ArticlePDF Available

Analysis of the Antimicrobial Properties of Thanaka, a Burmese Powder Used to Treat Acne

January 2017
Journal of Biosciences and Medicines 05(07):1-6

DOI:10.4236/jbm.2017.57001

License
CC BY 4.0

Authors:

Kirby-Bauer disk diffusion results: (a) E. coli and (b) S. aureus on MHA with clindamycin and buffer controls and varying concentrations of thanaka disks (values listed in mg/ml) (c) and (d) P. acnes on Brucella blood agar with the clindamycin and buffer controls and varying concentrations of thanaka disks (values listed in mg/ml, c = control, Cl = clindamycin).

…

Figures - available via license: Creative Commons Attribution 4.0 International

Content may be subject to copyright.

Available via license: CC BY 4.0

Content may be subject to copyright.

Journal of Biosciences and Medicines, 2017, 5, 1-6

http://www.scirp.org/journal/jbm

ISSN Online: 2327-509X

ISSN Print: 2327-5081

DOI: 10.4236/jbm.2017.57001 July 13, 2017

Analysis of the Antimicrobial Properties of

Thanaka, a Burmese Powder Used to Treat

Acne

Elizabeth V. Seiverling, Jordan P. Trubiano, Jacqueline C. Williams, Hadjh T. Ahrns,

David W. Craft, Matthew R. England

Departments of Dermatology, Family and Community Medicine, and Pathology, Pennsylvania State University - Milton S.

Hershey Medical Center, Hershey, PA, USA

Abstract

Thanaka, powder from Hesperethusa crenulata tree bark, has been used in

Burmese culture for acne treatment and prevention for over 2

000 years. The

purpose of this study was to evaluate the antimicrobial properties of thanaka

against

Staphylococcus aureus

Escherichia coli

, and

Propionibacterium acnes

Kirby-Bauer disk diffusion re

vealed no zones of inhibition for thanaka against

the tested microorganisms. Disk diffusion may not be the best modality for

definitive analysis of the antimicrobial activity of thanaka. Furthermore, the

utility of thanaka in acne treatment may be related to anti-inflammatory, r

ther than antimicrobial properties.

Keywords

Thanaka, Myanmar, Disk Diffusion,

Propionibacterium acnes

1. Introduction

Thanaka (also spelled thanakha) is a powder produced from the bark of

Hespe-

rethusa crenulata

Naringi crenulata

trees (Figure 1(a)). Thanaka is used for a

variety of cosmetic and dermatologic purposes including photo-protection, acne

treatment and prevention, skin cooling, skin lightening, pruritus relief, scar re-

duction, mosquito repellant, and odor prevention (Figure 1(b)) [1] [2] [3] [4].

Acne treatment and prevention were the most commonly reported reason for

applying thanaka to the skin in persons 12 - 16 years old [4].

P. acnes

is involved

in the release of proinflammatory mediators in the pilosebaceous unit and leads

to inflammatory papules, pustules, and nodules on the skin as seen in acne vul-

garis [5]. Thus, inhibition of

P. acnes

with topical antibacterial agents such as

How to cite this paper:

Seiverling, E.V.,

Trubiano, J

.P., Williams, J.C., Ahrns, H.T.,

Craft, D

.W. and England, M.R. (2017

)

Analysis of the Antimicrobial Properties of

Thanaka, a Burmese Powder Used to Treat

Acne

Journal of Biosciences and Med

cines

, 1-6.

https://doi.org/10.4236/jbm.2017.57001

Received:

May 17, 2017

Accepted:

July 9, 2017

Published:

July 13, 2017

7 by authors and

Scientific

Research Publishing Inc.

This work is licensed under the Creative

Commons Attribution International

License (CC BY

4.0).

http://creativecommons.org/licenses/by/4.0/

Open Access

E. V. Seiverling et al.

(a) (b)

Figure 1. Thanaka powder and application: (a) An example of thanaka powder produced

from the bark of

Hesperethusa crenulata

Naringi crenulata

trees and (b) An example

of direct topical application of thanaka on the face of a Burmese woman.

benzoyl peroxide or blockade of its downstream inflammatory effects is key in

treatment for acne [6]. One previous study reported that thanaka possesses some

anti-microbial properties against

E. coli

and

S. aureus

using a minimum inhibi-

tory concentration (MIC) assay [7]. The purpose of our study was to evaluate the

antimicrobial properties of thanaka against

P. acnes

S. aureus

and

E. coli

using

Kirby-Bauer disk diffusion and Clinical and Laboratory Standards Institute

(CLSI) breakpoints [8].

2. Methods

2.1. Preparation of Antimicrobial Disks

Kirby-Bauer disks impregnated with thanaka are not commercially available.

Thus, thanaka-laced antimicrobial disks were first created mimicking how tha-

naka is typically used in Myanmar: ground into powder, mixed with water, and

applied directly to the faceas a paste (Figure 1(b)). However, the thanaka was

not completely soluble in water. In an attempt to improve solubility, thanaka

was dissolved into 95% ethanol: water: tween 20 (5:93.5:1.5), to create 1, 5, and

10 mg/ml solutions, as reported in Wangthong

et al

. [7]. Sterile 6 mm blank pa-

per disks (Becton Dickinson, Cat #231039) were impregnated by soaking in the

thanaka solutions for 30 min.

2.2. Clinical and Laboratory Standards Institute (CLSI)

Kirby-Bauer Disk Diffusion

Isolates of

E. coli (

ATCC 25922),

S. aureus

(ATCC 25923), and

P. acnes

(clinical

isolates identified by matrix-assisted laser desorption/ionization time-of-flight

mass spectrometry) were isolated on 5% sheep-blood agar (Becton Dickinson,

Cat# 221261). Mueller-Hinton agar plates were inoculated with 1:10 dilutions of

0.5 McFarland bacterial solutions [8]. The following antimicrobial disks were

applied to each plate: 1 each of clindamycin (positive control, Beckton Dickin-

son, Cat #231213), ethanol: water: tween 20 (5:93.5:1.5) (negative control) and 2

each of the 1, 5, and 10 mg/mL thanaka-impregnated disks (Figure 2). Plates

were incubated at 24 h at 35˚C for

E. coli

and

S. aureus

and 48 h under anaerob-

ic conditions at 35˚C for

P. acnes

following CLSI protocol

E. V. Seiverling et al.

Figure 2. Kirby-Bauer disk diffusion results: (a) E. coli and (b) S. aureus on MHA with

clindamycin and buffer controls and varying concentrations of thanaka disks (values

listed in mg/ml) (c) and (d) P. acnes on Brucella blood agar with the clindamycin and

buffer controls and varying concentrations of thanaka disks (values listed in mg/ml, c =

control, Cl = clindamycin).

3. Results

The measured zone of inhibition for clindamycin was 33 mm against

S. aureus

consistent with CLSI guidelines (Figure 2) [8]. The measured zones of inhibition

for clindamycin against

E. coli

was 0 mm and against

P. acnes

was 48 mm; how-

ever there are no disk diffusion guidelines published for clindamycin against

coli

P. acnes

(Figure 2) [8]. There were no zones of inhibition for the disks of

1, 5, and 10 mg/ml thanaka or the negative control disks against

S. aureus

E. co-

or P. acnes

(Figure 2).

4. Discussion

In an attempt to study the antimicrobial properties of thanaka, the Kirby-Bauer

disk diffusion protocol was utilized [8] [9] [10] [11]. The lack of a zone of inhi-

bition for the thanaka disks of all three tested concentrations could be attributed

to a number of possibilities. First, thanaka is not completely soluble in the sterile,

deionized water (Figure 3(a)). In order to create thanaka-impregnated disks,

thanaka was first dissolved in sterile, de-ionized water. Mixing thanaka with wa-

ter mimics how the powder is typically used in Myanmar: the thanaka bark is

ground into powder, mixed with water, and applied directly to the face as a paste

E. V. Seiverling et al.

(a) (b)

Figure 3. Solubility testing: Solutions of thanaka dissolved in (a) sterile, de-ionized water

or (b) 95% Ethanol: Water: Tween 20 (5:93.5:1.5) at 1, 5, and 10 mg/ml.

(Figure 2). In an attempt to improve solubility, the protocol was modified by

dissolving the thanaka into 95% ethanol: water: tween 20 (5:93.5:1.5), similar to

thatused by Wangthong

et al

. [7]. Of note, Wangthong

et al

. utilized extracted

compounds from thanaka rather than testing the powder itself. Addition of al-

cohol and detergent led to improved solubility (Figure 3(b)), but may have im-

pacted the ability to measure antimicrobial activity. Second, the concentrations

previously demonstrated by MIC interpretations may not exhibit an equivalent

Kirby Bauer disk diffusion

in vitro

activity. This is not uncommon in the CLSI

tables [8]. Third, the thanaka product may not have direct antimicrobial proper-

ties against

E. coli

S. aureus

, or

P. acnes

. One of the chemical constituents of

thanaka is coumarin, which has known anti-oxidant and anti-inflammatory ac-

tivity [12] [13]. Consequently, the role thanaka plays in acne treatment may be

related to anti-inflammatory properties, rather than antimicrobial activity.

Fourth, it is possible that the thanaka, or one of its active ingredients, has poor

agar diffusion similar to other large, bulky antibiotics, like colistin or other po-

lymyxins [14]. Finally, it is important to note that commercially available thana-

ka powder is sometimes mixed with other ingredients such as sandalwood or

apple wood. Although we attempted to test ‘pure’ unmixed thanaka, we did not

have a method to validate its purity. Future research into thanaka would benefit

from a standardized product.

5. Conclusion

Thanaka powder is used for acne treatment and prevention, amongst other cos-

metic and dermatologic uses. In this study, the antimicrobial properties of tha-

naka were evaluated according to published CLSI breakpoint interpretation for

Kirby-Bauer disk diffusion. No zones of inhibition were observed when testing

an alcoholic solution of thanaka against

E. coli

S. aureus

and

P. acnes

. Thanaka

may have poor agar diffusion or may simply not have antimicrobial activity.

Aqueous and alcoholic extracts of thanaka have, however, been shown to inhibit

inflammation by blocking free radical release which may be beneficial in acne

[7]. Standardizing a system for obtaining extracts of thanaka would benefit fu-

ture investigations of its anti-acne properties. However, even with a standardized

product, disk diffusion may not be the best modality for testing the efficacy of

E. V. Seiverling et al.

thanaka against

P. acnes

or skin flora. Ultimately, studies exploring the an-

ti-inflammatory properties of thanaka may provide greater insight into its the-

rapeutic potential.

Acknowledgements

This work was supported by a grant from the James and Joyce Marks Clinician

Educator Endowment in the Department of Dermatology at the Pennsylvania

State University, Milton S. Hershey Medical Center.

References

[1] Goldsberry, A., Dinner, A. and Hanke, C.W. (2014) Thanaka: Traditional Burmese

Sun Protection.

Journal of Drugs and Dermatology

, 13, 306-307.

[2] Lourith, N., Kanlayavattanakul, M. and Pongpunyayuen, S. (2010) Skin Lightening

Agent from

Naringi Crenulata

World Academy of Science

Engineering and Tech-

nology

, 46, 1022-1023.

[3] Lindsay, S.W., Ewald, J.A., Samung, Y., Apiwathnasorn, C. and Nosten, F. (1998)

Thanaka (

Limonia acidissima

) and Deet (di-methyl benzamide) Mixture as a Mos-

quito Repellent for Use by Karen Women.

Medical and Veterinary Entomology

, 12,

295-301. https://doi.org/10.1046/j.1365-2915.1998.00115.x

[4] Seiverling, E.V. and Ahrns, H.T. (2013) Thanakha and Its Dermatologic Uses in

Myanmar (Burma) [Abstract].

Journal of Investigative Dermatology

, 133, S88-S103.

[5] Kistowska, M.,

et al

. (2015) Propionibacterium acnes Promotes Th17 and Th17/Th1

Responses in Acne Patients.

Journal of Investigative Dermatology

, 135, 110-118.

https://doi.org/10.1038/jid.2014.290

[6] Eichenfield, L.F.,

et al

. (2013) Evidence-Based Recommendations for the Diagnosis

and Treatment of Pediatric Acne.

Pediatrics

, 131, 163-186.

https://doi.org/10.1542/peds.2013-0490B

[7] Wangthong, S.,

et al

. (2010) Biological Activities and Safety of Thanaka (

Hespere-

thusa crenulata

) Stem Bark.

Journal of Ethnopharmacology

, 132, 466-472.

https://doi.org/10.1016/j.jep.2010.08.046

[8] Clinical and Laboratory Standards Institute (CLSI) (2015) Performance Standards

for Antimicrobial Disk Susceptibility Tests; Approved Standards - Twelfth Edition,

M02-A12.

[9] Fattah, N.S.A. and Darwish, Y.W. (2013) In Vitro Antibiotic Susceptibility Patterns

Propionibacterium acnes

Isolated From Acne Patients: an Egyptian University

Hospital-Based Study.

Journal of the European Academy of Dermatology and Ve-

nereology

, 27, 1546-1151. https://doi.org/10.1111/jdv.12057

[10] Eng, W. and Norman, R. (2010) Development of an Oregano-based Ointment With

Anti-Microbial Activity Including Activity Against Methicillin-Resistant

Staphylo-

coccus aureus

Journal of Drugs in Dermatology

, 9, 377-380.

[11] Antonio-Velmonte, M., Gonzaga, A.J. and Darvin, C.U. (1998) Local Production of

Low Cost Quality Antibiotic Susceptibility Disks for the Philippines.

Journal of Mi-

crobiology and Infectious Disease

, 17, 66-75.

[12] Nayar, M.N.S. and Bhan, M.K. (1972) Coumarins and Other Constituents of

Hes-

perethusa crenulata

Phytochemistry

, 11, 3331-3333.

https://doi.org/10.1016/S0031-9422(00)86402-X

[13] Fylaktakidou, K.C., Hadjipavlou-Litina, D.J., Litinas, K.E. and Nicolaides, D.N.

E. V. Seiverling et al.

(2004) Natural and Synthetic Coumarin Derivatives with Anti-Inflammatory/An-

tioxidant Activities.

Current Pharmaceutical Design

, 10, 3813-3833.

https://doi.org/10.2174/1381612043382710

[14] Galani, I.,

et al

. (2008) Colistin Susceptibility Testing by Etest and Disk Diffusion

Methods.

International

Journal of Antimicrobial Agents

, 31, 434-439.

https://doi.org/10.1016/j.ijantimicag.2008.01.011

Submit or recommend next manuscript to SCIRP and we will provide best

service for you:

Accepting pre-submission inquiries through Email, Facebook, LinkedIn, Twitter, etc.

A wide selection of journals (inclusive of 9 subjects, more than 200 journals)

Providing 24-hour high-quality service

User-friendly online submission system

Fair and swift peer-review system

Efficient typesetting and proofreading procedure

Display of the result of downloads and visits, as well as the number of cited articles

Maximum dissemination of your research work

Submit your manuscript at: http://papersubmission.scirp.org/

Or contact jbm@scirp.org

Antioxidant and anti-inflammatory effects in lipopolysaccharide-induced THP-1 cells of coumarins from the bark of Hesperethusa crenulata R.

Article

Full-text available

Dec 2021

All parts of Thanakha ( Hesperethusa crenulata R.) have been used as traditional skin care herbal material in Myanmar. In this study, coumarins from H. crenulata R. bark were isolated through solvent extraction, systematic solvent fractionation, and repeated column chromatography. Spectroscopic analyses using ESI–MS, 1D NMR (1H and 13C), 2D NMR (gHSQC and gHMBC), specific rotation, circular dichroism, and IR spectrometry revealed three coumarins 2 R -7-hydroxy-8-(2,3-dihydroxy-3-methylbutyl)-coumarin (compound 1 ), peucedanol (compound 2 ), and methylpeucedanol (compound 3 ), which were first isolated from Thanakha tree. Antioxidant capacities of three coumarins decreased as follows: compound 2 > compound 3 > compound 1 . Treatments of lipopolysaccharide-induced THP-1 human monocytic cells with compounds 2 and 3 at 378.8 μM and 359.7 μM inhibited tumor necrosis factor-α production by approximately 32.7% and 13.3%, respectively, compared with the negative control. In summary, these results suggest that Thanakha bark extracts can be used as a potent antioxidant and anti-inflammatory source for cosmetic ingredients.

Improvement of Thanaka Powder by Gamma Radiation: Microbial and Chemical Properties

Article

Full-text available

Mar 2021

Thanaka powder is made from the stem bark of the Hesperethusa crenulata plant. Most Burmese women use it on the skin of the face as sun protection, a moisturizing agent and acne treatment. For a hygiene purpose, gamma radiation is currently used to control microorganisms and insect contamination in many products. In this experiment, the the effects of gamma radiation on the microbial numeration, total phenolic content, antioxidant activity, and chemical constituent alterations in Thanaka powder were investigated. Gamma irradiation was applied to powder samples at 5, 10, 15 and 20 kGy. The total bacterial count and total yeast and mold count were decreased with increasing irradiation dose. Gamma irradiation at a dose of 5 kGy was sufficient to reduce the microbial load in the powder to meet the standards of microbial quality for cosmetic products in Thailand. No significant change in the DPPH activity of the Thanaka powder was observed after irradiation. Additionally, the radiation process caused significant increases in total phenolic content, FRAP value and arbutin content. At a dose of 20 kGy, the total phenolic content, FRAP value and arbutin content were significantly higher than the non-irradiated Thanaka powder at 7.45, 9.59 and 16.04%, respectively.

Investigation of Phytochemical Constituents and some Bioactivities of Root Bark of Hesperethusa crenulata Roxb. (Thanakha)

Article

Full-text available

Jul 2020

The preliminary phytochemical screening of different crude extracts of Hesperethusa crenulata Roxb.(Thanakha) revealed the presence of alkaloids, α-amino acids, carbohydrates, cyanogenic glycosides, flavonoids, glycosides, phenolic compounds, saponins, starchs, steroids, tannins and terpenoids and the absence of reducing sugars and organic acids. The extractable matter contents (% w/w) of obtained by extraction with different polarity of solvents such as water, ethanol, ethyl acetate and petroleum ether were in order of 16.47 % > 11.01 % > 3.85 % > 3.49 % respectively. The antioxidant activity of ethanol and watery extracts was evaluated by DPPH free radical assay method. The IC 50 values of ethanol and watery extracts were observed to be 75.61 and 185.70 μg/mL respectively. The antimicrobial activity of polar and non-polar extracts such as pet-ether, ethyl acetate, ethanol and water extracts was tested on six microorganisms by agar well diffusion method. Among the tested extracts, PE, EtOH and EtOAc extracts of root bark of Thanakha inhibited all species of test microorganisms with the inhibition zone diameters in the range between 12-20 mm. However, watery extract inhibited five species of microorganisms namely Bacillus subtilis, Staphylococcus aureus, Pseudomonas aeruginosa, Bacillus pumilusand Escherichia coli.

Access and Benefit Sharing and the Sustainable Trade of Biodiversity in Myanmar: The Case of Thanakha

Article

Full-text available

Nov 2021

The global demand for biological resources to use as natural ingredients in diverse products is rising rapidly. This creates investment opportunities for nature-based products, creating pressure on and threats to biodiversity and its associated traditional knowledge (TK). Myanmar’s great biodiversity is attractive for scientific investigations searching for natural substances for pharmaceutical, cosmetic, and other uses. Myanmar is amid profound political and economic changes, exposing the country to risks and opportunities. The recent opening to world trade put its rich biodiversity and TK under severe threat. One of the local natural biodiversity products is Thanakha, which is traditionally used for skincare. This study investigates the current and planned regulations and practices managing Access and Benefit Sharing (ABS) in Myanmar, focusing on one of the potential BioTrade products: Thanakha. A qualitative and quantitative survey was conducted through in-depth interviews with 37 key informants and 35 Thanakha farmers. The results show that while the current research and development activities at the Thanakha manufacturing level could trigger ABS obligations, the low awareness about ABS requirements and the lack of traceability raise uncertainties for its potential implementation. The implementation of BioTrade principles and ethical sourcing to promote the sustainable trade of Thanakha, as well as the implementation of ABS, would lead to the protection of biodiversity and TK, and the improvement of local livelihoods.

Propionibacterium acnes Promotes Th17 and Th17/Th1 Responses in Acne Patients

Article

Full-text available

Jul 2014

Propionibacterium acnes is a Gram-positive commensal bacterium thought to be involved in the pathogenesis of acne vulgaris. While the ability of P. acnes in the initiation of pro-inflammatory responses is well documented, little is known about adaptive immune responses to this bacterium. The observation that infiltrating immune cells consist mainly of CD4(+) T cells in the perifollicular space of early acne lesions suggests that helper T cells may be involved in immune responses caused by the intra-follicular colonization of P. acnes. A recent report showing that P. acnes can induce IL-17 production by T cells suggests that acne might be a Th17-mediated disease. In line with this, we show in this work that, in addition to IL-17 A both Th1 and Th17 effector cytokines, transcription factors and chemokine receptors are strongly upregulated in acne lesions. Furthermore, we found that, in addition to Th17, P. acnes can promote mixed Th17/Th1 responses by inducing the concomitant secretion of IL-17 A and IFNγ from specific CD4(+) T cells in vitro. Finally, we show that both P. acnes-specific Th17 and Th17/Th1 cells can be found in the peripheral blood of patients suffering from acne and, at lower frequencies, in healthy individuals. We therefore identified P. acnes-responding Th17/Th1 cells as previously unreported CD4(+) sub-population involved in inflammatory acne.Journal of Investigative Dermatology accepted article preview online, 10 July 2014; doi:10.1038/jid.2014.290.

Biological activities and safety of Thanaka (Hesperethusa crenulata) stem bark

Article

Full-text available

Nov 2010

The stem bark powder of Hesperethusa crenulata or Thanaka has been used on the face by Myanmar women for more than a thousand years as a skin care regiment. The aim of the current study was to both verify the safety and evaluate some biological activities of the Thanaka bark. Maceration of the Thanaka bark powder resulted in hexane, dichloromethane, ethyl acetate, methanol, 85% ethanol and water extracts. For the safety evaluation, cytotoxicity and genotoxicity of each extract were tested. Antibacterial, tyrosinase inhibition, antioxidant and anti-inflammatory activities were evaluated for each extract. Extracts from Thanaka bark showed strong anti-inflammatory, significant antioxidation, mild tyrosinase inhibition and slight antibacterial activities. All extracts and the original bark powder showed no detectable genotoxicity while very low cytotoxicity with IC(50) value of more than 12 mg/ml was detected in the water extract. Thus, the use of the Thanaka bark in the form of a watery paste as a skin care regiment is not only safe but also beneficial to skin.

Thanaka (Limonia acidissima) and deet (di-methyl benzamide) mixture as a mosquito repellent for use by Karen women

Article

Jul 1998

The prevention and treatment of drug-resistant malaria is becoming increasingly difficult. On the Thai-Myanmar border multi-drug resistant strains of falciparum malaria are increasing and, because the malaria vector Anopheles bite outdoors during early evening, insecticide house-spraying or impregnated bednets provide only limited protection. Therefore, the protective efficacy of repellent formulations containing di-methyl benzamide (deet) and permethrin against local vectors was estimated, when applied to the skin, and their acceptability amongst pregnant Karen women who are at relatively high risk from malaria was assessed. Human landing catches of mosquitoes showed that almost complete protection was achieved using different formulations of 20% deet and 0.5% permethrin for up to 6 h. All-night collections from human subjects indicated that this repellent combination reduced exposure to malaria parasites by at least 65 and 85% for those transmitted by Anopheles minimus and An. maculatus, respectively, the two principal vectors in this area. Pregnant women in the camps preferred repellents which were mixed with 'thanaka', a root paste made from pulp of the wood apple tree, Limonia acidissima, used locally as a cosmetic. Apart from a temporary warming sensation where repellent thanaka was applied to the skin, the repellents were well tolerated. An intervention trial is currently in progress to determine whether deer mixed with thanaka can protect pregnant women against malaria in this part of the world. Bioassays using a laboratory strain of Aedes aegypti demonstrated that thanaka is itself slightly repellent at high dosages and the mixture with deet provides protection for over 10 h. This treatment would therefore also provide some personal protection against dengue, which is increasing locally, transmitted by Ae. aegypti and Ae. albopictus biting during the daytime.

Skin lightening agent from Naringi crenulata

Article

Jan 2010

Naringi crenulata is continuously used as a traditional facial cosmetics in Myanmar and Northern Thailand for sunscreen, anti - acne, anti - aging and whitening effects. However, scientific evidence relating to these efficacies is rarely presented in addition to difference of the part used that varied by region. Therefore, comparative amount of skin lightening agent, Arbutin, in bark, stem wood, leaf and fruit of N. crenulata was studied. The powder of air dried bark, stem wood and leaf were separately macerated in MeOH similar to its fresh ripped fruit under room temperature for 24 hr by shaking at 150 rpm. The crude extracts were HPLC analyzed. Arbutin was found highest in leaf extract (2.4256 ± 0.0050 g/kg) following by fruit (0.2931 ± 0.0106 g/kg), stem wood (0.2600 ± 0.0214 g/kg) and bark (0.1710 ± 0.0275 g/kg), respectively. The traditionally used is, therefore, scientifically confirmed and promising for further development of natural lightening cosmetics.

Thanaka: Traditional Burmese Sun Protection

Article

Mar 2014

Limonia acidissima or Hesperethusa crenulata is a common tree in Southeast Asia. It is indigenous to the Republic of Myanmar (formerly Burma) as well as India, Sri Lanka, Java, and Pakistan. In English, the common names for Limonia acidissima are sandalwood, wood-apple, elephant-apple, monkey fruit, and curd fruit tree. The plant has a number of different names in different languages including bal or bael in Assamese, bael in Bengali, kaitha in Hindi, belingai in Malaysia, and thanaka in Burmese. Unique to the Burmese people, thanaka has been used as a cosmetic product for over 2000 years. Mention of thanaka has been traced back to ancient Burmese lyrics, and relics of equipment used by ancient royalty to grind thanaka can be found in museums.<SUP>1</SUP> J Drugs Dermatol. 2014;13(3):306-307.

Evidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne

Article

May 2013
Pediatrics

Acne vulgaris is one of the most common skin conditions in children and adolescents. The presentation, differential diagnosis, and association of acne with systemic pathology differs by age of presentation. Current acknowledged guidelines for the diagnosis and management of pediatric acne are lacking, and there are variations in management across the spectrum of primary and specialty care. The American Acne and Rosacea Society convened a panel of pediatric dermatologists, pediatricians, and dermatologists with expertise in acne to develop recommendations for the management of pediatric acne and evidence-based treatment algorithms. Ten major topic areas in the diagnosis and treatment of pediatric acne were identified. A thorough literature search was performed and articles identified, reviewed, and assessed for evidence grading. Each topic area was assigned to 2 expert reviewers who developed and presented summaries and recommendations for critique and editing. Furthermore, the Strength of Recommendation Taxonomy, including ratings for the strength of recommendation for a body of evidence, was used throughout for the consensus recommendations for the evaluation and management of pediatric acne. Practical evidence-based treatment algorithms also were developed. Recommendations were put forth regarding the classification, diagnosis, evaluation, and management of pediatric acne, based on age and pubertal status. Treatment considerations include the use of over-the-counter products, topical benzoyl peroxide, topical retinoids, topical antibiotics, oral antibiotics, hormonal therapy, and isotretinoin. Simplified treatment algorithms and recommendations are presented in detail for adolescent, preadolescent, infantile, and neonatal acne. Other considerations, including psychosocial effects of acne, adherence to treatment regimens, and the role of diet and acne, also are discussed. These expert recommendations by the American Acne and Rosacea Society as reviewed and endorsed by the American Academy of Pediatrics constitute the first detailed, evidence-based clinical guidelines for the management of pediatric acne including issues of special concern when treating pediatric patients.

In vitro antibiotic susceptibility patterns of Propionibacterium acnes isolated from acne patients: An Egyptian university hospital-based study

Article

Dec 2012
J EUR ACAD DERMATOL

Background: Antibiotics have been used for more than 40 years against Propionibacterium acnes (P. acnes), the most common agent of acne. Antibiotic resistance to this bacterium becomes a worldwide problem in recent years. No studies are available on antibiotic susceptibility patterns of P. acnes among Egyptian acne patients. Objective: To determine antibiotic susceptibility patterns of P. acnes isolated from acne patients attending the Dermatology outpatient clinic of an Egyptian university hospital to the most commonly prescribed antibiotics and to determine the difference in relation to age of patients, disease duration and previous antibiotic therapy for acne. Methods: Cutaneous samples were obtained from pustular acne lesions on the face of 115 patients, which were cultured in anaerobic media to demonstrate the presence of P. acnes. Antibiotic susceptibility tests of isolated P. acnes were then performed to clindamycin, erythromycin, azithromycin, oxytetracycline and doxycycline by disk diffusion method. Results: Propionibacterium acnes was isolated from 98 patients. Eighty-nine isolates were susceptible to azithromycin, followed by doxycycline and oxytetracycline isolated from 82 and 72 patients respectively. Resistance of P. acnes to clindamycin was detected in 65 patients, followed by erythromycin in 48 patients. Comparing the antibiotic susceptibility patterns of P. acnes isolated from patients with and without previous antibiotic therapy for acne revealed statistically non-significant differences as regards any of the antibiotics tested except for clindamycin and erythromycin. Statistically non-significant differences existed between antibiotic susceptibility patterns of P. acnes to all tested antibiotics regarding age of patients (< or ≥ 20 years) and disease duration (< or ≥ 2 years). Conclusion: Propionibacterium acnes in vitro susceptibility patterns differed among Egyptian patients to the commonly prescribed antibiotics with the highest to lowest resistance to clindamycin, erythromycin, oxytetracycline, doxycycline and azithromycin.

Coumarins and other constituents of Hesperethusa crenulata

Article

Nov 1972

Sitosterol, 4-methoxy-1-methy-2-quinolone and four coumarins, one of which is a 1,2-epoxide, were isolated from the petrol. extract of the root bark of Hesperethusa crenulata.

Development of an Oregano-based Ointment With Anti-microbial Activity Including Activity Against Methicillin-resistant Staphlococcus aureus

Article

Apr 2010

Increasing antibiotic resistance has prompted a search for new compounds with anti-microbial activity. In the authors' previous study, oregano extract was identified as one of the most potent anti-microbial compounds. The disk diffusion method was employed to assess the degree of inhibition against various microorganisms, and the bacteriostatic or bactericidal mechanism of action. Disk diffusion studies showed that oregano was found to be bacteriostatic for Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus, (MRSA) but bacteriocidal for seven other microorganisms. Pseudomonas aeruginosa could not be inhibited by oregano. An ointment consisting of 1-10% oregano could inhibit most organisms except for Proteus mirabilis and Proteus vulgaris, which required 20% and Pseudomonas which could not be inhibited even at the highest concentration of 80%. Oregano extracts can be formulated into an ointment that shows broad antimicrobial activity. Additional testing to assess tissue toxicity and other adverse reactions would be needed prior to human testing.

Thanaka and DEET mixture as a mosquito repellent for use by Karen women

Article

Aug 1998

The prevention and treatment of drug-resistant malaria is becoming increasingly difficult. On the Thai-Myanmar border multi-drug resistant strains of falciparum malaria are increasing and, because the malaria vector Anopheles bite outdoors during early evening, insecticide house-spraying or impregnated bednets provide only limited protection. Therefore, the protective efficacy of repellent formulations containing di-methyl benzamide (deet) and permethrin against local vectors was estimated, when applied to the skin, and their acceptability amongst pregnant Karen women who are at relatively high risk from malaria was assessed. Human landing catches of mosquitoes showed that almost complete protection was achieved using different formulations of 20% deet and 0.5% permethrin for up to 6 h. All-night collections from human subjects indicated that this repellent combination reduced exposure to malaria parasites by at least 65 and 85% for those transmitted by Anopheles minimus and An. maculatus, respectively, the two principal vectors in this area. Pregnant women in the camps preferred repellents which were mixed with 'thanaka', a root paste made from pulp of the wood apple tree, Limonia acidissima, used locally as a cosmetic. Apart from a temporary warming sensation where repellent thanaka was applied to the skin, the repellents were well tolerated. An intervention trial is currently in progress to determine whether deet mixed with thanaka can protect pregnant women against malaria in this part of the world. Bioassays using a laboratory strain of Aedes aegypti demonstrated that thanaka is itself slightly repellent at high dosages and the mixture with deet provides protection for over 10 h. This treatment would therefore also provide some personal protection against dengue, which is increasing locally, transmitted by Ae. aegypti and Ae. albopictus biting during the daytime.