 1.17). We found similar but more certain results for short-term improvement (4 studies, 850 participants, 12 weeks after start of treatment, RR 1.14, 95% CI 0.89 to 1.47; high-quality evidence). For the outcome 'any adverse effect', we found high-quality evidence for little or no difference between topical 5% imiquimod and vehicle (3 studies, 827 participants, RR 0.97, 95% CI 0.88 to 1.07), but application site reactions were more frequent in the groups treated with imiquimod (moderate-quality evidence): any application site reaction (3 studies, 827 participants, RR 1.41, 95% CI 1.13 to 1.77, the number needed to treat for an additional harmful outcome (NNTH) was 11); severe application site reaction (3 studies, 827 participants, RR 4.33, 95% CI 1.16 to 16.19, NNTH over 40).For the following 11 comparisons, there was limited evidence to show which treatment was superior in achieving short-term clinical cure (low-quality evidence): 5% imiquimod less effective than cryospray (1 study, 74 participants, RR 0.60, 95% CI 0.46 to 0.78) and 10% potassium hydroxide (2 studies, 67 participants, RR 0.65, 95% CI 0.46 to 0.93); 10% Australian lemon myrtle oil more effective than olive oil (1 study, 31 participants, RR 17.88, 95% CI 1.13 to 282.72); 10% benzoyl peroxide cream more effective than 0.05% tretinoin (1 study, 30 participants, RR 2.20, 95% CI 1.01 to 4.79); 5% sodium nitrite co-applied with 5% salicylic acid more effective than 5% salicylic acid alone (1 study, 30 participants, RR 3.50, 95% CI 1.23 to 9.92); and iodine plus tea tree oil more effective than tea tree oil (1 study, 37 participants, RR 0.20, 95% CI 0.07 to 0.57) or iodine alone (1 study, 37 participants, RR 0.07, 95% CI 0.01 to 0.50). Although there is some uncertainty, 10% potassium hydroxide appears to be more effective than saline (1 study, 20 participants, RR 3.50, 95% CI 0.95 to 12.90); homeopathic calcarea carbonica appears to be more effective than placebo (1 study, 20 participants, RR 5.57, 95% CI 0.93 to 33.54); 2.5% appears to be less effective than 5% solution of potassium hydroxide (1 study, 25 participants, RR 0.35, 95% CI 0.12 to 1.01); and 10% povidone iodine solution plus 50% salicylic acid plaster appears to be more effective than salicylic acid plaster alone (1 study, 30 participants, RR 1.43, 95% CI 0.95 to 2.16).We found no statistically significant differences for other comparisons (most of which addressed two different topical treatments). We found no randomised controlled trial evidence for expressing lesions or topical hydrogen peroxide.Study limitations included no blinding, many dropouts, and no intention-to-treat analysis. Except for the severe application site reactions of imiquimod, none of the evaluated treatments described above were associated with serious adverse effects (low-quality evidence). Among the most common adverse events were pain during application, erythema, and itching. Included studies of the following comparisons did not report adverse effects: calcarea carbonica versus placebo, 10% povidone iodine plus 50% salicylic acid plaster versus salicylic acid plaster, and 10% benzoyl peroxide versus 0.05% tretinoin.We were unable to judge the risk of bias in most studies due to insufficient information, especially regarding concealment of allocation and possible selective reporting. We considered five studies to be at low risk of bias. AUTHORS' CONCLUSIONS: No single intervention has been shown to be convincingly effective in the treatment of molluscum contagiosum. We found moderate-quality evidence that topical 5% imiquimod was no more effective than vehicle in terms of clinical cure, but led to more application site reactions, and high-quality evidence that there was no difference between the treatments in terms of short-term improvement. However, high-quality evidence showed a similar number of general side effects in both groups. As the evidence found did not favour any one treatment, the natural resolution of molluscum contagiosum remains a strong method for dealing with the condition. DOI: 10.1002/14651858.CD004767.pub4 PMCID: PMC6481355 PMID: 28513067 [Indexed for MEDLINE] Conflict of interest statement: Johannes C van der Wouden: My institution has received money from the following non‐profit sources which have no real or potential vested interest in the findings of this Cochrane review: Editorial Board, Huisarts en Wetenschap (monthly journal of Dutch College of GPs); Advisory Board of Achmea Health Database (health insurance company). The funds did not come from sources that produce any of the drugs that might be included in the review or competitors to the drugs in the review. Renske van der Sande: nothing to declare. Emma J Kruithof: nothing to declare. Annet Sollie: nothing to declare. Lisette WA van Suijlekom‐Smit: I have received a travel grant from Pfizer (American College of Rheumatology Annual Meeting 2014 Boston). Sander Koning: nothing to declare.
13. Photobiomodul Photomed Laser Surg. 2026 Apr;44(4):258-266. doi: 10.1177/25785478261428958. Epub 2026 Mar 18. Comparison between the Effect of Intense Pulsed Light and Lid Hygiene on the Tear Film and Ocular Surface: A Randomized Controlled Study. Jha S(1), Li Q(1), Jin Y(1), Yang Z(1), Liu H(1), Pazo EE(1), Zhao S(1), Huang Y(1). Author information: (1)Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China. PURPOSE: Demodex folliculorum infestation is an important contributor to meibomian gland dysfunction (MGD) and chronic ocular surface disease. This study evaluated and compared the therapeutic efficacy of intense pulsed light (IPL) and eyelid hygiene (ELH) for Demodex-associated MGD. METHODS: In this prospective, randomized comparative trial, 50 patients (100 eyes) with Demodex-associated MGD were allocated to two arms. Group A (n = 25) received three Eyesis IPL sessions at baseline, week 2, and week 4. Group B (n = 25) performed daily eyelid hygiene with OCuSOFT Lid Scrub for 6 weeks. Ocular surface parameters, including ocular surface disease index (OSDI), tear film lipid layer thickness (TFLL), noninvasive tear film break-up time (NITBUT), meibomian gland dropout, meibum quality and expressibility, corneal fluorescein staining (CFS), Schirmer's I, and Demodex count, were assessed from baseline to week 6. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were recorded at each visit. RESULTS: Both treatments significantly improved OSDI, NITBUT, TFLL, Schirmer's I, and CFS over 6 weeks (all p < 0.001). Compared with ELH, IPL achieved larger and earlier reductions in symptoms, greater increases in TFLL, and superior improvements in meibum quality and expressibility from week 4 onward (between-group p ≤ 0.021). Demodex counts decreased significantly in both groups with no between-group difference at week 6. BCVA, IOP, and adverse events remained stable, indicating a favorable short-term safety profile. CONCLUSION: IPL and ELH are effective for Demodex-related MGD, but IPL provides faster and more pronounced improvements in meibomian gland function, tear film stability, and patient-reported symptoms over 6 weeks. DOI: 10.1177/25785478261428958 PMID: 41848673 [Indexed for MEDLINE] Conflict of interest statement: Author Disclosure StatementThe authors declare no conflicts of interest.
14. J Indian Soc Pedod Prev Dent. 2025 Jul 1;43(3):410-417. doi: 10.4103/jisppd.jisppd_253_25. Epub 2025 Sep 30. Comparative evaluation of antibacterial efficacy of sequential herbal irrigation with conventional irrigation in endodontic therapy of primary teeth: A randomized controlled trial. Kendre SB(1), Bhatane AU, Dadpe MV, Kale YJ, Dahake PT. Author information: (1)Department of Pediatric and Preventive Dentistry, MIDSR Dental College and Hospital, Latur, Maharashtra, India. BACKGROUND: Successful endodontic therapy in primary teeth relies on effective microbial control. Although conventional irrigants are effective, they pose risks such as cytotoxicity, unpleasant taste, and tissue irritation. Herbal alternatives offer a safer, biocompatible option, especially suitable for children. AIMS: To evaluate and compare the antimicrobial efficacy of a sequential herbal irrigation protocol with a conventional irrigation protocol in the endodontic treatment of primary teeth. MATERIALS AND METHODS: It is a split-mouth, double-blind, and randomized controlled trial that included 15 pediatric patients aged 4-8 years with bilateral primary molars indicated for pulpectomy. Group I received conventional irrigation with 3% sodium hypochlorite, 17% ethylenediaminetetraacetic acid, and 2% chlorhexidine. Group II underwent sequential herbal irrigation using ethanolic extracts of 12.5% Salvadora persica (Miswak), 20% Azadirachta indica (Neem), 2% tea tree oil, and 10% phytic acid. Pre and postirrigation microbial samples were collected and cultured to quantify Enterococcus faecalis and Prevotella intermedia. Statistical analysis used paired t-tests for intragroup comparisons and one-way analysis of variance for intergroup differences, with significance set at P < 0.05. RESULTS: Both groups showed significant microbial reduction (P < 0.0001). Group I had 90.54% and 87.6% reductions in E. faecalis and P. intermedia, respectively, while Group II achieved 92.2% and 90.54%. Herbal irrigation showed significantly greater E. faecalis reduction (P = 0.025), but P. intermedia reduction was not significant (P = 0.384). CONCLUSIONS: The sequential herbal irrigation protocol showed comparable antimicrobial efficacy to conventional agents, with added benefits of safety, biocompatibility, and reduced cytotoxicity, making it a promising natural alternative in pediatric endodontics. Copyright © 2025 Journal of Indian Society of Pedodontics and Preventive Dentistry. DOI: 10.4103/jisppd.jisppd_253_25 PMID: 41026567 [Indexed for MEDLINE]
15. Poult Sci. 2023 Nov;102(11):102936. doi: 10.1016/j.psj.2023.102936. Epub 2023 Jul 15. Effects of adding tea tree oil on growth performance, immune function, and intestinal function of broilers. Liu Y(1), Xu L(1), Du H(1), Feng J(2), Zhang W(1), Li H(1), Xu F(1), Lin J(1), Fu H(1), Zhao X(3), Zheng Y(4), Chang LJ(5), Shu G(6). Author information: (1)College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China. (2)Institute of Animal Husbandry and Veterinary Medicine, Academy of Agricultural and Animal Husbandry Sciences, Tibet Autonomous Region, Lhasa, China. (3)College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, China. (4)Center for Veterinary Sciences, Zhejiang University, Hangzhou, China. (5)Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Washington, DC, USA. (6)College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China. Electronic address: dyysg2005@sicau.edu.cn. The aim of this study was to investigate the effects of adding tea tree oil (TTO) in the basal diet on growth performance, immune function, and intestinal function in broilers. This study utilized 1,650 one-day-old broilers with good health and similar body weight. Subjects were randomized into 5 groups with 6 replicates each: the control group (CON, basal diet), positive control group (PCG, basal diet + 100 mg/kg oregano oil in diet), low-dose TTO group (TTO-L, 50 mg/kg TTO added in the basal diet), medium-dose TTO group (TTO-M, 100 mg/kg TTO added in the basal diet), and high-dose TTO group (TTO-H, 200 mg/kg TTO added in the basal diet). The whole test period lasted 28 d. The results showed that the broilers fed with TTO supplemented diet had significantly higher body weight and average daily gain (ADG) (P = 0.013), and had a lower feed conversion ratio (F/G) (P = 0.010) throughout the trial period. The index of thymus in TTO-M increased significantly compared to CON (P = 0.015) on d 28. On d 14 and 28, C3, IFN-γ, TNF-α, and IL-2 levels in TTO-L serum were significantly increased (P < 0.001); the 3 test groups supplemented with TTO had significantly higher titers of avian influenza H9 subtype in their serum (P < 0.05). Tea tree oil supplement in the diet also had a positive and significant effect on the intestinal morphology of broilers throughout the experiment (P < 0.05). These results indicate that TTO has the ability to promote broiler growth, regulate immunity, and improve intestinal morphology. The proposed dosage of adding 50 mg/kg in broiler basal diets provides a theoretical basis for its subsequent use in livestock feeds. Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.psj.2023.102936 PMCID: PMC10506096 PMID: 37708764 [Indexed for MEDLINE]
16. Breastfeed Med. 2023 Mar;18(3):226-232. doi: 10.1089/bfm.2022.0260. Epub 2023 Feb 10. Effect of Tea Tree Oil and Coconut Oil on Nipple Crack Formation in the Early Postpartum Period. Şahin E(1), Yildirim F(2), Büyükkayaci Duman N(2). Author information: (1)Department of Obstetrics and Gynecology Nursing, Faculty of Health Sciences, Ordu University, Ordu, Turkey. (2)Department of Obstetrics and Gynecology Nursing, Faculty of Health Sciences, Hitit University, Çorum, Turkey. Background: The aim of the study was to determine the effect of tea tree oil and coconut oil applied to the nipples during the early postpartum period on nipple crack formation. Methods: This randomized controlled experimental research included a total of 90 women in the research sample abiding by the research criteria, with 30 each in the intervention groups (coconut oil or tea tree oil application) and 30 in the control group. Women in the intervention groups applied coconut oil or tea tree oil to the nipples on the 3rd, 7th, and 10th days postpartum, whereas the control group did not have any intervention. Data in the research were collected with the Descriptive Information Form for Mothers, Early Postpartum Period Breast Problem Assessment Form, and Visual Analog Scale (VAS). Analysis of data used the chi-square test, Kruskal-Wallis test, and Friedman's test. Results: Mean age of women participating in the research was 28.23 ± 5.21 years. The differences between the groups applying coconut oil and tea tree oil on the 3rd, 7th, and 10th days postpartum and the control group were significant in terms of incidence of nipple cracks. In addition, the difference in mean VAS points for nipple pain in the groups using coconut oil and tea tree oil and the control group was found to be statistically significant (p < 0.05). Conclusions: According to the research findings, coconut oil and tea tree oil were determined to reduce nipple crack formation and nipple pain. It is recommended to increase the use of coconut oil and tea tree oil related to breast problems in nursing care during the postpartum period. Clinical Trials Registration Number: NCT05456438. DOI: 10.1089/bfm.2022.0260 PMID: 36763614 [Indexed for MEDLINE]
17. Cont Lens Anterior Eye. 2022 Dec;45(6):101733. doi: 10.1016/j.clae.2022.101733. Epub 2022 Jul 13. Short-term tolerability of commercial eyelid cleansers: A randomised crossover study. Craig JP(1), Bitton E(2), Dantam J(3), Jones L(3), Ngo W(3), Wang MTM(4). Author information: (1)Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand; École d'optométrie, Université de Montréal, Quebec, Canada; Centre for Ocular Research and Education, School of Optometry and Vision Science, University of Waterloo, Ontario, Canada. Electronic address: jp.craig@auckland.ac.nz. (2)École d'optométrie, Université de Montréal, Quebec, Canada. (3)Centre for Ocular Research and Education, School of Optometry and Vision Science, University of Waterloo, Ontario, Canada. (4)Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand. PURPOSE: To evaluate the short-term tolerability of five commercially available anti-demodectic eyelid cleansers; OCuSOFT Oust Demodex (OD), I-MED I-Lid'n Lash Plus (ILL+), Labtician BlephaDex (BD), Chrissanthe Eye Cleanse (EC), and Théa Blephademodex (BDdx). METHODS: Thirty healthy non-contact lens wearers (18 female; mean ± SD age, 33 ± 12 years) were enrolled in a prospective randomised crossover study. On separate visits, spaced at least 48 h apart, participants were randomised to receive topical application of one of five eyelid cleansers or saline. Participants rated subjective ocular discomfort during the 10-minute post-application period. Visual acuity, non-invasive tear film stability, conjunctival hyperaemia, and ocular surface staining were assessed at baseline and 10 min. RESULTS: No inter-group differences in ocular parameters were noted at baseline (all p > 0.05). Ocular discomfort scores significantly exceeded baseline scores for 60 s following BD application, 120 s with OD, 135 s with BDdx, 150 s with ILL+, and 195 s with EC (all p < 0.05). Deterioration in non-invasive tear film stability, limbal conjunctival hyperaemia, as well as corneal, conjunctival, and lid margin staining was detected following EC application (all p < 0.05), and increased bulbar conjunctival hyperaemia was observed following both EC and ILL+ treatment (both p < 0.05). CONCLUSIONS: Study outcomes highlight varying tolerability profiles with different anti-demodectic lid cleanser preparations, and the potential to induce tear film instability, conjunctival hyperaemia and ocular surface staining on application. Awareness of possible adverse effects arising from topical application of commercial anti-demodectic lid cleanser formulations may help clinicians set realistic patient expectations and encourage better compliance in their use of lid hygiene therapies. Copyright © 2022. Published by Elsevier Ltd. DOI: 10.1016/j.clae.2022.101733 PMID: 35842288 [Indexed for MEDLINE] Conflict of interest statement: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
18. Photochem Photobiol. 2023 Jan;99(1):176-183. doi: 10.1111/php.13660. Epub 2022 Jul 25. Cosmetic Formulations with Melaleuca alternifolia Essential Oil for the Improvement of Photoaged Skin: A Double-Blind, Randomized, Placebo-Controlled Clinical Study. Hugo Infante V(1), Maria Maia Campos P(1), Darvin M(1), Lohan S(1), Schleusener J(1), Schanzer S(2), Lademann J(3), Meinke M(4). Author information: (1)Pharmaceutical Sciences, University of Sao Paulo, Ribeirao Preto, Brazil. (2)Department of Dermatology and Allergology, Universitätsmedizin Berlin, Berlin, Germany. (3)Charité - Universitätsmedizin, Berlin, Germany. (4)Klinik für Dermatologie, CCP, Charité - Universitätsmedizin Berlin, Berlin, Germany. This aim of this study was to evaluate the penetration depth, antioxidant capacity and the clinical efficacy of Melaleuca alternifolia pure essential oil and in a nanoemulsion to prevent skin photoaging. For this, 2% of pure essential oil or 2% of this essential oil in a nanoemulsion were vehiculated in a formulation. The skin penetration was evaluated using confocal Raman microspectroscopy. The radical protection factor was evaluated using electron paramagnetic resonance spectroscopy. For a clinical study, 40 male participants, aged 18-28 years, were enrolled, being divided into three groups: vehicle formulation, M. alternifolia pure essential oil and M. alternifolia Nanoemulsion. All the participants also received a sunscreen SPF 50 to use during the day. Before and after 90 days of study, skin hydrolipidics and morphological characteristics were performed by skin imaging and biophysical techniques. The nanoemulsion presented a lower antioxidant capacity and a higher penetration through the stratum corneum, reaching the viable epidermis, improving the stratum granulosum morphology. The groups presented an increase in the papillary depth, improving in the dermis echogenicity and the collagen fibers. Melaleuca alternifolia essential provides the potential to improve photoaged skin, being the application of nanoemulsion able to reach deeper skin layers. © 2022 American Society for Photobiology. DOI: 10.1111/php.13660 PMID: 35668682 [Indexed for MEDLINE]
19. Indian J Pharmacol. 2022 Mar-Apr;54(2):77-83. doi: 10.4103/ijp.ijp_772_20. Efficacy of Melaleuca alternifolia and chlorhexidine mouth rinses in reducing oral malodor and Solobacterium moorei levels. A 1 week, randomized, double-blind, parallel study. Srikumar KP(1), Bhagyashree BN(1), Srirangarajan S(1), Ravi RJ(1), Vinaya R(1). Author information: (1)Department of Periodontics, Bangalore Institute of Dental Sciences and Postgraduate Research Centre, Bengaluru, Karnataka, India. OBJECTIVES: The objective is to evaluate the association of Solobacterium moorei (S. moorei) to halitosis and to also check for the effects of two different mouth rinses on levels of S. moorei in saliva and tongue coating and its impact on oral halitosis. MATERIALS AND METHODS: This was a placebo-controlled parallel study of 160 individuals who were randomized and the study was performed using double-blinded protocol. Enrolled individuals filled a structured questionnaire regarding demographic data, oral hygiene habits, and dietary habits. Full mouth organoleptic odor scores (OLR), volatile sulfur compounds levels, Miyazaki's tongue coating index, and Plaque scores were recorded before intervention (baseline) and after 1-week post treatment. Microbiological samples obtained from the tongue and saliva was investigated for S. moorei levels using real time polymerase chain reaction. Participants were randomly assigned for two test mouth rinses (Melaleuca alternifolia and Chlorhexidine) and placebo groups. RESULTS: All salivary and tongue coating samples were tested positive for S. moorei in the halitosis group. One week post-treatment S. moorei counts in saliva and tongue coating samples of test group showed a significant reduction at P < 0.001. Paired t-test results showed that Melaleuca alternifolia was comparable with chlorhexidine in reduction of OLR, and VSC scores (P < 0.001). Salivary levels of S. moorei in Melaleuca alternifolia group showed a higher reduction (5.67 log10 copies/mL) than chlorhexidine group (5.1log10 copies/mL). CONCLUSION: S. moorei showed a positive correlation with oral halitosis scores. Both Melaleuca alternifolia and chlorhexidine were equally effective in reducing S. moorei levels and halitosis score. DOI: 10.4103/ijp.ijp_772_20 PMCID: PMC9249155 PMID: 35546457 [Indexed for MEDLINE] Conflict of interest statement: None
20. Cornea. 2023 Jan 1;42(1):44-51. doi: 10.1097/ICO.0000000000003046. Epub 2022 Apr 13. Role of Blepharoexfoliation in Demodex Blepharitis: A Randomized Comparative Study. Mohammad-Rabei H(1), Arabi A(1), Shahraki T(1), Rezaee-Alam Z(1), Baradaran-Rafii A(1)(2). Author information: (1)Department of Ophthalmology, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and. (2)Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, FL. PURPOSE: The purpose of this study was to evaluate the safety and efficacy of blepharoexfoliation in the treatment of Demodex blepharitis. METHODS: Patients with microscopically approved Demodex blepharitis were enrolled. Patients in the treatment group were treated once with in-office blepharoexfoliation (BlephEx LLC; Franklin, TN) using tea tree oil 2% shampoo, followed by eyelid scrubs with tea tree oil 2% shampoo twice a day for 8 weeks. Patients in the control group were treated with the same protocol, except for the in-office sham blepharoexfoliation procedure. As the main outcome measurement, the changes in the severity of symptoms [Ocular Surface Disease Index (OSDI) score] were compared. The changes in Demodex count and meibomian gland dysfunction (MGD) severity were compared as the secondary outcome measurements. RESULTS: Eighty-one patients (36 male and 45 female) were included. The mean age of the patients was 53.56 ± 8.13 years. The mean baseline OSDI score was 33.30 ± 11.80. The mean baseline Demodex count was 4.84 ± 1.49. The Demodex count at the baseline visit was moderately correlated with the baseline OSDI score (R = 0.526, P = 0.011) and baseline MGD severity ( P = 0.02). At the 8-week visit, the OSDI score was 22.62 ± 8.23 and 27.09 ± 9.11 in the blepharoexfoliation and control groups, respectively ( P = 0.016). At the 8-week visit, the Demodex count was 2.6 ± 1.08 and 3.03 ± 1.27 in the treatment and control groups, respectively ( P = 0.025). MGD improved in both groups ( P = 0.84). In the blepharoexfoliation group, the change in the OSDI score was moderately correlated with the baseline OSDI score (R = 0.611, P = 0.01). CONCLUSIONS: One session of blepharoexfoliation, followed by manual eyelid scrubs was more effective than eyelid scrubs alone in reducing patients' symptoms and Demodex count. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/ICO.0000000000003046 PMID: 35439775 [Indexed for MEDLINE] Conflict of interest statement: Conflicts of interest statement: The authors have no funding or conflicts of interest to disclose.
21. Int J Cosmet Sci. 2022 Feb;44(1):118-130. doi: 10.1111/ics.12761. Epub 2022 Feb 10. Safety and efficacy of combined essential oils for the skin barrier properties: In vitro, ex vivo and clinical studies. Infante VHP(1)(2), Maia Campos PMBG(1), Gaspar LR(1), Darvin ME(2), Schleusener J(2), Rangel KC(1), Meinke MC(2), Lademann J(2). Author information: (1)School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. (2)Freie Universität Berlin, Department of Dermatology, Venereology and Allergology, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Berlin, Germany. OBJECTIVE: To evaluate the safety and the synergistic effects of tea tree, lavender, eucalyptus and tangerine essential oils in combination on the skin using in vitro, ex vivo and clinical studies. METHODS: The phototoxicity was predicted using 3T3 neutral red uptake phototoxicity test (OECD TG 432). Skin penetration was evaluated by confocal Raman microspectroscopy using direct application of essential oils to pig ears. For the clinical studies, 40 participants were enrolled and randomized in three groups: (1) lavender, eucalyptus and tangerine, (2) the same essential oils plus melaleuca and (3) placebo group. The skin was evaluated by noninvasive techniques before and after a 90-day period of topical use. RESULTS: The essential oils were non-phototoxic, but the tangerine oil showed dose-dependent cytotoxicity (IC50: 33.1 µg/ml), presenting 35% of penetration in the viable epidermis. On the contrary, 17.7 µg/ml in combination was applied per day in the clinical study and the penetration rate for the combinations (10%, 1.77 µg/ml achieving the viable epidermis) guaranteed the safety, since in the clinical study, the application of the four essential oils improved skin barrier and morphologic skin characteristics, as well as increased skin hydration and decreased sebum levels, with no unwanted effects reported. CONCLUSIONS: All essential oils studied were considered non-cytotoxic or non-phototoxic separately except tangerine, which present a dose-dependent cytotoxicity. Finally, the essential oils in combination in an appropriate amount were safe and effective in the improvement of the hydrolipidic balance and morphological properties of the skin. Publisher: OBJECTIF: évaluer la sécurité d’emploi et les effets synergiques des associations d’huiles essentielles d’arbre à thé, de lavande, d’eucalyptus et de mandarine sur la peau à l’aide d’études in vitro, ex vivo et cliniques. MÉTHODES: la phototoxicité a été prédite avec le test de phototoxicité de fixation du rouge neutre 3T3 (OCDE TG 432). La pénétration cutanée a été évaluée par microspectroscopie confocale de Raman grâce à l’application directe d’huiles essentielles sur les oreilles de cochons. Pour les études cliniques, 40 participants ont été inclus et randomisés dans trois groupes : (1) lavande, eucalyptus et mandarine, (2) les mêmes huiles essentielles plus melaleuca et (3) un groupe placebo. La peau a été évaluée par des techniques non invasives avant et après une période d’utilisation topique de 90 jours. RÉSULTATS: les huiles essentielles se sont avérées non phototoxiques, mais l’huile de mandarine a montré une cytotoxicité dose-dépendante (CI 50 : 33,1 µg/ml), représentant 35 % de pénétration dans l’épiderme viable. À l’inverse, dans l’étude clinique, une quantité de 17,7 µg/ml par jour en association a été appliquée, et le taux de pénétration des associations (10 %, soit 1,77 µg/ml atteignant l’épiderme viable) a garanti la sécurité d’emploi, puisque dans l’étude clinique, l’application des quatre huiles essentielles a amélioré la barrière cutanée et les caractéristiques morphologiques de la peau, et a entraîné une augmentation de l’hydratation cutanée et une diminution des taux de sébum, sans signalement d’effets indésirables. CONCLUSIONS: chacune des huiles essentielles étudiées a été considérée comme non cytotoxique ou non phototoxique, à l’exception de la mandarine, qui présente une cytotoxicité dose-dépendante. Enfin, l’association d’huiles essentielles en quantité appropriée a démontré sa sécurité d’emploi et son efficacité dans l’amélioration de l’équilibre hydrolipidique et des propriétés morphologiques de la peau. © 2022 Society of Cosmetic Scientists and the Société Française de Cosmétologie. DOI: 10.1111/ics.12761 PMID: 34986500 [Indexed for MEDLINE]
22. Fish Shellfish Immunol. 2022 Jan;120:458-469. doi: 10.1016/j.fsi.2021.12.025. Epub 2021 Dec 18. Effects of dietary tea tree oil on the growth, physiological and non-specific immunity response in the giant freshwater prawn (Macrobrachium rosenbergii) under high ammonia stress. Liu M(1), Gao Q(2), Sun C(3), Liu B(1), Liu X(1), Zhou Q(4), Zheng X(3), Xu P(5), Liu B(6). Author information: (1)Wuxi Fisheries College, Nanjing Agricultural University, Wuxi, 214081, China. (2)Zhejiang Institute of Freshwater Fishery, Huzhou, 313001, PR China. (3)Key Laboratory of Freshwater Fisheries and Germplasm Resources Utilization, Ministry of Agriculture and Rural Affairs, Freshwater Fisheries Research Center, Chinese Academy of Fishery Sciences, Wuxi, 214081, PR China. (4)Wuxi Fisheries College, Nanjing Agricultural University, Wuxi, 214081, China; Key Laboratory of Freshwater Fisheries and Germplasm Resources Utilization, Ministry of Agriculture and Rural Affairs, Freshwater Fisheries Research Center, Chinese Academy of Fishery Sciences, Wuxi, 214081, PR China. (5)Wuxi Fisheries College, Nanjing Agricultural University, Wuxi, 214081, China; Key Laboratory of Freshwater Fisheries and Germplasm Resources Utilization, Ministry of Agriculture and Rural Affairs, Freshwater Fisheries Research Center, Chinese Academy of Fishery Sciences, Wuxi, 214081, PR China. Electronic address: xup@ffr.cn. (6)Wuxi Fisheries College, Nanjing Agricultural University, Wuxi, 214081, China; Key Laboratory of Freshwater Fisheries and Germplasm Resources Utilization, Ministry of Agriculture and Rural Affairs, Freshwater Fisheries Research Center, Chinese Academy of Fishery Sciences, Wuxi, 214081, PR China. Electronic address: liub@ffrc.cn. This study aimed to investigate the effects of dietary tea tree oil (TTO) on the performance, intestinal antioxidant capacity, and non-specific immunity after ammonia nitrogen stress in Macrobrachium rosenbergii. Six experimental diets were formulated with 0, 25, 50, 100, 200, 400 mg/kg TTO, respectively. A total of 900 prawns (average initial weight, 0.39 ± 0.01 g) were randomly assigned to 6 groups in triplicate in 18 tanks. After an 8-week feeding trial, 20 prawns from each tank were changed with 20 mg/L ammonia stress for 24 h. The results showed that 100 mg/kg TTO significantly increased prawns performance and survival rate compared with the control group. Moreover, 100 and 200 mg/kg TTO significantly improved intestinal antioxidant capabilities by increasing SOD enzyme activities and decreasing MDA levels. In addition, the prawns fed with 100 mg/kg TTO diet showed the highest survival rate under ammonia stress. After ammonia stress, the group of 100 mg/kg TTO significantly improved antioxidant capacity by increasing hemolymph respiratory burst activity, as well as intestinal anti-superoxide anion activity and SOD. Coincidentally, 100 mg/kg TTO significantly upregulated the intestinal relative expression of antioxidant-related genes (peroxiredoxin-5). Further, it was found that 100 mg/kg TTO activated the toll-dorsal pathway in prawns, which performed the similar function as the classic NF-κB pathway by upregulating the TNF-α and IL-1. Finally, 100 mg/kg TTO increased the levels of iNOS activities and NO contents after ammonia stress and enhanced non-specific immunity. The results indicated that 100 mg/kg TTO could significantly improve the M. rosenbergii performance, antioxidant capacity and ammonia stress resistance. We suggested that the mechanisms may be attributed to that TTO enhanced the antioxidant capacity and non-specific immunity of M. rosenbergii via the NF-κB signal pathway. Copyright © 2021 Elsevier Ltd. All rights reserved. DOI: 10.1016/j.fsi.2021.12.025 PMID: 34929307 [Indexed for MEDLINE]
23. BMJ Open. 2021 Jul 29;11(7):e047380. doi: 10.1136/bmjopen-2020-047380. Treatment of tungiasis using a tea tree oil-based gel formulation: protocol for a randomised controlled proof-of-principle trial. Abrha S(1)(2), Christenson JK(1), McEwen J(1), Tesfaye W(3), Vaz Nery S(4), Chang AY(5), Spelman T(6), Kosari S(1), Kigen G(7), Carroll S(1)(8), Heukelbach J(9), Feldmeier H(10), Bartholomaeus A(11), Daniel M(12), Peterson GM(13), Thomas J(14). Author information: (1)Pharmacy, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia. (2)Department of Pharmaceutics, Mekelle University, Mekelle, Tigray, Ethiopia. (3)Pharmacy, Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia. (4)The Public Health Interventions Research Program, The Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, New South Wales, Australia. (5)Department of Dermatology, University of California San Francisco, San Francisco, California, USA. (6)Public Health, Burnet Institute International Health Research Group, Melbourne, Victoria, Australia. (7)Department of Pharmacology and Toxicology, Moi University School of Medicine, Eldoret, Central, Kenya. (8)Global School Partners, Canberra, Australian Capital Territory, Australia. (9)Department of Community Health, Federal University of Ceará, Fortaleza, Brazil, Fortaleza, Brazil. (10)Institute of Microbiology and Infection Immunology, Campus Benjamin Franklin, Charité University Medicine, Berlin, Germany. (11)Diamantina Institute, The University of Queensland, Woolloongabba, Queensland, Australia. (12)Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia. (13)School of Pharmacy, University of Tasmania, Hobart, Tasmania, Australia. (14)Pharmacy, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia Jackson.Thomas@canberra.edu.au. INTRODUCTION: Tungiasis (sand flea disease or jigger infestation) is a neglected tropical disease caused by penetration of female sand fleas, Tunga penetrans, in the skin. The disease inflicts immense pain and suffering on millions of people, particularly children, in Latin America, the Caribbean and sub-Saharan Africa. Currently, there is no standard treatment for tungiasis, and a simple, safe and effective tungiasis treatment option is required. Tea tree oil (TTO) has long been used as a parasiticidal agent against ectoparasites such as headlice, mites and fleas with proven safety and efficacy data. However, current data are insufficient to warrant a recommendation for its use in tungiasis. This trial aims to generate these data by comparing the safety and efficacy of a 5% (v/w) TTO proprietary gel formulation with 0.05% (w/v) potassium permanganate (KMnO4) solution for tungiasis treatment. METHODS AND ANALYSIS: This trial is a randomised controlled trial (RCT) in primary schools (n=8) in South-Western Kenya. The study will include school children (n=88) aged 6-15 years with a confirmed diagnosis of tungiasis. The participants will be randomised in a 1:1 ratio to receive a 3-day two times a day treatment of either 5% TTO gel or 0.05% KMnO4 solution. Two viable embedded sandflea lesions per participant will be targeted and the viability of these lesions will be followed throughout the study using a digital handheld microscope. The primary outcome is the proportion of observed viable embedded sand fleas that have lost viability (non-viable lesions) by day 10 (9 days after first treatment). Secondary outcomes include improvement in acute tungiasis morbidities assessed using a validated severity score for tungiasis, safety assessed through adverse events and product acceptability assessed by interviewing the participants to rate the treatment in terms of effectiveness, side effects, convenience, suitability and overall satisfaction. ETHICS AND DISSEMINATION: The trial protocol has been reviewed and approved by the University of Canberra Human Research Ethics Committee (HREC-2019-2114). The findings of the study will be presented at scientific conferences and published in a peer-reviewed journal. TRIAL REGISTRATION NUMBERS: Australian New Zealand Clinical Trials Registry (ACTRN12619001610123); PACTR202003651095100 and U1111-1243-2294. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. DOI: 10.1136/bmjopen-2020-047380 PMCID: PMC8323357 PMID: 34326048 [Indexed for MEDLINE] Conflict of interest statement: Competing interests: None declared.
24. Eye Contact Lens. 2021 Nov 1;47(11):604-610. doi: 10.1097/ICL.0000000000000807. Swabs Containing Tea Tree Oil and Chamomile Oil Versus Baby Shampoo in Patients With Seborrheic Blepharitis: A Double-Blind Randomized Clinical Trial. Mergen B(1), Arici C, Yildiz-Tas A, Bahar-Tokman H, Tokuc E, Ozturk-Bakar Y, Kutlubay Z, Sahin A. Author information: (1)Department of Ophthalmology (B.M.), University of Health Sciences, Basaksehir Cam ve Sakura City Hospital, Istanbul, Turkey ; Department of Ophthalmology (C.A.), Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey ; Department of Ophthalmology (A.Y.-T., A.S.), Koc University Medical Faculty, Istanbul, Turkey ; Department of Medical Microbiology (H.B.-T., E.T., Y.O.-B.), Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey; and Department of Dermatology (Z.K.), Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey. PURPOSE: The comparison of the efficacy of swabs containing tea tree oil and chamomile oil and baby shampoo (BS) in the treatment of seborrheic blepharitis was aimed. METHODS: This randomized, double-blind, parallel-group, active control, multicenter clinical trial included patients with seborrheic blepharitis using block randomization (BS, n=23; swabs, n=26). Patients were treated with BS or swabs for 8 weeks followed by 4 weeks of treatment withdrawal. Change in Blepharitis Symptom measure (BLISS), Demodex count, Ocular Surface Disease Index (OSDI) score, Schirmer test, tear breakup time (TBUT), noninvasive TBUT (NI-TBUT), corneal staining, and meibography at different visits (baseline, fourth, , and 12th week) were the main outcome measures. RESULTS: Patients in both groups showed similar baseline parameters (P>0.05). Patients using swabs showed significantly lower BLISS scores compared with patients using BS at the 4th, 8th, and 12th week visits (3.6±6.1 vs. 6.3±4.5 P=0.011; 1.1±2.8 vs. 6.6±6.7, P<0.001; 0.9±2.8 vs. 5.7±6.6, P=0.002, respectively). Patients using swabs showed improvement in OSDI scores after 8 weeks of treatment compared with the baseline visit (P<0.001). Despite a similar Demodex reduction effect in both treatment arms even after 4 weeks of treatment (P<0.001), both treatment modalities did not show any effect on the other parameters. CONCLUSION: Although both swabs and BS showed efficacy for the treatment of seborrheic blepharitis in terms of the Demodex reduction and symptomatic improvement, swabs may provide better symptomatic improvement. Four weeks of treatment discontinuation may not cause any recurrence in the symptoms or Demodex infestation. Copyright © 2021 Contact Lens Association of Ophthalmologists. DOI: 10.1097/ICL.0000000000000807 PMID: 34310352 [Indexed for MEDLINE] Conflict of interest statement: The authors have no funding or conflicts of interest to disclose.
25. Arch Dermatol Res. 2022 Sep;314(7):673-679. doi: 10.1007/s00403-021-02267-2. Epub 2021 Jul 12. A topical gel of tea tree oil nanoemulsion containing adapalene versus adapalene marketed gel in patients with acne vulgaris: a randomized clinical trial. Najafi-Taher R(1), Jafarzadeh Kohneloo A(2)(3), Eslami Farsani V(4), Mehdizade Rayeni N(4), Moghimi HR(5), Ehsani A(6), Amani A(7)(8). Author information: (1)Department of Medical Nanotechnology, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran. (2)Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran. (3)Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran. (4)Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. (5)Department of Pharmaceutics and Nanotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran. (6)Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. ehsanih@sina.tums.ac.ir. (7)Department of Medical Nanotechnology, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran. a.amani@nkums.ac.ir. (8)Natural Products and Medicinal Plants Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran. a.amani@nkums.ac.ir. Adapalene is used for treatment of acne vulgaris, a common dermatological disease. Nano-based carriers have been developed to improve solubility and bioavailability of adapalene and other acne treatment drugs. In our previous report, tea tree oil nanoemulsion containing adapalene gel (TTO NE + ADA Gel) showed appropriate physical and biological properties such as stability, viscosity, pH, size, morphology and biocompatibility in an animal model. The present study was designed to assess efficacy and safety of the TTO NE + ADA Gel in comparison with 0.1% adapalene marketed gel (ADA Marketed Gel). A total of 100 patients were randomized to receive TTO NE + ADA Gel or ADA Marketed Gel, once daily at night, for 12 weeks. Analysis for efficacy was conducted by acne lesion count (total, inflammatory and non-inflammatory) and acne severity index at weeks 4, 8 and 12 using generalized estimating equation along with the safety assessments in each measurement for assessing dryness, erythema, burning sensation and irritation. Significantly better reduction in total, inflammatory, and non-inflammatory acne lesions were reported for TTO NE + ADA Gel as compared to the ADA Marketed Gel overall and on each measurement occasion (p value < 0.001 for all). Mean acne severity index also reduced with TTO NE + ADA Gel significantly in comparison with ADA Marketed Gel (p value < 0.001). Dryness was the most common adverse effect reported in both groups and it was higher in TTO NE + ADA Gel group. In conclusion, TTO NE + ADA Gel compared to ADA Marketed Gel appears more effective in the treatment of acne vulgaris, with no important change in adverse effects. © 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. DOI: 10.1007/s00403-021-02267-2 PMID: 34251536 [Indexed for MEDLINE]
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