Effectiveness and Safety of Herbal Medicine for Atopic Dermatitis: An Overview of Systematic Reviews

Abstract

Objectives. Herbal medicine (HM) is attracting attention for treating atopic dermatitis (AD). This overview was conducted to summarize and critically evaluate the current systematic reviews (SRs) on HM for the treatment of AD. Methods. Through comprehensive searches, all relevant SRs on HM for AD published until May 2020 were included. The quality of included SRs was assessed using the AMSTAR-2 tool. Moreover, original randomized controlled trials (RCTs) included in the SRs were resynthesized to investigate the efficacy and safety of oral HM for AD. The quality of evidence for the main findings was evaluated using the GRADE approach. Results. Nine SRs were included in this overview. HM showed significantly better efficacy in terms of total effective rate (TER), itching and sleep symptom scores, quality of life, and the dose of topical treatment used compared with placebo. HM as a monotherapy and/or an adjunctive therapy to conventional medication (CM) showed significantly better results on the efficacy, symptom relief, and some laboratory parameters related to the inflammatory response. The methodological quality was generally low. When 58 original RCTs were reanalyzed, HM showed significantly lower SCORing Atopic Dermatitis (SCORAD) score and higher TER than the placebo or CM. In terms of the safety profile, HM was not significantly different from the placebo and was better than CM. The quality of evidence ranged from “moderate” to “very low.” Conclusion. The results suggested that HM as a monotherapy or an adjunctive therapy is promising for the treatment of AD. However, due to low methodological quality and low quality of evidence, further rigorous, well-designed, high-quality SRs, and RCTs are needed to make clinical recommendations on HM use.

Orthosiphon aristatus Alleviates Skin Barrier through Cytokines Regulation in DNCB- induced Atopic Dermatitis BALB/C Mice Model

“…Recently, complementary and supportive therapy like herbal medicine, have been reported more frequently and globally. Although evidences are limited, some herbal medicines administered topically and orally effective for treating AD [25]. Orthosiphon aristatus leaves extract is one of important herbal medicines.…”

Ovalicin attenuates atopic dermatitis symptoms by inhibiting IL-31 signaling and intracellular calcium influx

“…Topical calcineurin inhibitors and antihistamine drugs inhibit pruritus in AD patients by T-cell inactivation, but these drugs also cause side effects, including localized burning and stinging [ 25 – 26 ] . In contrast, herbal medicines efficiently improve AD symptoms and exert fewer side effects [ 27 ] . This study showed that ovalicin alleviates AD symptoms in a DNCB-induced AD mouse model by inhibiting IL-31 signaling and the inflammatory response more than Dexa does.…”

Effect of Astaxanthin on Anti-Inflammatory and Anti-Oxidative Effects of Astaxanthin Treatment for Atopic Dermatitis-induced Mice

“…Moreover, there is toxicity and side effects associateed ewith long-term use of antihistamines, immunosuppressants and local corticosteroids. Therefore, there is a need for new insight and therapeutic materials in the treatment of AD; natural products [25], and herbal medicines [26] have been studied.…”