Fulvic Acid -A Natural and Multifaceted Approach to the Management of Inflammatory Dermatosis

Abstract

Fulvic Acid is a part of Humic substances found in the humus of soil. It has the advantage of higher oxygen content, water solubility at all pH, and low molecular weight as compared to other humic substances. Fulvic acid has been studied for its various clinical benefits including Anti-inflammatory, Astringent, Anti-oxidant, Anti-allergic and Anti-microbial properties which makes it a useful option in the management of inflamma-tory conditions of the skin (Inflammatory Dermatosis like Eczema, Atopic dermatitis and Psoriasis). Its effectiveness and tolerance have been demonstrated in clinical studies, and its health benefits have also been known part of traditional medicine in India. Topical cream/lotion formulations of fulvic acid in a moisturizing base is now available in India. Fulvic acid can serve to be of added value over emollients alone in managing skin inflammation, and also be beneficial for long term daily application in pre-disposed patients.

Full text

Review Article
The Indian Practitioner q Vol.72 No.10. October 2019
Fulvic Acid – A Natural and Multifaceted Approach to the
Management of Inammatory Dermatosis
Varsha Narayanan
1
, Rajendra Kharkar
2
Abstract
Fulvic Acid is a part of Humic substances found in the humus of soil. It has the advantage of higher oxygen
content, water solubility at all pH, and low molecular weight as compared to other humic substances. Fulvic
acid has been studied for its various clinical benets including Anti-inammatory, Astringent, Anti-oxidant,
Anti-allergic and Anti-microbial properties which makes it a useful option in the management of inamma-
tory conditions of the skin (Inammatory Dermatosis like Eczema, Atopic dermatitis and Psoriasis). Its ef-
fectiveness and tolerance have been demonstrated in clinical studies, and its health benets have also been
known part of traditional medicine in India. Topical cream/lotion formulations of fulvic acid in a moisturizing
base is now available in India. Fulvic acid can serve to be of added value over emollients alone in managing
skin inammation, and also be benecial for long term daily application in pre-disposed patients.
Keywords: Fulvic acid, Inammatory dermatosis, Eczema, Atopic, Humic
Conict of Interest: None declared.
1
Health and Pharmaceutical consultant, Dr Varsha’s Health Solutions, Mumbai, India.
2
Consultant Dermatologist, Dr Kharkar’s Skin Clinic, Mumbai, India.
28
Introduction
Fulvic acid has recently gained prominence for
having multiple scientic properties and health
benets.
The source of Fulvic acid is humus which is organic
material that forms in soil when plant and animal mat-
ter decay and decompose by microbial activity over
several years.
Humus is dened as a brown to black complex
variable of organic compounds recognized under a
light microscope as possessing cellular organization
distinct from that of plant and animal bodies.1 Soil hu-
mus is slow to decompose under natural conditions.
When in combination with soil minerals, soil hu-
mus can persist in the soil for several hundred years.
Humus is the major soil organic maer component,
making up 65% to 75% of the total and consists of
about 60% carbon, 6% nitrogen, and smaller amounts
of phosphorus and sulfur.
Humic substances are the components of humus,
the major organic fraction of soil, peat, and coal. They
are high molecular weight compounds that together
form the brown to black hydrophilic, structurally ex-
ible, polyelectrolytes called humus.1 Many of the hu-
mic substances are heterogeneous and relatively large
stable organic complexes. They function to give the
soil structure, porosity,water holding capacity, allow
cation and anion exchange, and are involved in the
chelation of mineral elements.
Humic acids are of the following types – humin,
humic acid and fulvic acid. They show decreasing or-
der of colour intensity, molecular weight, polymeriza-
tion and carbon content, and increasing order of solu-
bility and oxygen content. Fulvic acid represents the
yellow coloured, low molecular weight (in the range

Review Article
The Indian Practitioner q Vol.72 No.10. October 2019
29
of 1000 Da) component of humus which is rich in oxy-
gen and soluble in water at all pH.1
Though it would be reasonable to assume that hu-
mans consume fulvic acid complexes through plants,
in practice this is not the case. Poor agricultural prac-
tices, pesticides, chemical fertilizers, and soil erosion,
have greatly reduced microbial activity, nutrition and
mineral content of the soil and thereby plants and
food produced from it.2
Fulvic acid has been discovered and created in ex-
tremely small amounts by the action of millions of ben-
ecial microbes, working on decaying plant maer in
a soil environment with adequate oxygen.3 Fulvic acid
is part of the humic structure in rich composting soil.
Fulvic acids contain a vast amount of naturally occur-
ring biochemicals, supercharged antioxidants, free-
radical scavengers, superoxide dismutases (SOD),
nutrients, enzymes, hormones, amino acids, natural
anti-bacterials, antivirals, and fungicides.
Fulvic acid is of low molecular weightand is bio-
logically very active.4 Because of its low molecular
weight, it has the necessity and ability to readily bond
minerals and elements into its molecular structure
causing them to dissolve and become mobilized fulvic
complexes. Fulvic acid from humic (or humate) de-
posits usually carries 60 or more minerals and trace el-
ements dissolved into its molecular complexes. These
are then in ideal natural form to be absorbed and in-
teract with living cells.5
Fulvic Acid is neither an alpha hydroxyl acid nor a
beta hydroxyl acid; it is an electrolyte.6 Electrolytes en-
hance the availability of nutrients to make them more
readily absorbable. This property restores each indi-
vidual cell to a normal chemical balance. Electrolytes
allow our skin cells to function at a higher level and
eectively repair cell damage.
Pharmacological Actions of Fulvic Acid
Astringent and Detoxication: Fulvic acid is easily
able to pass through cellular membranes, allowing it
to be properly absorbed and also increasing assimila-
tion of other nutrients or supplements. Its detoxifying
activity results from its structure made up of aromatic,
organic polymers with many carboxyl groups that re-
lease hydrogen ions, resulting in an electric charge,
helps aract free radicals, heavy metals and other tox-
ins within the body, helps them become more soluble
in water, and aids their easy excretion.7 Fulvic acid
also dissolves and transports vitamins, co-enzymes,
hormones and natural antibiotics across cells and
make nutrients bio-available to the skin allowing for
deep penetration. Humic substances possess astrin-
gent activity of skin cleansing, tightening pores and
reducing oily secretions, thereby reducing itch and ir-
ritation.8
Anti-oxidant: Fulvic acid is one of the powerful an-
tioxidants and free radical scavengers known. As a ma-
jor source of key electrolytes and antioxidants, Fulvic
acid helps slow down ageing and control inamma-
tion. It’s been shown to improve various cellular pro-
cesses, muscle functions, digestive abilities, heart and
brain health. Fulvic acid helps cells absorb the amount
of minerals they need and discard o waste by acting
as an ion transporter. It also stimulates the immune
system to help defend the body from infections.9
Anti-inammatory action: Fulvic acid acts as an
anti-inammatory agent by reducing the release of
pro-inammatory mediators like TNF-Alpha, COX2,
and PGE2 from cells.10 The anti- inammatory activ-
ity of topically applied fulvic acid was compared with
that of diclofenac sodium and betamethasone in a
murine model of contact hypersensitivity. The fulvic
acid cream compared favorably with both the positive
control creams in suppressing the cutaneous inam-
matory response.11 In vitro studies on the eect of ful-
vic acid on broblasts and matrix metalloproteinases
(MMPs), showed that 1% fulvic acid increased cell vi-
ability by 26.1% when compared with a control, and
up to 5% fulvic acid did not show any cytotoxicity.
Fulvic acid can thereby reducing inammatory colla-
gen degradation.12
Antiallergic action: A pilot clinical study showed
that coal-derived fulvic acid (oxiFulvic acid) at 4.5%
(w/w) reduces wheal and are size after allergen chal-
lenge in humans with the reduction by fulvic acid
showing similar results to 1% hydrocortisone.13 Fulvic
acid from solubilized sludge (SS-FA) as well as from
Canadian Peat is shown to reduce B-hexosaminidase
and histamine release in immunoglobulin-E-sensi-
tized mast cells and basophil cells with reductions in
IL-4 and IL13, suggesting further that fulvic acid can
have anti-allergy eects.14,15
Anti-microbial action: An in-vitro study to deter-
mine the antibacterial eect of fulvic acid, on solutions
on the growth of 8 microbial pathogens was determined
by the macro-broth tube dilution method. Fulvic acid
was reported to be bactericidal against the following
organisms – Streptococcus faecalis, Streptococcus pyo-
genes, Staphylococcus aureus, Pseudomonas aeruginosa,
Escherichia coli, Klebsiella pneumonia, Proteus mirabilis,
and Candida albicans.16 Fulvic acid is also seen to have
anti-viral properties against enveloped viruses along

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The Indian Practitioner q Vol.72 No.10. October 2019
30
with its anti-bacterial and anti-fungal activity.17
Topically applied carbohydrate derived fulvic acid
showed reduction in the size of wounds infected with
Staphylococcus aureus, and other antibiotic-resistant
pathogens. This suggests a bimodal immune modify-
ing eect of fulvic acid.18,19
Clinical Studies
The ecacy and safety of topical fulvic acid has
been demonstrated in a few clinical studies which
have given way to topical formulations containing
fulvic acid now being available.
A pilot study to evaluate the safety and therapeutic
ecacy of topical Fulvic acid was performed in atopic
volunteers.13 The study objectives were to establish
rst the safety, and second, the therapeutic ecacy of
topically applied fulvic acid derived from coal com-
pared to 1% hydrocortisone and placebo creams. In
this double-blind cross-over study, 23 healthy volun-
teers allergic to grass or house dust mite allergen were
randomized to apply either 4.5 or 9% fulvic acid for
2 weeks on the volar aspect of one forearm (100 mm
diameter) and re-challenged 21 days later to establish
sensitization. Thereafter, volunteers were randomized
to either placebo. 1% hydrocortisone, 4.5 or 9% fulvic
acid creams. Creams were applied under occlusions
1 hour prior to intradermal allergen challenge and
every 8 hours thereafter for 3 days (21-day intervals).
The surface areas of the immediate and late phase skin
reactions were calculated. Topically applied coal de-
rived fulvic acid had no signicant eect on any of the
safety parameters and also did not induce sensitiza-
tion when applied on the skin. The 4.5% cream caused
inhibition of the elicited inammatory reaction at 15
minutes and diered signicantly from the 9% cream
at 24 hours. These changes were similar to that caused
by hydrocortisone. No other signicant changes were
detected.
Ecacy and safety of topical fulvic acid has been
evaluated in the treatment of inammatory dermato-
sis like eczema. In a randomized, parallel-group, dou-
ble-blind, controlled study with carbohydrate-derived
topical fulvic acid, 36 volunteers with pre-determined
eczema were randomly assigned to receive either the
study drug or placebo (emollient only) twice daily for
four weeks.20 All safety parameters remained within
normal limits, with no signicant dierences in either
group. Signicant dierences were observed for both
severity of eczema,and erythema in the placebo and
fulvic acid groups. With regard to the investigator as-
sessment of global response to treatment, a signicant
improvement was observed in the fulvic acid group
when compared with the placebo group. A statisti-
cally signicant decrease in visual analog scale score
was observed in both groups, when comparing the
baseline with the nal results. Apart from a short lived
mild burning sensation in some patients, the study
drug was well tolerated.
Fulvic acid and humic substances have been used
as part of traditional medicine in Asian countries like
India, China and Korea. In India, Shilajit, herbo-min-
eral medicinal substance containing humus, with ful-
vic acid as the main carrier molecule has been used
for multiple health benets including treating skin in-
ammations and sunburns, and for dermal photopro-
tection.21 Topical fulvic acid in the form of 3% cream
and lotion in a moisturizing base has been recently in-
troduced in India (FULVICARETM) for management of
inammatory dermatosis.
In Korea, a cream preparation of 1, 2, 5 and 10%
fulvic acid was tested for various human skin param-
eters.22 The study demonstrated maintenance of skin
cell viability and collagen concentrations with up to
10% fulvic acid, with an increase in wound healing
area with human epidermal keratinocytes by 40%.
Free radical scavenging ability showed progressive in-
crease with increasing fulvic acid concentrations with
30-40 times increase with 10% concentration.
In conclusion, fulvic acid when formulated as a
cream or lotion in a moisturizing base can be an eec-
tive and well tolerated option for the initial manage-
ment for inammatory dermatosis. As emollients and
moisturizers form the initial and rst line management
in skin inammation, fulvic acid due to its showing
beer response than an emollient alone, can be a more
suitable alternative. Due to being natural and devoid
of some skin adverse eects seen with topical treat-
ments like corticosteroids or immune-suppressants,
fulvic acid may also serve to be a suitable option for
long term day to day use for maintenance in patients
known to develop recurrent dermatitis. Further clini-
cal studies in specic skin indications will add value
to enhance the current usage of fulvic acid topical
preparations.
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