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TREATMENT OF ALOPECIA AREATA WITH TOPICAL GARLIC EXTRACT

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Azar Maluki M.D. at T Lab Inc. (https://www.tlabdx.com)
Azar Maluki M.D.
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Thikrah M. Mahmood
Thikrah M. Mahmood
Thikrah M. Mahmood
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Qabas Neamah. Al-Hajjar at University Of Kufa Faculty of pharmacy
Qabas Neamah. Al-Hajjar
  • University Of Kufa Faculty of pharmacy
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Abstract: Background: Alopecia areata is a non scarring localized hair fall, probably of autoimmune ateology, that responds to treatment with many topically applied irritant substances. Garlic had been known for a long time by its unique chemical composition that has many pharmacological implications. Objective: To determine the efficacy of topical garlic extract in the treatment of alopecia areata. Methods: Ten patients complaining of single or multiple patches of alopecia areata on the scalp region (total of 18 patches) were enrolled in this study from July 2006 to July 2007, in the out patient clinic in Najaf city. All patches were treated by topical garlic extract twice daily, for two months. Re-growth of terminal coarse hairs was evaluated every two weeks. Results: Four females and six males were studied, their ages ranged from 10 – 45 years (mean 27 yrs.). Total of 18 patches of alopecia areata were treated. All patients (100%) responded to this treatment. Hair growth started by the end of second week in eight patches (44.4%), within four weeks in seven patches (38.9%), and within six weeks in three patches (16.7%). Erythema was observed in all patients, in addition to itching in 8 patches (44.4%) and burning sensation in 5 patches (27.7%). Conclusions: Garlic is an efficient and rapid topical treatment for alopecia areata. It is cheep, available and with negligible side effects.
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330
Kufa Med. Journal 2009. VOL.12 No.1 ___________________________
TREATMENT OF ALOPECIA AREATA WITH TOPICAL
GARLIC EXTRACT
Dr. Azar H. Maluki, DDV, FICMS, CABDV.*
Dr. Thikrha A. Mahmood, Msc. Community Medicine. **
Dr. Qabas N. Hadi, Msc. Biology. ***
*Assist. Prof. Head of Dep. Of Dermatology, University of Kufa, College of Medicine.
**Assist. Lecturer, Dep. of Community Medicine, University of Kufa, College of
Medicine.
***Assist. Lecturer, Dep. of Microbiology, University of Kufa, College of Pharmacy.
Keywords: Alopecia areata, Garlic extract
Correspondance and reprints to:
Dr. Azar Maluki, P.O. Box (450), AL-Najaf post office, Najaf, Iraq.
Email: azarmaluki@yahoo.com
ﺔﺻﻼﺨﻟﺍ:
ﺔﺳﺍﺭﺪﻟﺍ ﺔﻣﺪﻘﻣ: ﺮﻌﺷ ﻂﻗﺎﺴﺗ ﺐﺒﺴﺗ ﻲﺘﻟﺍ ﺔﻴﻋﺎﻨﻤﻟﺍ ﺽﺍﺮﻣﻻﺍ ﻦﻣ ﺐﻠﻌﺜﻟﺍ ءﺍﺩ ﺮﺒﺘﻌﻳ ﺝﻼﻌﻠﻟ ﻞﺑﺎﻗ ﻮﻫﻭ ﻲﻌﺿﻮﻣ
ﺔﻴﺋﺎﻴﻤﻴﻜﻟﺍ ﺩﺍﻮﻤﻟﺍ ﻦﻣ ﺪﻳﺪﻌﻟﺍ ﻰﻠﻋ ﻪﺋﺍﻮﺘﺣﺎﺑ ﻑﻭﺮﻌﻤﻟﺍ ﻡﻮﺜﻟﺍ ﺓﺩﺎﻣ ﺎﻬﻨﻤﺿ ﻦﻣﻭ ﺪﻠﺠﻠﻟ ﺔﺷﺪﺨﻤﻟﺍ ﺔﻴﺒﻄﻟﺍ ﺕﺍﺮﻀﺤﺘﺴﻤﻟﺎﺑ
ﻲﺟﻼﻌﻟﺍ ﻝﻮﻌﻔﻤﻟﺍ ﺕﺍﺫ.
ﺔﺳﺍﺭﺪﻟﺍ ﻑﺪﻫ: ﺎﻴﻌﺿﻮﻣ ﺐﻠﻌﺜﻟﺍ ءﺍﺩ ﺝﻼﻋ ﻲﻓ ﻡﻮﺜﻟﺍ ﺓﺩﺎﻣ ﺺﻠﺨﺘﺴﻣ ﺓءﺎﻔﻛ ﻢﻴﻴﻘﺗ. "
ﺔﺳﺍﺭﺪﻟﺍ ﻖﺋﺍﺮﻃ: ﺕﻻﺎﺣ ﺓﺮﺸﻋ ﺔﺳﺍﺭﺩ ﻢﺗ ﺔﻘﻄﻨﻣ ﻲﻓ ﺩﺪﻌﺘﻤﻟﺍ ﻭﺍ ﺩﺮﻔﻨﻤﻟﺍ ﻲﻌﺿﻮﻤﻟﺍ ﺐﻠﻌﺜﻟﺍ ءﺍﺩ ﻦﻣ ﻥﻮﻧﺎﻌﻳ ﻦﻤﻣ
ﺯﻮﻤﺗ ﻦﻣ ﺓﺮﺘﻔﻠﻟ ﻒﺠﻨﻟﺍ ﺔﻨﻳﺪﻣ ﻲﻓ ﺱﺍﺮﻟﺍ2006 ﺯﻮﻤﺗ ﻰﻟﺍ2007 . ﻮﻫ ﻊﻘﺒﻟﺍ ﻉﻮﻤﺠﻣ ﻎﻠﺑ18 ﺔﻌﻘﺑ . ﺝﻼﻌﻟﺍ ﻥﺎﻛ
ﺎﻴﻣﻮﻳ ﻥﺎﺗﺮﻣ ﺢﺴﻤﻟﺍ ﺭﺮﻜﻳﻭ ﻂﻗﺎﺴﺘﻟﺍ ﺔﻘﻄﻨﻣ ﻲﻓ ﻡﻮﺜﻟﺍ ﺔﺒﺣ ﺺﻠﺨﺘﺴﻤﻟ ﺮﺷﺎﺒﻤﻟﺍ ﻚﻟﺪﻟﺍ ﺔﻘﻳﺮﻄﺑ .ﻼﻌﻟﺍ ﺓﺮﺘﻓ ﺕﺮﻤﺘﺳﺍ ﺝ
ﻦﻴﻋﻮﺒﺳﺍ ﻞﻛ ﻢﺘﻳ ﺮﻌﺸﻟﺍ ﻮﻤﻧ ﺺﺤﻓ ﻥﺎﻛﻭ ﻦﻳﺮﻬﺷ ﺓﺪﻣ.
ﺔﺳﺍﺭﺪﻟﺍ ﺞﺋﺎﺘﻧ: ﻦﻴﺑ ﻢﻫﺭﺎﻤﻋﺍ ﺖﺣﻭﺍﺮﺗ ﺭﻮﻛﺫ ﺖﺳﻭ ﺙﺎﻧﺍ ﻊﺑﺭﺍ ﻰﻠﻋ ﺕﻻﺎﺤﻟﺍ ﺖﻠﻤﺘﺷﺍ10 ﻰﻟﺍ45 ﺔﻨﺳ) ﻂﺳﻮﺘﻣ
ﺮﻤﻌﻟﺍ27 ﺔﻨﺳ .( ﻥﺎﻛ ﺔﺠﻟﺎﻌﻤﻟﺍ ﻊﻘﺒﻟﺍ ﻉﻮﻤﺠﻣ18 ﺔﻌﻘﺑ . ﺮﻌﺸﻟﺍ ﻮﻤﻧ ﺃﺪﺑ ﺚﻴﺣ ﺕﻻﺎﺤﻟﺍ ﻊﻴﻤﺟ ﻲﻓ ﺓﺪﻴﺟ ﺔﺑﺎﺠﺘﺳﻻﺍ ﺖﻧﺎﻛ
ﻉﻮﺒﺳﻻﺍ ﻲﻓ ﻊﻘﺑ ﺔﻴﻧﺎﻤﺛ ﻲﻓ ﻲﻧﺎﺜﻟﺍ)44.4 ( % ﻊﻘﺑ ﺔﻌﺒﺳ ﻲﻓ ﻊﺑﺍﺮﻟﺍ ﻉﻮﺒﺳﻻﺍ ﻲﻓﻭ)38.9 (% ﺱﺩﺎﺴﻟﺍ ﻉﻮﺒﺳﻻﺍ ﻲﻓﻭ
ﻊﻘﺑ ﺔﺛﻼﺛ ﻲﻓ)16.7 .(% ﻲﻓ ﺔﻳﺪﻠﺟ ﺔﻜﺣ ﻰﻟﺍ ﺔﻓﺎﺿﺍ ﻊﻘﺒﻟﺍ ﺔﻓﺎﻛ ﻲﻓ ﺪﻠﺠﻟﺍ ﺭﺍﺮﻤﺣﺍ ﻰﻠﻋ ﺔﻴﺒﻧﺎﺠﻟﺍ ﺽﺍﺮﻋﻻﺍ ﺕﺮﺼﺘﻗﺍ
ﻊﻘﺑ ﺔﻴﻧﺎﻤﺛ)44.4 (% ﻊﻘﺑ ﺔﺴﻤﺧ ﻲﻓ ﺪﻠﺠﻟﺍ ﻲﻓ ﺔﻗﺮﺣﻭ)27.7.(%
ﺝﺎﺘﻨﺘﺳﻻﺍ: ﺐﻠﻌﺜﻟﺍ ءﺍﺩ ﺕﻻﺎﺣ ﺝﻼﻋ ﻲﻓ ﺔﻌﻳﺮﺴﻟﺍﻭ ﺔﺤﺟﺎﻨﻟﺍ ﺔﻴﺟﻼﻌﻟﺍ ﻕﺮﻄﻟﺍ ﻦﻣ ﺎﻴﻌﺿﻮﻣ ﻡﻮﺜﻟﺍ ﻡﺍﺪﺨﺘﺳﺍ ﺮﺒﺘﻌﻳ
ﺔﻴﺒﻧﺎﺠﻟﺍ ﺽﺍﺮﻋﻻﺍ ﻦﻣ ﻦﻜﻤﻣ ﺪﺣ ﻰﻧﺩﺍ ﺭﻮﻬﻇ ﻊﻣ ﻲﻌﺿﻮﻤﻟﺍ.
ﺢﻴﺗﺎﻔﻤﻟﺍ :ﻡﻮﺜﻟﺍ ﺺﻠﺨﺘﺴﻣ ، ﺐﻠﻌﺜﻟﺍ ءﺍﺩ .
331
Kufa Med. Journal 2009. VOL.12 No.1 ___________________________
Abstract:
Background: Alopecia areata is a non scarring localized hair fall, probably of
autoimmune ateology, that responds to treatment with many topically applied irritant
substances. Garlic had been known for a long time by its unique chemical composition
that has many pharmacological implications.
Objective: To determine the efficacy of topical garlic extract in the treatment of
alopecia areata.
Methods: Ten patients complaining of single or multiple patches of alopecia areata on
the scalp region (total of 18 patches) were enrolled in this study from July 2006 to July
2007, in the out patient clinic in Najaf city. All patches were treated by topical garlic
extract twice daily, for two months. Re-growth of terminal coarse hairs was evaluated
every two weeks.
Results: Four females and six males were studied, their ages ranged from 10 – 45 years
(mean 27 yrs.). Total of 18 patches of alopecia areata were treated. All patients (100%)
responded to this treatment. Hair growth started by the end of second week in eight
patches (44.4%), within four weeks in seven patches (38.9%), and within six weeks in
three patches (16.7%). Erythema was observed in all patients, in addition to itching in 8
patches (44.4%) and burning sensation in 5 patches (27.7%).
Conclusions: Garlic is an efficient and rapid topical treatment for alopecia areata. It is
cheep, available and with negligible side effects.
INTRODUCTION:
Alopecia areata is characterized by round or oval patches of nonscarring hair loss.
Men and women are equally affected and the prevalence is almost the same for all
ethnic groups [1],[2],[3] .It is a common disease and at any given time, about 0.2% of
people are involved with alopecia areata and 1.7% of the populations experience an
episode of alopecia areata during their lifetime [4],[5],[6] .
The etiology and pathogenesis of alopecia areata is still uncertain, but many factors
have been have been described in its pathogenesis, e.g., genetic, family history, the
atopic state, nonspecific immune and organ-specific autoimmune reactions, possible
emotional stress, infectious agents and neurological factors.
A range of treatments have been tried for the treatment of alopecia areata, such as
contact sensitizers, immunomodulators and biologic response modifiers [7],[8],[9],[10],[11]
.Though different medications with various efficacies have been used for long, no
definitive treatment has been introduced yet [1] .Garlic, onion and aromatherapy are
claimed to have hair growth promoting properties but the scientific basis is still lacking
[12],[13],[14] .Bacteria, fungi, protozoa and viruses have been shown to be sensitive to
crushed garlic preparations. Moreover, garlic has been reported to reduce blood lipids
and to have anticancer properties. The main active component present in large quantities
in garlic cloves is alliin , an oxygenated sulfur amino acid. In crushed garlic, alliin is
converted to allicin , which gives the garlic its therapeutic properties [15],[16] .
332
Kufa Med. Journal 2009. VOL.12 No.1 ___________________________
AIM OF THE STUDY:
To determine the efficacy of topical garlic extract in the treatment of alopecia areata.
PATIENTS AND METHODS : This study was a therapeutic trial to test the efficacy of topical garlic extract for two
months in patients with alopecia areata. The study was carried out between July 2006
and July 2007, in the out patient clinic in Najaf. Plant material is Allium sativum L. The garlic was blended and the extract was
achieved by crushing. Garlic extract was rubbed on the alopecia patches, twice daily for
two months. Re-growth of terminal coarse hairs was evaluated every two weeks.
Patients selected met the inclusion criteria of the study. Inclusion criteria included patients above five years of age, having up to three hairless
patches, overall extension of patches less than 10 cm² and duration of disease less than
one month. The patients with history of previous treatment, pregnant and lactating
women, eyelash and eyebrow involvement, ophiasis pattern and history of sensitivity to
garlic were excluded from the study. Before enrolment, patients were not receiving treatment with any other form of topical
or systemic medication.
RESULTS: Ten patients were enrolled in this study according to the inclusion criteria, four
females and six males .Their ages ranged from 10 - 45 years (mean 27 yrs.). All of them
completed the study. Total of 18 patches of alopecia areata were treated. All patients (100%) responded to
this treatment. Hair growth started at the end of second week of treatment in eight
patches (44.4%), after four weeks in seven patches (38.9%), and within six weeks in
three patches (16.7%). Erythema was observed in all patients, in addition to itching in 8
patches (44.4%) and burning sensation in 5 patches (27.7%). The results are illustrated in Table 1 and Figure 1, Figure 2.
TABLE 1: Course of treatment of alopecia areata
Percentage No. of cured patches
Duration of
Treatment
44.4% 8 Two weeks
38.9% 7 Four weeks
16.7% 3 Six weeks
333
Kufa Med. Journal 2009. VOL.12 No.1 ___________________________
A
B
Figure 1: Alopecia areata before (A) and four weeks (B) after treatment.
334
Kufa Med. Journal 2009. VOL.12 No.1 ___________________________
A
B
Figure 2: Alopecia areata before (A) and six weeks (B) after treatment.
335
Kufa Med. Journal 2009. VOL.12 No.1 ___________________________
DISCUSSION: In this study, hair growth was observed in all patients, no significant complications
were observed. Unfortunately, only a few studies have been done about the effectiveness of garlic
components in managing alopecia areata. Garlic is used all over the world for different
diseases. In Traditional Iranian Medicine (TIM), garlic was prescribed as a remedy for
different diseases such as infections, cancers, injuries, gastrointestinal dysfunctions and
cardiovascular diseases. Some therapeutic mechanisms of garlic are not clear. The hair
growth stimulating mechanisms of garlic are unknown yet. Different researchers have shown that alopecia areata is marked by autoimmune
assault on the hair follicle resulting in hair loss [17],[18] .The modulatory effects of garlic
on immune responses [19],[20],[21],[22],[23] .may justify its efficacy in alopecia areata. In a
comparative study by Sharquie et al ., crude onion juice applied topically in treatment of
patchy alopecia areata was compared with tap water; it was found that it can be
effective in treatment of alopecia areata [16]. Onion and garlic belong to a widely grown
vegetable family named Asparagus. Both of them contain diallyl disulfide, which may
provide their therapeutic effects [23] .Though different modalities of treatment, local and
systemic, have been used to induce hair re-growth; all of them have their own
complications and efficacies. The high spontaneous remission rate of alopecia areata,
sometimes makes it difficult to clearly assess the true efficacy of a given therapy [3].
CONCLUSION:
Garlic extract proved to be an effective topical treatment modality for early alopecia
areata.
REFRENCES:
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why? Dermatol Clin 1996; 14:739-44.
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11-Sharquie KE, Al-Obaidi HK. Onion juice (Allium cepa L.), a new topical treatment
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contact dermatitis to garlic ( Allium sativum L.). Identification of the allergens: the role
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(guinea-pig). Arch Dermatol Res 1983; 275:229-34.
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Induced immunosuppression in mice. Cancer Lett 1998;134:73-9.
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asparagus. An Sist Sanit Navar 2003;26:17-23
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  • Apr 2020
  • ARCH DERMATOL RES
Alopecia areata is a chronic inflammatory disease that characterized by round or oval patches of non-scarring hair loss. From the past, Urginea maritima (white squill) was used for the treatment of hair loss in Iranian traditional medicine. We aimed the comparison of Clobetasol lotion and squill extract efficacy in treatment of alopecia areata in a randomized, double-blind clinical trial. The 42 patients were randomized into two groups. Both groups received topical squill and clobetasol lotion twice daily lotion for 12 weeks. Clinical evaluation included size of patches (using 1×1 cm² schablone), total number of grown hair and number of terminal hair was performed every 2 weeks. Re-growth of terminal coarse hairs was evaluated using a semi-quantitative regrowth score (RGS) (0: no regrowth, 1: growth of <25%, 2: growth of 25-50%, 3: growth of 51-75%, 4: growth of >75%). There were significant differences between RGS4 in two groups after 2- and 3-month treatment (P<0.05). At the end of follow-up period, the mean hair growth rates increased significantly from 6.5 to 11.3 in squill group (P = 0.031) and it improved significantly from 10.3 to 17.9 in clobetasol group (P = 0.001). There were no significant differences between mean hair growth rates in two groups after 3-month treatment (P = 0.969). The lotion 2% of U. maritima bulbs extract showed good effect in 45% patients with patchy alopecia areata and showed moderate effect on re-growth of terminal hairs.
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... These results are promising as they signal increasing investigation into the use of natural and botanical products for the treatment of alopecia. Maluki [51] et al., (2009) were reported that alopecia areata is a non-scarring localized hair fall, probably of autoimmune etiology, that responds to treatment with many topically applied irritant substances. Garlic had been known for a long time by its unique chemical composition that has many pharmacological implications. ...
Medicinal Importance of Allium Species: A current review
Article
  • Mar 2017
Nature is a good friend of human. Plants are serving humanity from hundreds of the years. Herbal/ayurvedic medicines are used for the treatment of several diseases without any harm. Allium species are one of the remedial herbs with bioactive parts, that act as medicinal plant and cure diseases, their roots stems leaves and also juices are valuable for human health. Allium species like (Allium cepa, Allium sativum, Zingiber officinale) are studied for the treatment of cancer, cardiovascular diseases, inflammation, reducing blood sugar, baldness, gastric ulcer, colic diseases, oxidative damage, etc. These species are evaluated for their total phenolics, flavonoids, antioxidant activity, hepatoprotective and microbial study. Total phenolic content was examined spectrophotometrically with the Folin-Ciocalteu phenol reagent and total antioxidant activity were studied by the ferric reducing antioxidant power (FRAP) and diphenyl picryl hydrazyl (DPPH) methods. Watery and alcoholic concentrates in Pbs subjected to an antibacterial activity test using the agar well diffusion procedure against various contagious pathogenic microorganisms. HPLC and LC–MS/MS demonstrated the nearness of Gallic corrosive, ferulic corrosive, protocatechuic corrosive, kaempferol, curcumin and quercetin content can possibly contribute as a dietary supplement for controlling hyperglycemia, treatment of alopecia areata and oxidative anxiety connected diabetes complexities. The biological activities, chemical characteristics and used in pharmaceutics are well studied. Some of its major chemical components reported are volatile oils, steroids, diterpinoids, flavonoids and phenolic compounds.
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... Maluki [51] et al., (2009) were reported that alopecia areata is a non-scarring localized hair fall, probably of autoimmune etiology, that responds to treatment with many topically applied irritant substances. Garlic had been known for a long time by its unique chemical composition that has many pharmacological implications. ...
Medicinal Importance of Allium Species: A Current Review
Article
Full-text available
  • May 2017
Nature is a good friend of human. Plants are serving humanity from hundreds of the years. Herbal/ayurvedic medicines are used for the treatment of several diseases without any harm. Allium species are one of the remedial herbs with bioactive parts, that act as medicinal plant and cure diseases, their roots stems leaves and also juices are valuable for human health. Allium species like (Allium cepa, Allium sativum, Zingiber officinale) are studied for the treatment of cancer, cardiovascular diseases, inflammation, reducing blood sugar, baldness, gastric ulcer, colic diseases, oxidative damage, etc. These species are evaluated for their total phenolics, flavonoids, antioxidant activity, hepatoprotective and microbial study. Total phenolic content was examined spectrophotometrically with the Folin-Ciocalteu phenol reagent and total antioxidant activity were studied by the ferric reducing antioxidant power (FRAP) and diphenyl picryl hydrazyl (DPPH) methods. Watery and alcoholic concentrates in Pbs subjected to an antibacterial activity test using the agar well diffusion procedure against various contagious pathogenic microorganisms. HPLC and LC–MS/MS demonstrated the nearness of Gallic corrosive, ferulic corrosive, protocatechuic corrosive, kaempferol, curcumin and quercetin content can possibly contribute as a dietary supplement for controlling hyperglycemia, treatment of alopecia areata and oxidative anxiety connected diabetes complexities. The biological activities, chemical characteristics and used in pharmaceutics are well studied. Some of its major chemical components reported are volatile oils, steroids, diterpinoids, flavonoids and phenolic compounds.
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... Maluki [51] et al., (2009) were reported that alopecia areata is a non-scarring localized hair fall, probably of autoimmune etiology, that responds to treatment with many topically applied irritant substances. Garlic had been known for a long time by its unique chemical composition that has many pharmacological implications. ...
Medicinal Importance of Allium Species: A Current Review
Article
Full-text available
  • May 2017
Nature is a good friend of human. Plants are serving humanity from hundreds of the years. Herbal/ayurvedic medicines are used for the treatment of several diseases without any harm. Allium species are one of the remedial herbs with bioactive parts, that act as medicinal plant and cure diseases, their roots stems leaves and also juices are valuable for human health. Allium species like (Allium cepa, Allium sativum, Zingiber officinale) are studied for the treatment of cancer, cardiovascular diseases, inflammation, reducing blood sugar, baldness, gastric ulcer, colic diseases, oxidative damage, etc. These species are evaluated for their total phenolics, flavonoids, antioxidant activity, hepatoprotective and microbial study. Total phenolic content was examined spectrophotometrically with the Folin-Ciocalteu phenol reagent and total antioxidant activity were studied by the ferric reducing antioxidant power (FRAP) and diphenyl picryl hydrazyl (DPPH) methods. Watery and alcoholic concentrates in Pbs subjected to an antibacterial activity test using the agar well diffusion procedure against various contagious pathogenic microorganisms. HPLC and LC–MS/MS demonstrated the nearness of Gallic corrosive, ferulic corrosive, protocatechuic corrosive, kaempferol, curcumin and quercetin content can possibly contribute as a dietary supplement for controlling hyperglycemia, treatment of alopecia areata and oxidative anxiety connected diabetes complexities. The biological activities, chemical characteristics and used in pharmaceutics are well studied. Some of its major chemical components reported are volatile oils, steroids, diterpinoids, flavonoids and phenolic compounds.
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Development of topical patches releasing allicin using garlic extract
Article
  • Oct 2021
Introduction Treating hair loss of Alopecia areata is a quite challenge. The treatment not only needs to be effective but must meet specific requirements in terms of accurate dose, sustain release, comfortable application with aesthetic appearance. Thus, the study was designed to develop sustained release topical patches releasing allicin using different sources, including the extract from fresh and aged garlic, and commercially pure one. Methods Patches were formulated by solvent casting method using ethylene-vinyl acetate as backing layer and Carbopol® 971P NF (CP) as mucoadhesive polymer. Physicochemical properties were evaluated including weight, thickness, drug content, surface pH, moisture content, folding endurance, and swelling. In addition to in vitro diffusion study across the cellulose and Strat-M® membranes. Results Patches showed good physicochemical properties. No significant difference (p > 0.05) was obvious in the percentage of allicin diffused across cellulose membrane between patch A (loaded with commercial allicin), patch B1 (loaded with fresh garlic extract), and patch C (loaded with aged garlic extract). However, ethanol enhanced the diffusion of allicin. The percentage of allicin diffused across cellulose membrane over 20 h from patch E (45 mg CP, 2 mL fresh garlic extract—equivalent to 60 mg allicin—and 1 mL of ethanol) was 79.94%. The flux and permeability coefficients were 2.62 mg/cm²/h and 0.52 cm/h, respectively, with an enhancement ratio of 2.60 times the reference patch M (mashed garlic). Conclusion Promising development of topical patches of allicin using garlic extract as natural source with lower cost than the commercial pure allicin and higher aesthetic acceptance than the used mashed garlic.
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Garlic compounds modulate macrophage and T-lymphocyte function
Article
Full-text available
  • Jul 1991
  • Mol Biother
Organosulfur compounds of garlic have been shown to inhibit growth of animal tumors and to modulate the activity of diverse chemical carcinogens. There is also evidence that garlic may modulate antitumor immunity. In this study, we determined the effects of an aqueous garlic extract and a protein fraction isolated from the extract on the chemiluminescent oxidative burst of the murine J774 macrophage cell line and thioglycollate-elicited peritoneal macrophages obtained from BALB/c mice. T-lymphocyte activity was determined using mouse splenocytes incubated with phytohemagglutinin, labeled with [3H]-thymidine and assayed for lymphoproliferation. Significant dose-related augmentation of oxidative burst was observed with garlic extract and the protein fraction. The protein fraction also enhanced the T-lymphocyte blastogenesis. The data suggest that garlic compounds may serve as biological response modifiers by augmenting macrophage and T-lymphocyte functions.
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Contact dermatitis due to topical treatment with garlic in Hong Kong
Article
  • Apr 1991
Contact dermatitis due to garlic is usually due to handling of garlic for cooking. Among the Chinese, garlic is also used as a form of topical medicament. 8 patients developed contact dermatitis after rubbing the cut end of a fresh garlic bulb onto the skin to treat fungal and other infections at the groin, neck, lower limb, hand or face. The distribution and morphology of the lesions were different from the classical form as described in the literature. Repeated open application tests with fresh garlic were all positive and patch tests with garlic extract were all negative. 5 controls tested by repeated open application with fresh garlic juice were also positive and patch tests in 10 controls with garlic extract were also negative. The results confirmed that the contact dermatitis was due to irritation. The patients were treated successfully with topical fluorinated steroid. For prevention, the practice of direct application of fresh garlic onto the skin for treating infections should be discouraged.
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Allergic contact dermatitis to garlic (Allium sativum L.) identification of the allergens: The role of mono-, di-, and trisulfides present in garlic - A comparative study in man and animal (Guinea-pig)
Article
  • Feb 1983
Garlic (Allium sativum L.) water- and ethanol-soluble extracts were prepared and purified by column chromatography. They were tested on garlic-sensitive patients and showed that the allergenic fraction was well located in a few column chromatography fractions. Guinea-pigs were sensitized with garlic water-soluble extracts and tested (open epicutaneous tests) with several fractions. The presence of diallyldisulfide was detected in the sensitizing chromatographic fractions. Guinea-pigs were successfully sensitized to this product and cross-reacted to garlic; animals sensitized to garlic extracts cross-reacted to diallyldisulfide. Both groups reacted to allicin, an oxidized derivative of diallyldisulfide present in garlic. Garlic-sensitive patients showed positive tests to diallyldisulfide, allylpropyldisulfide, allylmercaptan and allicin.
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Garlic dermatitis
Article
  • Jun 1996
Allergic contact dermatitis to garlic usually has a typical clinical presentation but this is often masked if it presents concurrently with another form of hand dermatitis. Patch testing with 1% diallyl disulfide in petrolatum is recommended when garlic allergy is suspected.
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Treatment of alopecia areata (AA) with squaric acid dibutylester
Article
  • Feb 1996
  • INT J DERMATOL
Among contact allergens that are frequently used in the treatment of alopecia areata (AA), squaric acid dibutylester (SADBE) stands out for its good tolerability and its mild side effects. One hundred and forty-four patients with AA of varying degrees were treated with SADBE. Of these, 71 had AA affecting less than 50% of the scalp, and 73 had a severe form, including 13 patients with alopecia totalis (AT) and two with alopecia universalis (AU). The patients were treated using both traditional and nontraditional methods. In the less severe form, we obtained a 80% rate of regrowth, compared to the 49% of the more severe form including 13 cases of AT and the two of AU. The failure rate was higher for patients with the more severe form (29%) compared to a 7% rate only for patients with mild AA. We also observed four cases of initial regrowth on the side of the scalp opposite to the site of application ('castling phenomenon'). Among those patients who were treated with application of SADBE on the right side of the back, three displayed regrowth on the left side of the scalp, (i.e., on the opposite side) and in an area distant from the site of application; for two patients the regrowth began on the right side of the scalp and one of them also displayed growth of fine hairs in the right dorsal region, the site of application of the compound. Our data further support the hypothesis of a systemic action of SADBE; however, further confirmation on a larger sample of cases is needed.
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Sharma VK, Dawn G, Kumar BProfile of alopecia areata in Northern India. Int J Dermatol 35:22-7
Article
  • Jan 1996
  • INT J DERMATOL
Epidemiologic studies of alopecia areata (AA) are available from USA, Japan and European countries, but there is a paucity of literature on AA from Asian countries, especially from the Indian subcontinent. In a prospective, hospital-based study lasting for a decade (1983-1992), the epidemiology of AA was studied, including associated diseases and risk factors for development of severe AA. Simultaneously a similar study was carried out in age- and sex-matched controls. Eight hundred and eight patients (532 men, 276 women) and 572 age- and sex-matched controls (370 men, 202 women) were studied. The incidence of AA was 0.7% of new dermatology outpatients. The majority of patients (712, 88%) were below 40 years of age, including 196 children < 16 years of age (24%). Almost half (46%) of the women patients had onset of AA in childhood, compared to only 19% in men (P < 0.001). Alopecia was total, universal, or extensive in 154 patients (19%). An onset in the first two decades was more often associated with severe alopecia (P < 0.001), especially in men (P < 0.01). Alopecia areata was recorded in family members of 70 patients (9%), being more frequent in the severe forms of AA (16%). Evidence of atopy was recorded in a total of 146 instances (18%). The frequency of atopy was the same in circumscribed alopecia (18.1%) and severe alopecia (18.2%). Nail changes were found in 162 patients (20%) and were more frequent in 76 (47%) with the severe form of AA (P < 0.001). On 39 occasions (5%), autoimmune-related diseases were detected: vitiligo in 15 (1.8%), thyroid disorders in 8 (1%), lichen planus in 6 (0.7%), collagen vascular diseases in 5 (0.6%), diabetes mellitus in 4 patients (0.4%), and pemphigus foliaceus in 1 (0.1%) patient. Patients with family members having vitiligo (recorded in 5.9% of patients), were more frequently affected with severe alopecia (P < 0.001). Alopecia areata in North Indians showed a preponderance in men (M:F = 2:1) and the majority of persons with disease (88%) were below 40 years of age. Onset in childhood was more frequent in girls or women, but the incidence of severe alopecia was higher in boys or men with onset at an earlier age. Diseases associated with autoimmunity were seen in only 5% of patients. Atopy was found to be associated in 18% of patients, but its reported association with younger age of onset and severe alopecia was not confirmed. Presence of vitiligo in family members and onset before 20 years of age, especially in boys or men, were found to be risk factors for severe alopecia.
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Topical immunotherapy in Alopecia Areata: What, how, and why?
Article
  • Nov 1996
  • DERMATOL CLIN
At present the induction and elicitation of an ACD with potent contact allergens such as DCP appear to be the most effective, but still not definitively curative, approach in treating extensive forms of AA. Experimental data suggest that cytokines and growth factors such as IL 1 beta are involved in the pathogenesis of AA as well as the therapeutic effect mediated by contact sensitizers. It seems reasonable to assume that factors inherent in the late phase of ACD modulate a T-cell mediated mechanism responsible for AA, thus inducing hair regrowth. Such counteracting activities are most likely mediated by proinflammatory cytokines such as TNF-alpha, IL-10, or TGF-beta 1. This hypothesis may oversimplify the underlying immunologic mechanisms, but the effectiveness of topical immunotherapy in AA would be compatible with this concept. This mode of treatment is, however, a rather rough approach and recurrences are possible. It is hoped that advances in basic science will eventually allow us to find a more specific mode of treatment.
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Treatment of alopecia areata
Article
  • Nov 1996
  • DERMATOL CLIN
Some individuals question whether any treatment is effective in severe alopecia areata. Certainly many patients, especially those with mild disease, experience spontaneous hair regrowth; however, results of double-blind studies clearly indicate that some treatments do promote hair regrowth even in those with extensive disease. Some patients never show either spontaneous or treatment-related hair regrowth; others experience hair regrowth only while maintained on treatment, repeatedly losing hair within a few weeks of discontinuing treatment and regrowing it within several weeks after restarting treatment. Some patients who have been responsive to treatment may experience exacerbation of their disease such that even high-dose systemic steroids do not prevent the development of alopecia universalis. Some treatments appear to work on some patients some or all of the time, but no treatment appears to work on all patients all of the time. We would suggest a few practical points that we find useful: To maximize the potential for cosmetic hair growth in alopecia areata that is extensive or flaring, treat the entire scalp instead of "chasing" patches. Do not change any topical treatment sooner than 3 months after starting it; early regrowth may first be present at 3 months. Cosmetic regrowth may take a year or more to achieve. Maintenance treatment increases the likelihood of maintenance of cosmetic hair growth, but patches of hair loss may still come and go. Atopic patients who experience seasonal hair loss may benefit (ie, have less severe hair loss flares or respond more readily to topical therapy) by using an antihistamine or mast cell stabilizer prophylactically. Whether one looks at the therapeutic cup as half full or half empty, most patients urge us to continue to try to find safe, effective long-term treatments for this disease.
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Gilhar A, Ullmann Y, Berkutzki T, Assy B, Kalish RSAlopecia areata transferred to human scalp explants on SCID mice with T-lymphocyte injections. J Clin Invest 101: 62-67
Article
  • Feb 1998
Alopecia areata is a tissue-restricted autoimmune disease of the hair follicle, which results in hair loss and baldness. It is often psychologically devastating. The role of T lymphocytes in this disorder was investigated with cell transfer experiments. Scalp explants from patients were transplanted to severe combined immunodeficiency (SCID) mice and injected with autologous T lymphocytes isolated from involved scalp. T lymphocytes which had been cultured with hair follicle homogenate along with antigen-presenting cells were capable of inducing the changes of alopecia areata, including hair loss and perifollicular infiltrates of T cells, along with HLA-DR and ICAM-1 expression of the follicular epithelium. Similar changes were not noted in grafts injected with scalp-derived T cells that had not been cultured with follicular homogenate. These data indicate that alopecia areata is mediated by T cells which recognize a follicular autoantigen.
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Hair regrowth. Therapeutic agents
Article
  • May 1998
  • DERMATOL CLIN
Today there are new classes of hair growth promotors with proven efficacy. This article reviews the current state of the art agents for treatment of two of the most common forms of hair loss encountered in clinical practice, androgenetic alopecia and alopecia areata. Current therapeutic strategies are based on recent advances in the understanding of disordered hair growth. Practical treatment protocols are presented.
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