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- Tea Tree (Melaleuca alternifolia, Myrtaceae) Oil
- Acne
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Date:
01-31-2017 | HC# 071636-561
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Re: Review on Efficacy and Safety of Tea Tree Oil in Treating Acne
Hammer
KA. Treatment of acne with tea tree oil (melaleuca) products: a review of
efficacy, tolerability and potential modes of action. Int J Antimicrob Agents. 2015;45(2):106-110.
Acne,
which affects mostly adolescents and young adults, is caused by a combination
of factors, including excessive sebum production, inflammation, and the
presence of the bacterium Propionibacterium
acnes. Acne can cause physical discomfort, potential scarring, and emotional
stress. Although some prescription medications are available, many acne
sufferers self-treat with over-the-counter products, including tea tree (Melaleuca alternifolia, Myrtaceae) oil.
The aim of this review was to examine the efficacy, safety, and tolerability of
tea tree oil products for treating acne and address potential modes of action.
Tea
tree oil is a monoterpene-rich, lipophilic, essential oil that exhibits
broad-spectrum antimicrobial activity. It contains about 100 components, the
most abundant being terpinen-4-ol, which is typically about 40% of the oil.
Among the tea tree oil products for acne are face and body washes, soaps,
toners, treatment gels or lotions, spot or blemish sticks, and masks. Some
topical products combine tea tree oil with other acne treatment agents such as
benzoyl peroxide, salicylic acid, glycolic acid, or azelaic acid.
The
author's literature search, which was not described, identified seven publications
that systematically evaluated the efficacy of products containing tea tree oil
for treating acne. Six studies were published in full; one was published as an
abstract only. All studies included patients with mild-to-moderate acne.
The
earliest of the comparative studies was a double-blind study comparing the
efficacy of a 5% tea tree oil water-based gel (n=58) and a 5% benzoyl peroxide
water-based lotion (n=61) in treating acne.1 Applied twice daily for
eight weeks, both treatments significantly reduced inflamed lesions, with the
benzoyl peroxide producing better results than the tea tree oil. Both
treatments performed equally in reducing noninflamed lesions and erythema.
Darabi
et al. conducted a single-blind, comparative study of 5% tea tree oil gel and
2% erythromycin gel in 60 patients.2 After the twice-daily
applications of the study products for six weeks, the tea tree oil gel proved
significantly better than the erythromycin gel in reducing the number of acne
lesions.
A
six-week, double-blind, placebo-controlled trial, conducted by Enshaieh et al.,
compared the efficacy of 5% tea tree oil gel (n=30) with a placebo gel (n=30);
the product was applied and left on for 20 minutes twice daily.3 The
tea tree oil gel significantly reduced the number of lesions compared with
placebo gel. Compared with baseline, the tea tree oil gel resulted in a significant
decrease in total lesion count and an acne severity index.
Yadav
et al. studied the following three interventions in a four-week, open-label
study: 5% tea tree oil gel (n=46), 5% tea tree oil gel and a polyherbal tablet
(n=46), and the polyherbal tablet alone (n=48).4 All treatments
significantly improved the patients' acne; however, the investigators did not
conduct analyses to compare the three treatments to determine whether they
differed significantly in effectiveness.
In
their double-blind, split-face study, Kwon et al. compared 5% tea tree oil with
5% Lactobacillus-fermented hinoki
cypress (Chamaecyparis obtusa,
Cupressaceae) extract, with 34 patients in each group.5 The
investigators report that both treatments, applied twice daily for eight weeks,
significantly reduced the number of inflammatory lesions; the hinoki cypress
extract was significantly more effective than the tea tree oil.
Two
studies evaluated products containing tea tree oil combined with one or more
plant extracts. The first study6 compared an undescribed baseline
acne intervention (control, n=27) with the same program plus an essential oil
treatment containing a mixture of 3% tea tree oil and 2% lavender (Lavandula angustifolia, Lamiaceae) oil
in jojoba (Simmondsia chinensis,
Simmondsiaceae) oil (n=27) applied twice daily. After four weeks, the number of
acne lesions was reduced by 4.8% in the control group and by 9.2% in the
essential oil group. The second study, a four-week noncomparative study by Yoo
et al.,7 evaluated a cream containing 0.5% tea tree oil and 0.01% white
mulberry (Morus alba, Moraceae) bark
extract applied at an unspecified frequency to treat acne in 20 patients.
Compared with baseline, the number of acne lesions decreased by 28.7%.
Adverse
effects were reported with the use of tea tree oil products in five studies.
The effects were typical for topically applied acne treatments and occurred at
similar or lower rates than adverse effects reported with other medicated acne
products. Darabi et al.2 suggested that one or more patients
withdrew because of adverse effects.
Potential
modes of action for tea tree oil as an acne treatment include its antimicrobial
and anti-inflammatory activities. It exhibits antibacterial activity against a
range of clinically important bacteria, with most organisms inhibited at <2%
(per volume).
In
vitro and in vivo studies have shown that tea tree oil and its major components
can suppress inflammation. Clinical studies have reported reduced inflammation
following the application of tea tree oil for treating hemorrhoids, ocular
demodecosis, and tinea.
Several
of the studies reviewed here report tea tree oil products reduced the number of
lesions in patients with mild-to-moderate acne. In the comparative trials, tea
tree oil products were more effective in treating acne than placebo; their
efficacy was comparable to products containing benzoyl peroxide and
erythromycin. The oil's efficacy may be attributed to its antibacterial and
anti-inflammatory activities. Further studies are needed to corroborate these
findings.
—Shari Henson
References
1Bassett IB, Pannowitz
DL, Barnetson RS. A comparative study of tea-tree oil versus benzoylperoxide in
the treatment of acne. Med J Aust.
1990;153(8):455-458.
2Darabi R, Hafezi MA,
Akbarloo N. A comparative, investigator-blind study of topical tea tree oil
versus erythromycin gel in the treatment of acne. Abstract number: 1133_249. Presented
at: 15th European Congress of Clinical Microbiology and Infectious Diseases;
April 2-5, 2005; Copenhagen, Denmark.
3Enshaieh S, Jooya A,
Siadat AH, Iraji F. The efficacy of 5% topical tea tree oil gel in mild to
moderate acne vulgaris: a randomized, double-blind placebo-controlled study. Indian J Dermatol Venereol Leprol.
2007;73(1):22-25.
4Yadav N, Singh A,
Chatterjee A, Belemkar S. Evaluation of efficacy and safety of Perfact face gel
and Perfact face tablets in management of acne. J Clin Exp Dermatol Res. 2011;2:118. doi:
10.4172/2155-9554.1000118.
5Kwon HH, Yoon JY, Park
SY, Min S, Suh DH. Comparison of clinical and histological effects between Lactobacillus-fermented Chamaecyparis obtusa and tea tree oil
for the treatment of acne: an eight-week double-blind randomized controlled
split-face study. Dermatology.
2014;229(2):102-109.
6Kim BY, Shin S.
Antimicrobial and improvement effects of tea tree and lavender oils on acne
lesions. Journal of Convergence Information
Technology. 2013;8(13):339-345.
7Yoo JY, Park SH,
Hwang IA, et al. A clinical study on the effect of a cream containing ramulus mori
extract and tea tree oil on acne vulgaris and aerobic skin flora. Korean Journal of Dermatology.
2003;41(9):1136-1141.
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