Efficacy of a Morinda citrifolia Based Skin Care Regimen

Abstract

A six week clinical trial of a Morinda citrifolia (noni) based skin care regimen was conducted with 49 women, ages 38 to 55 years. Daily application of three product formulations to the face and neck resulted in significant reductions in lateral canthal fine lines and wrinkles (crow's feet), as measured by technician scoring and digital image analysis. Use of the regimen also improved skin elasticity and firmness Cutometer® measurements. No evidence of skin irritation was present in any participant at any time during the trial. A study questionnaire revealed that the measured improvements were visibly perceptible to more than 90% of the participants. The trial results substantiate traditional uses of the noni plant to improve skin health.

Full text

Current Research Journal of Biological Sciences 4(3): 310-314, 2012
ISSN: 2041-0778
© Maxwell Scientific Organization, 2012
Submitted: January 19, 2012 Accepted: February 08, 2012 Published: April 05, 2012
Corresponding Author: Brett J. West, Research and Development Department, Morinda, Inc., American Fork, Utah, USA Tel.:1
(801) 234-3621 310
Efficacy of a Morinda citrifolia Based Skin Care Regimen
Brett J. West and Rachel A. Sabin
Research and Development Department, Morinda, Inc., American Fork, Utah, USA
Abstract: A six week clinical trial of a Morinda citrifolia (noni) based skin care regimen was conducted with
49 women, ages 38 to 55 years. Daily application of three product formulations to the face and neck resulted
in significant reductions in lateral canthal fine lines and wrinkles (crow’s feet), as measured by technician
scoring and digital image analysis. Use of the regimen also improved skin elasticity and firmness Cutometer®
measurements. No evidence of skin irritation was present in any participant at any time during the trial. A study
questionnaire revealed that the measured improvements were visibly perceptible to more than 90% of the
participants. The trial results substantiate traditional uses of the noni plant to improve skin health.
Key words: Clinical trial, Morinda citrifolia, noni, skin care
INTRODUCTION
Morinda citrifolia, commonly known as noni, is a
widely distributed tropical tree. It grows on the islands of
the South Pacific, Southeast Asia, Central America,
Indian subcontinent, and in the Caribbean. The fruit and
leaves of this tree have a history of use both as food and
for the promotion of health (Morton, 1992). The leaves
were found by indigenous people to be particularly useful
in treating various types of inflammation and poisonous
fish and insect stings (Cambi and Ash, 1994; Dittmar,
1993). The leaves are reported to have been one of the
leading plants used in the Marquesas Islands to treat
topical inflammation, as well as in Rotuma for burns
(Brown, 1935; McClatchey, 1993). In a clinical trial, noni
leaf extracts have been shown to provide protection to the
skin against ultraviolet light induced erythema (West et
al., 2009). Such anti-inflammatory activity could help
prevent premature aging of the skin. Noni fruits were also
used by Pacific Islanders to treat skin conditions, such as
boils and ulcerated sores (Whistler, 1992; Weiner, 1970).
The fruit was also used to treat a condition described as
“spreading dark spots on the skin” and as an emollient
(Dittmar, 1993).
All of the aforementioned properties indicate
potential utility of noni fruit and leaf derived ingredients
in skin care products. Potential benefits may include
prevention or reduction of the appearance of facial
wrinkles and improvement in skin elasticity. However,
such skin care properties, as constituted in a format that is
useful to consumers, have not been adequately evaluated
in a human trial. The purpose of our investigation was to
evaluate both the safety and efficacy of a skin care
regimen involving the use of three noni based products
formulated to improve the appearance of facial fine lines
and wrinkles, as well as improve skin elasticity.
MATERIALS AND METHODS
Noni fruits were harvested in French Polynesia and
allowed to fully ripen. The fruit was then processed into
a puree by mechanical removal of the seeds and skin,
followed by pasteurization at a good manufacturing
certified fruit processing facility in Mataiea, Tahiti. Noni
seeds were collected from discarded material from the
noni fruit finishing process on the island of Tahiti. Seeds
were washed and dried. Following drying the seeds were
cracked and ground to 2-20 mm particle size. The flaked
seeds were then pressed in a screw press to expel the oil,
followed by an additional oil extraction. Fresh noni leaves
were collected from the Society Islands of French
Polynesia and shipped to the main island of Tahiti. There,
the leaves were pressed in a cloth copra press to extract
the juice. These ingredients were incorporated into three
investigational products to be used as a skin care regimen.
These included a cream for the skin surrounding the eyes
(referred to as an eye treatment), an emulsion (referred to
as a serum) to apply to cleansed facial skin, and a cream
to be applied to the face at night (referred to as a night
cream). The eye area treatment included (in order of
predominance) noni fruit juice, noni seed oil, and noni
leaf juice. The facial serum included noni leaf juice and
noni seed oil. The night cream contained noni fruit
juice and noni seed oil. All products contained

Curr. Res. J. Biol. Sci., 4(3): 310-314, 2012
311
other functional ingredients in addition to the noni based
ingredients.
Forty-nine women, ages 38 to 55 years, were enrolled
in and completed the clinical trial. Two of the participants
were Hispanic. The remaining women were Caucasian.
Inclusion criteria were: a fine line and wrinkle score of
five (noticeable) or greater in the lateral canthi (crow’s
feet areas), ability to give written informed consent, and
ability to complete the study. Exclusion criteria were
visible skin disease, sunburn or suntan during the study,
participation in concurrent research trial involving the
face, use of medication which may interfere with the
study, dermabrasion or laser resurfacing on the face
within the previous 2 years, chemical face peel within the
previous year, superficial peel in the past two months, or
surgical cosmetic procedures within the previous 10
years. Exclusion criteria also included the presence of
acne, psoriasis, or active eczema, history of cancer,
current treatment for asthma or diabetes, and known
sensitivities to cosmetics or personal care products.
All women were provided with investigational
products, were given instructions on the use of the
products, and were provided with a daily diary.
Participants were instructed to record in the diary the
dates and times the products were used, as well as any
comments they had while using the products. They were
also instructed to abstain from using any new skin care or
cosmetic products. They were also asked to refrain from
using any other anti-aging treatments, serums, eye
treatments, or eye creams during the trial. For six weeks,
the participants were to follow a daily skin care regimen.
This regimen involved applying the eye treatment, every
morning and night, to the cleansed skin surrounding the
eyes. It also involved applying the serum, every morning
and night, over the cleansed face and neck, with an
upward and outward motion. This step was to be
completed prior to applying moisturizer. The final step in
the daily regimen was to massage the night cream onto
the cleansed face and neck, with an upward and outward
motion, every evening.
Baseline evaluations of the participants were made
just prior to the in-use phase of the trial. Evaluations were
made with participants having freshly washed faces, with
no cosmetic or skin care products applied to the eye and
facial areas. The same evaluation procedures were
followed after two, four, and six weeks of following the
skin care regimen. A trained technician scored lateral
canthal wrinkles according to a semi-quantitative scale, as
follows: 0 = none; 1 to 3 = slight; 4 to 6 = noticeable; and
7 to 9 = very noticeable. Digital images of the face from
the front, right and left side views were also taken of each
participant during each visit. Parallel and cross-polarized
lighting were used to obtain digital images. Images were
also obtained with fluorescent lighting. To standardize the
evaluation of the images, each participant was draped in
black cloth around the shoulders and wore a black
headband to cover and pull hair away from the face.
Digital images were analyzed with Image-Pro® software
(Media Cybernetics, Bethesda, MD, USA) to determine
changes in lateral canthal mean wrinkle score. This was
done by calculating the mean wrinkle width, in pixels, for
each image obtained at baseline and weeks two, four, and
six. Percent changes from baseline of both the semi-
quantitative and digital image derived wrinkle scores were
compared with Student’s t-test and the Wilcoxon signed-
rank test.
The elasticity and firmness of the skin, in mm vertical
deformation under controlled partial vacuum, was
measured on the face of each participant with a
Cutometer® (Courage+Khazaka, Cologne, Germany), a
device that is widely used in skin health research (Dobrev,
2002). Percent increases from baseline in skin elasticity
and firmness were compared with Student’s t-test and the
Wilcoxon signed-rank test. Irritation of the facial skin was
also evaluated visually at each visit by a trained
technician. Visible evidence of irritation was scored
accordingly: 0 = no irritation; + = irritation barely
perceptible; 1 = mild irritation; 2 = moderated irritation;
3 = marked irritation; 4 = severe irritation. At the end of
six weeks, each participant completed a questionnaire,
summarized in Table 1, concerning the perceived efficacy
of the skin care regimen.
All statistical analyses were conducted with JMP®
statistical software (SAS Institute, Cary, NC, USA). The
study complied with the regulations governing good
clinical practices, as described in the U.S. Code of Federal
Regulations, Title 21, Part 50. Written informed consent
was obtained from each participant in the study.
RESULTS AND DISCUSSION
The methods used to assess fine lines and wrinkles
are typical of those reported in previous publications
(Callaghan and Wilhelm, 2008). Technician scored lateral
canthal lines (crow’s feet) were significantly reduced with
use of the skin care regiment, Table 2. This decrease
appeared to occur within the first two weeks of product
use, as mean scores remained constant through the
remainder of the trial. The more sensitive digital image
analysis also revealed significant wrinkle reductions due
to the skin care regimen, Table 2. But unlike the
technician scored values, mean lateral canthal line widths
continued to decrease throughout the entire trial period.
By the sixth week, participants experienced a 7.4%
average decrease in crow’s feet lines and wrinkle widths.
The percentage of participants experiencing a reduction in
fine lines and wrinkles, based on the image analysis,
increased throughout the trial to 96% by the end of six
weeks.

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Table 1: Participant questionnaire prompts, statements and possible answers
Graded prompts Possible responses to graded prompts
Lessening of the appearance of crow's feet fine lines/wrinkles Extremely noticeable change
Improved skin firmness -- skin has become more firm. Very noticeable change
Improved skin elasticity. Noticeable change
Lessening of the appearance of age spots/skin discolorations. Slight change
Skin tone appears more "even". No change
Skin appears "healthier" since applying the product.
Skin appears “younger” since applying the product.
Statements of agreement Possible responses to statements
After using the product, the overall quality of my skin improved. Agree
After using the product, I would purchase it if it were available on the market. Disagree
After using the product, I would recommend it to a friend.
Fig. 1: Reduction in lateral canthal fine lines and wrinkles (crow’s feet) of a 52 year old female
Table 2: Lateral canthal wrinkle scores (mean±standard deviation)
Mean % decrease
Week Mean score from baseline
Technician evaluation
0 (baseline) 6.2±1.2 -
2 5.7±0.7* 4.9
4 5.7±0.7* 5.3
6 5.7±1.2* 5.3
Digital image analysis
0 (baseline) 7.0±0.5 -
2 6.8±0.4** 3.7
4 6.7±0.5** 5.3
6 6.5±0.4** 7.4
*: Statistically significant difference from baseline (p<0.05); **:
Statistically significant difference from baseline (p<0.001)
Table 3:Cutometer® measurements, in mm of vertical deformation
(mean±standard deviation), of facial skin elasticity/firmness
No. of individuals
Week Mean score improved from baseline
0 (baseline) 0.559±0.145 -
2 0.651±0.128* 32
4 0.624±0.182* 30
6 0.613±0.142 27
*: Statistically significant difference from baseline (p<0.05)
An example of the reduction in fine lines and wrinkles of
one of the participants, a 52 year old female, is
presented in Fig. 1. Skin elasticity and firmness improved
throughout the trial period, Table 3. Mean Cutometer®
measurements were significantly greater by the second
week of following the skin regimen. Week two and four
average elasticity/firmness readings were, respectively,
42.4 and 33.8% greater than baseline values. At the
end of the trial, mean facial skin elasticity/firmness was
greater than prior to the start of the study, but not as great
as during the previous two visits. However, 55% of
participants had measureable increases in elasticity and
firmness by the end of the trial. The data suggest that the
greatest improvement occurs within the first two weeks of
product use.
The skin care regimen was found to be non-irritating.
In fact, no signs of facial irritation were observed in any
participant and any time during the trial. This finding is
consistent with a previously reported repeat insult patch
test of extracts made from noni leaves (West et al., 2009),
as well as the traditional uses of the plant to sooth
inflamed skin.
Responses to the questionnaire provide some insight
into the perceived efficacy of the products in the skin care
regimen, Table 4. Consistent with the results of the
technician scored and digital image analyses, at least 92%
of the participants reported some degree of change in the
reduction of the appearance of fine lines and wrinkles,
while 96% reported increased skin firmness and elasticity.
The questionnaire also revealed that 92% of the
participants felt that a decrease in the appearance of age
spots/skin discolorations had occurred. The perceived
reduction in skin discoloration is of particular interest, as
bioactive constituents of noni have been reported to
inhibit the process of melanogenesis (Masuda et al.,
2012). The percentage of subjects who felt that some
improvement had occurred in skin tone, appearance of
healthy skin, and appearance of younger skin was 84,

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Table 4: Questionnaire responses at completion of skin care regimen trial. Results are expressed as percentages of the total responses for each prompt
or statement Percentage of responses
-----------------------------------------------------------------------------------------------------------------------
Extremely noticeable Very noticeable Noticeable change Slight change No change
change change
Lessening of the appearance of 10.2 18.4 38.8 24.5 8.2
crow's feet fine lines/wrinkles
Improved skin firmness -- skin 12.2 22.4 36.7 24.5 4.1
has become more firm
Improved skin elasticity 14.3 18.4 38.8 20.4 8.2
Lessening of the appearance of 6.1 16.3 32.7 36.7 8.2
age spots/skin discolorations
Skin tone appears more "even" 2.0 34.7 30.6 16.3 16.3
Skin appears "healthier" since 16.3 28.6 34.7 16.3 4.1
applying the product
Skin appears "younger" since 8.2 22.4 30.6 30.6 8.2
applying the product Agree Disagree
After using the product, the 87.8 12.2
overall quality of my skin improved.
After using the product, I would purchase 87.8 12.2
it if it were available on the market.
After using the product, I would 87.8 12.2
recommend it to a friend.
96 and 92, respectively. Generally, the largest group of
participants felt that these changes were “noticeable”,
with a smaller number reporting “very noticeable” or
“extremely noticeable” changes. All but a small
fraction of study participants felt that the skin care
regiment improved the overall quality of the skin and
indicated that they would use the product, or
recommend it to a friend, if available on the market.
CONCLUSION
The results of the six week clinical trial of the
safety and efficacy of a noni based skin care regimen
appear to substantiate the traditional uses of the noni
plant for the improvement of skin health. Significant
improvements in the appearance of fine lines and
wrinkles and skin elasticity and firmness were evident.
These benefits appeared within two weeks of product
use. Consistent with traditional use and previous safety
tests of noni leaf extract, the products of the regimen
were nonirritating. The current trial has demonstrated
the safety and potential utility of noni derived
ingredients for the improvement of skin health and
appearance.
ACKNOWLEDGMENT
Support for this study was provided by Tahitian
Noni International, Inc. Study conduct was carried out
under the direction of Annemarrie Hollenback, Essex
Testing Clinic, New Jersey, U.S.A. The investigational
products (Defy brand Face Lifting Night Cream, Age
Erasing Serum, and Renewing Eye Treatment) were
provided by Tahitian Noni International, Inc.
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