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- Tea Tree (Melaleuca alternifolia)
- Dermatology
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Date:
12-30-2013 | HC# 081324-487
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Re: Applications of Tea Tree Oil in Dermatology
Pazyar
N, Yaghoobi R, Bagherani N, Kazerouni A. A review of applications of tea tree
oil in dermatology. Int J Dermatol. 2013;52(7):784-790.
Tea
tree oil (TTO) is obtained by steam distillation of terminal branch leaves of the
native Australian plant, Melaleuca
alternifolia. TTO (also known as "melaleuca oil") has
demonstrated effectiveness for various skin infections and inflammatory
immune-related skin disorders. This review is the first to summarize findings
of in vivo, in vitro, and clinical studies for applications of TTO in
dermatology.
Medical
literature searches were performed in two databases (PubMed and ISI Web of
Knowledge), limited to articles published in English from 1990 to February 2011
containing the terms "tea tree oil," "dermatology," and
equivalent terms. The search produced 47 references total. Results of the
search allowed information to be collected on the bioactive constituents of TTO
and its chemotypes, as well as any adverse effects and the mechanism of action
of TTO. A review of in vitro, in vivo, and clinical studies produced results on
studies testing TTO use for regulation of wheal and flare, and use of TTO as an
antioxidant, antibacterial, antiviral, antifungal, and antiprotozoal agent. Research
on use of TTO in treatment of acne vulgaris, seborrheic dermatitis, and wound
healing was also reviewed. Additional research included the antitumor activity
of TTO against melanoma and its potential use as a chronic gingivitis treatment.
TTO
is at least 30% terpinen-4-ol (a major component of TTO) and no greater than 15%
1,8-cineole. Topical application of TTO can cause adverse reactions at higher
concentrations. 1,8-cineole is an undesirable allergen, and adverse reactions
to TTO diminish with minimization of 1,8-cineole content.1 TTO can
be potentially toxic if ingested at high doses; however, no human deaths caused
by TTO were reported in the literature. In contrast to 1,8-cineole, terpinen-4-ol
exhibits strong antimicrobial and anti-inflammatory properties, mediated
through reduction of tumor necrosis factor (TNF), interleukin-1 (IL-1), IL-8,
IL-10, and prostaglandin E2 production. Commercial TTO products are of a terpinen-4-ol
chemotype.2
Topical
application of TTO has been shown to regulate wheal and flare by reducing histamine-induced
edema often associated with type I allergic immediate hypersensitivities.3-5 As for the
antibacterial activity of TTO, terpinen-4-ol has activity against methicillin-resistant
Staphylococcus aureus (MRSA) and
coagulase-negative staphylococcus. Research has shown TTO treatment to be
comparable to topical antibiotics against S.
aureus with no resistance detected, and washing with TTO effectively removed
MRSA from skin. Studies on the antibacterial activity of TTO show that TTO could
also be effective against oral bacteria, reducing the amount of plaque that
develops. Antiviral research shows that TTO has virucidal activity against
herpes simplex virus 1 (HSV-1) and HSV-2, and that TTO could be an effective treatment
of recurrent herpes labialis and hand warts caused by human papillomavirus.
Studies
on the antifungal activity of TTO demonstrate effectiveness against Madurella mycetomatis and Candida in vitro. In addition, randomized
controlled trials have demonstrated effectiveness for TTO use in treatment of interdigital
tinea pedis and distal subungual onychomycosis. Research on antiprotozoal
properties of TTO show that TTO is able to reduce growth of Leishmania major and Trypanosoma brucei, in addition to being
effective against Trichomonas vaginalis.
In vitro research demonstrated that no mites of Sarcoptes scabiei var. hominis
survived three hours of exposure to 5% TTO. The insecticidal characteristic may
be attributable to anticholinesterase activity of TTO. TTO has also shown
efficacy for treatment of eyelid demodex, improving demodicidosis.
The
rationale for TTO as treatment for acne vulgaris is formed on the basis that
TTO has demonstrated broad-spectrum antimicrobial and anti-inflammatory
properties in vitro. TTO could be used
as an alternative to antibiotics as emergence of antibiotic-resistant strains
is problematic. TTO treatment for seborrheic dermatitis is based on seborrheic
dermatitis being considered a superficial fungal skin disorder caused by an overactive
inflammatory response to colonization by the yeast Malassezia furfur. TTO exerts antifungal activity against Malassezia species, and the review
reported one study showing TTO was useful and well tolerated in the treatment
of dandruff.
The
authors found one study reporting use of TTO hydrogel for cooling burn wounds
and increasing the rate of wound healing in immediate and delayed applications.
Research on the antitumor activity has shown that TTO can inhibit growth of melanoma
cells, specifically, drug-resistant melanoma cells. Research reviewed also
mentioned use of the anti-inflammatory properties of TTO for topical treatment
of inflamed gingival tissues, and possibly chemotherapeutic periodontal
therapy.
This
present review highlights dermatological applications for which TTO (and its
main component terpinen-4-ol) has shown promise as treatment. The authors
suggest that, for conditions where TTO treatment is of benefit, further
research should be done to establish guidelines for application.
Adverse
side effects may include skin irritation and allergic contact dermatitis.
—Alexis
Collins
References
[1]Mondello F, De
Bernardis F, Girolamo A, Cassone A, Salvatore G. In vivo activity of
terpinen-4-ol, the main bioactive component of Melaleuca alternifolia Cheel (tea tree) oil against
azole-susceptible and -resistant human pathogenic Candida species. BMC Infect
Dis. 2006;6:158. doi: 10.1186/1471-2334-6-158.
2Carson CF, Hammer KA, Riley TV. Melaleuca alternifolia (tea tree) oil: a
review of antimicrobial and other medicinal properties. Clin Microbiol Rev. 2006;19(1):50-62.
3Khalil Z, Pearce AL, Satkunanathan N, Storer
E, Finlay-Jones JJ, Hart PH. Regulation of wheal and flare by tea tree oil:
complementary human and rodent studies. J
Invest Dermatol. 2004;123(4):683-690.
4Brand C, Townley SL, Finlay-Jones JJ,
Hart PH. Tea tree oil reduces histamine-induced oedema in murine ears. Inflamm Res. 2002;51(6):283-289.
5Koh
KJ, Pearce AL, Marshman G, Finlay-Jones JJ, Hart PH. Tea tree oil reduces
histamine-induced skin inflammation. Br J
Dermatol. 2002;147(6):1212-1217.
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