Topical Treatment of Necrotising Herpes Zoster with Betulin from Birch Bark

Abstract

Betulin, a pentacyclic triterpene, is the main constituent of the outer bark of birches (Betula alba). In recent years, anti-microbial, anti-inflammatory and differentiation-promoting effects of betulin have been described. A betulinbased emulsion without preservatives and detergent emulsifiers can be prepared from birch bark extract. We report the successful treatment with betulin emulsion of a severe necrotising herpes zoster in an immunosuppressed patient who had not responded to a conventional topical treatment. The betulin emulsion was directly applied to the wounds without causing any side effects. The presented case report demonstrates impressive skin tolerance and wound-healing properties of the betulin emulsion. These should be further evaluated.

From a Traditional Medicinal Plant to a Rational Drug: Understanding the Clinically Proven Wound Healing Efficacy of Birch Bark Extract

“…Recently, efficacy of birch bark preparations has also been proven clinically. A case report described the successful treatment of necrotizing herpes zoster when using a birch bark emulsion [12]. Moreover, birch bark extract was found to be effective in the treatment of two patients suffering from a second degree burning [13].…”

Isolation of triterpene-rich extracts from outer birch bark by hot water and alkaline pre-treatment or the appropriate choice of solvents

“…In addition to exhibiting promising therapeutic properties, betulin is an excellent water-oil system emulsifier for the production of cosmetic products, demonstrating a positive anti-inflammatory side effect (Weckesser et al, 2010). It has been well established that these triterpenes can be extracted in good yields (20-40%) from outer birch bark with a great number of different organic solvents (Eckerman and Ekman, 1985;Kislitsyn, 1994).…”

Ex vivo Skin Permeation of Betulin from Water-in-Oil Foams

“…Wounds and injured skin of several types have been examined: actinic keratoses, surgical skin lesions and necrotizing herpes zoster [14,15,16,17], and the benefit of this dry TE in wound healing has been underlined. Besides, the molecular mechanism and ex vivo wound-healing models have been investigated [18].…”