Evaluation of the efficacy of a topical chamomile-pumpkin oleogel for the treatment of plaque psoriasis: an intra-patient, double-blind, randomized clinical trial

Abstract

Background: Plaque psoriasis is a chronic inflammatory skin disease. Conventional treatments of psoriasis are not completely effective. In addition, unwanted side effects limit their long-term use. In this regard, developing new natural treatments with fewer side effects could be an alternative option. This study was designed to evaluate the efficacy and safety of topical chamomile-pumpkin oleogel (ChP) in treating plaque psoriasis.
 Methods: A total of 40 patients with mild-to-moderate plaque psoriasis were enrolled in this intra-patient, double-blind, block-randomized clinical trial. In each patient, bilateral symmetrical plaques were treated with ChP or placebo twice daily for four weeks. For clinical assessment, the Psoriasis Severity Index (PSI) and the Physician's Global Assessment (PGA) scale were evaluated at baseline and after the treatment. At the end of the study, patients' satisfaction with the treatment was evaluated using a visual analog scale (VAS) ranging from 0 to 10. For safety assessment, all treatment-related side effects were recorded.
 Results: Thirty-seven subjects (20 female, 17 male; age 20–60 years) completed the study. The mean decreases in the PSI score in the ChP group (4.09 +/- 2.24) were significantly (p = 0.000) greater than the placebo group (0.48 +/- 1.39). According to the PGA results, 13/37 (35%) of the ChP-treated plaques could achieve marked to complete improvement compared to 0% in the placebo group. Three patients dropped out from the study due to worsening of bilateral plaques during the first week of trial.
 Conclusion: Our results suggest that topically applied ChP could provide a safe and effective complementary option for psoriasis plaque management. IRCT registration code: IRCT2016092830030N1.

The Therapeutic Potential of Essential Oils in Managing Inflammatory Skin Conditions: A Scoping Review

“…Patients suffering from one of the above-mentioned inflammatory skin conditions may face disappointing results from the conventional treatment options and/or experience adverse drug reactions leading to premature termination of the therapy. If so, patients may be willing to try an alternative or complementary therapy, for instance, in the form of an EO, in the hope of better clinical outcomes and fewer adverse drug reactions [3,[7][8][9][29][30][31][32]. In this context, it is worth mentioning that a rising global trend has been found in the use of complementary medicines among psoriatic patients, especially in semi-urban areas where such therapies are favored due to their accessibility and affordability, as well as their presumed effectiveness and safety [33].…”

“…Three patients (7.5%) reported itching and irritations, which were more severe on the side treated with the ChP oleogel. The intervention and control products were extracted and prepared by the researchers without conducting additional analyses [31].…”

Can Essential Oils/Botanical Agents Smart-Nanoformulations Be the Winning Cards against Psoriasis?

“…Kolahdooz et al conducted several clinical studies to assess the efficacy of chamomile oil against plaque psoriasis. Symmetrical plaques were treated with chamomile, pumpkin oleogel and placebo, and there was an observed improvement in PASI scores, including erythema and scaling scores in chamomile and pumpkin oleogel groups compared to the placebo, with a low incidence of side effects [ 100 ]. Another study also proved that the efficacy of topical application of chamomile was equivalent to that of hydrocortisone and superior to diflucortolone, suggesting that chamomile oil could be an effective and safe treatment weapon against psoriasis and generally recognized as safe (GRAS) [ 101 ].…”

Polymeric Gels and Their Application in the Treatment of Psoriasis Vulgaris: A Review

“…Similarly, topical chamomile-pumpkin oleogel was not compared with the traditional drug form in Kolahdooz et al [ 162 ], which also does not enable us to conclude whether the oleogel form improves psoriasis vulgaris treatment. The active substances in the oleogel were M. chamomilla oil (47.5% mass) and C. pepo seed oil (47.5% mass).…”