Dermatological effects of Pistacia species: A systematic review

Abstract

Different parts of Pistacia species are traditionally used to treat various skin problems. Traditional ‎ experiences can be a good basis for research on the therapeutic effects of medicinal
plants. The ‎ active compounds of plants can be identified and used in different disorders in an innovative way.‎‏ ‏ There are several studies that have evaluated the Pistacia species for dermatological disorders. ‎ However, despite the valuable effects of the Pistacia species on
skin disease, there is no ‎ comprehensive review of the dermal effects of these plants. So, in this study, current evidence ‎ regarding the dermatological effect of the Pistacia species has been reviewed. Electronic ‎ databases including PubMed, Scopus, and Google Scholar were
searched for in vivo, in vitro, and ‎ clinical studies that examined dermatological effects of Pistacia species. According to the ‎ review, most of the evidence of dermatological effects in the
Pistacia genus comes from ‎ preliminary studies on wound healing, cutaneous leishmaniasis, inflammation caused by UV rays and photo-protection, ‎ hyperpigmentation disorders, and
atopic dermatitis. The Pistacia genus was ‎ implicated in 3 clinical studies and 30 in vivo/in vitro studies showing several mechanisms that go ‎ beyond its dermatological effects. The
traditional medicinal effects of these herbs ‎ are supported by some scientific evidence. The potential protective/therapeutic effects of these ‎ herbs need to be studied further so that they can be considered as possible future candidates for use ‎ in skin care products.

Full text

Journal of Herbmed Pharmacology
J Herbmed Pharmacol. 2024; 13(1): 28-42.
Dermatological effects of Pistacia species: A systematic
review
Mahbubeh Bozorgi1
ID
, Maryam Iranzad1
ID
, Ahmad Ali2
ID
, Zahra Memariani3*
ID
1School of Persian Medicine, Shahed University, Tehran, Iran
2Department of Life Sciences, University of Mumbai, Vidyanagari, Mumbai 400098, India,
3Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences,
Babol, I.R. Iran
*Corresponding author: Zahra Memariani,
Email: z.memariani@mubabol.ac.ir
Implication for health policy/practice/research/medical education:
This review demonstrated that the Pistacia genus had potential applications in different dermatological conditions like wounds,
hyperpigmentation, leishmaniasis, and dermatitis. These data might be used for further research and preparation of new drugs.
Please cite this paper as: Bozorgi M, Iranzadasl M, Memariani Z. Dermatological effects of Pistacia species: A systematic
review. J Herbmed Pharmacol. 2024;13(1):28-42. doi: 10.34172/jhp.2024.48163.
Different parts of Pistacia species are traditionally used to treat various skin problems.
Traditional experiences can be a good ba sis for research on the ther apeutic effects of med icina l
plants. The active compounds of plants can be identified and used in different disorders
in an innovative way. There are several studies that have evaluated the Pistacia species for
dermatological disorders. However, despite the valuable effects of the Pistacia species on
skin disease, there is no comprehensive review of the dermal effects of these plants. So, in
this study, current evidence regarding the dermatological effect of the Pistacia species has
been reviewed. Electronic databases including PubMed, Scopus, and Google Scholar were
searched for in vivo, in vitro, and clinical studies that examined dermatological effects of
Pistacia species. According to the review, most of the evidence of dermatological effects in the
Pistacia genus comes from preliminary studies on wound healing, cutaneous leishmaniasis,
inflammation caused by UV rays and photo-protection, hyperpigmentation disorders, and
atopic dermatitis. The Pistacia genus was implicated in 3 clinical studies and 30 in vivo/in
vitro studies showing several mechanisms that go beyond its dermatological effects. The
traditional medicinal effects of these herbs are supported by some scientific evidence. The
potential protective/therapeutic effects of these herbs need to be studied further so that they
can be considered as possible future candidates for use in skin care products.
A R T I C L E I N F O
Keywords:
Herbal medicine
Natural products
Pistacia
Skin disorders
Traditional Persian medicine
Wound
Article History:
Received: 26 July 2023
Accepted: 1 October 2023
Article Type:
Review
A B S T R A C T
Introduction
Skin medicines and cosmetics can benefit from herbal
medicines. Several herbal medicinal and cosmetic products
have been developed in recent years for preventing and
treating different skin problems (1,2). It has been shown
that complementary and alternative medicine, including
traditional medicines, can reduce healthcare costs and
prevent the unnecessary use of drugs (3). Many studies
are being conducted on plants that are traditionally used
as skin care agents (4-6). Pistacia species are among the
oldest plants that have been used for these conditions.
These species are resin-bearing shrubs and trees
that belong to the Anacardiaceae family. According to
economic and food industry factors, pistachio (Pistacia
vera L.) is the most important plant in this genus. Mastic
(Pistacia lentiscus L.) is another commercially important
species used as a food additive. P. terebinthus L., P.
atlantica Desf., and P. integerrima J. L. Stewart ex Brandis
are other main species of the Pistacia family distributed
from the Mediterranean basin to central Asia. The resin,
leaves, seeds, and fruits of Pistacia species have been
used for a variety of therapeutic purposes throughout the
world for centuries (7). In particular, there is evidence
from different systems of traditional and complementary
medicine for using the oleo-resin of P. lentiscus and P.
atlantica to prevent and treat skin diseases (8). A number
http://www.herbmedpharmacol.com doi: 10.34172/jhp.2024.48163

Journal of Herbmed Pharmacology, Volume 13, Number 1, January 2024
http://www.herbmedpharmacol.com 29
Dermatological eects of Pistacia genus
of pharmacological effects of Pistacia species have been
documented, including neurologic, gastrointestinal,
anticancer, antidiabetic, antihyperlipidemic, anti-
inflammation, antinociceptive, antioxidant, antimicrobial,
and antiviral effects (9,10). Numerous phytochemicals
have been detected in Pistacia species. Monoterpenes like
α-pinene, limonene, 𝛼-terpinolene, and ocimene are the
main constituents of essential oil (EO) of these plants.
In addition, masticadienonic acid, masticadienolic acid,
and morolic acid have been reported in resin of Pistacia
species. Seeds of Pistacia species contain fatty acids and
sterols like linolenic, palmitic, palmitoleic, stearic, and
myristic acids (7,11). In various studies, these active
ingredients have been shown to be effective in treating
skin diseases (12)
A considerable number of studies have studied
Pistacia species for dermatological conditions such as
wound healing, cutaneous leishmaniasis, UV-induced
inflammation, and atopic dermatitis (AD) (13-16). This
makes the Pistacia species a valuable potential source for
developing new drugs for the treatment of various skin
diseases. In spite of this, there is a lack of comprehensive
review about their dermal effects. In this study, we
reviewed in vivo and in vitro studies on the dermatological
effects of Pistacia species as a possible source of innovative
dermatological products.
Search strategy
Electronic databases, including PubMed, and Scopus,
were searched using the following search formula in
the title/abstract/keywords: (pistacia OR pistachio OR
mastic) AND (derm OR skin OR topical OR wound
OR burn OR melanoma OR melasma OR leishmaniasis
OR hyperpigmentation OR cosmetic OR urticaria OR
eczema OR acne OR vitiligo OR psoriasis OR scar). For
additional articles, Google Scholar was searched based on
the title with pistachio or pistachio OR Pistacia OR mastic
keywords with the name of each disease or disorder
separately.
Articles were collected from inception to December
2022. Only papers with English full-texts were included in
this review. All types of in vitro, in vivo, and clinical studies
related to topical application or systemic administration
of Pistacia species for the management of a skin disorder
were considered. Congress abstracts with no full texts
and research papers in non-English languages were
excluded from our review (Figure 1). The final included
articles were screened to extract the type of disease, part
of Pistacia species, animal model for in vivo and type of
cell line for in vitro studies, route of preparation of extract
or topical formulation, concentration/dosage, duration
of treatment and outcomes. The main outcomes of
this review, represented as follow and effects of Pistacia
species in different dermatological problems, are shown
in Tab l e 1. The risk of bias of each preclinical study was
checked by two reviewers. The Systematic Review Center
for Laboratory animal Experimentation (SYRCLE) was
used for analyzing the methodological quality (Tab le 2)
(17).
Records identified from
databases (n=1074)
Records removed before
screening:
Duplicate records removed
(n=151)
Records marked as ineligible
by automation tools (n=0)
Records removed for other
reasons (n=67)
Records screened
(n=856)
Records excluded
(n =634)
Reports assessed for eligibility
(n=222)
Reports excluded:
(n =189)
Review articles= 9
Irrelevant titles=173
Articles with other languages=5
Without full text=2
Studies included in review
(n=33)
Identification of studies via databases and registers
Identification
Screening
Included
Figure 1. Flowchart of the selection process.

Bozorgi et al
Journal of Herbmed Pharmacology, Volume 13, Number 1, January 2024 http://www.herbmedpharmacol.com
30
Table 1. Effect of Pistacia species on different dermatological problems (in vitro and in vivo studies)
Pistacia
species Plant part Type of preparaon Type of skin problem Type of study Duraon
of study Posive control Result Suggested responsible
constuents Ref.
Wounds
P. vera
Nut 5% and 10% ointment (adding
oil to ointment base)
Second-degree burn
wound
Animal model in
rats 22 days Dexpanthenol
Aer 12 days: Signicant burn wound repair in ointment
(10%) group. Aer 22 days: No scar in ointment (10%) group.
Denser collagen deposion in the recular layer and repaired
epithelium in ointment group.
- (18)
Oleoresin Ointment 5% (adding EO to
petroleum jelly) Wound Animal model in
rabbits 16 days Cicatryl-Bio Strong wound healing eect α-Pinene (19)
Oleoresin Ointment 5% w/w (adding
oleoresins to Vaseline Wound Animal model in
rabbits 16 days Cicatryl Remarkable wound contracon from day 8 to day 16 α-Pinene, β-pinene, trans-
pinocarveol (20)
Hull Methanol 80% extract Wound
Scratch assay on
NIH/3T3 murine
broblast cells
- -
3-Epimascadienolic acid determined as eecve substance
and at dose of 200 (µg/mL) signicantly enhanced the broblast
proliferaon and migraon and caused 45% reducon of the
scratch area.
- (21)
P. atlanca
Resin oil Ointment (5, 10, and 20%) Burn wound Animal model in
rats 14 days ↑Concentraon of the platelet-derived growth factor, the bFGF
and angiogenesis
α-Pinene, β -pinene, trans-
verbenol, sabinene and
trans-pinocarveol
(22)
Resin oil Oil with concentraon of 300
μL/kg/d Burn wound Animal model in
rats 14 days Sulfadiazine ↓wound size, ↑VEGF and hydroxyproline, ↓ MDA α-Pinene (23)
Fruit oil Oil (5% and 10%) was added
to gel base Cutaneous wound Animal model in
rats 21 days ↑Anoxidant parameters (SOD, CAT, plasma glutathione
peroxidase), ↓Plasma MDA α -Tocopherol (24)
Fruit oil Oil (5% and 10%) was added
to gel base Cutaneous wound Animal model in
rats 21 days
↑Tensile strength, ulmate stress, yield strength and sness.
More organized paern of collagen bers and beer ssue
alignment
Tocopherols and
tocotrienols (25)
Gum
Oral suspensions from
hydroethanolic extract (30
and 60%) and topical creams
from adding oil to Eucerin (30
and 60%)
Wound Animal model in
rabbits
21
days
The best wound healing eect was achieved with 60% cream
treatment
Flavonoids, triterpenes
and other phenolic
compounds
(26)
Hull
Ointment (1/5, 3 and 5%)
hydroethanolic extract was
added to Eucerin and Vaseline
Wound Animal model in
rats
21
days
↑Wound contracon rao, ↑ Fibroblast distribuon, ↓
Immune cells inltraon, ↑Mast cells up-regulaon and
neovascularizaon, ↓ Inammaon phase by smulang the
broblast proliferaon
Phenols and avonoids (27)
Hull
Ointment (2%) hydroethanolic
extract was added to
Eucerin and Vaseline with
combinaon of axseed (2%)
Wound Animal model in
rabbits 21 days
Nitrofurazone
ointment
(0.2%, w/w)
↑Wound healing, ↓ Inammaon phase, ↑Cellularity,
↑Collagen synthesis
High amount of α-pinene may be responsible for P. atlanca
wound healing eect
α-Pinene (28)
Fruit
Fruit oil (20%) in combinaon
with Sesamum indicum oil
(60%), Cannabis sava (12%)
oil and Juglans regia oil (8%)
Burn wound Animal model in
mice 21 days Silver
sulfadiazine
↑Wound contracon, ↓Epithelializaon me
-Signicant granulaon ssue formaon, scaered
inammatory cells inltraon, and collagenizaon in the dermis
and skin appendages.
Oleic acid, linoleic acid,
phenolic compounds and
pheophyn
(29)

Dermatological eects of Pistacia genus
Journal of Herbmed Pharmacology, Volume 13, Number 1, January 2024
http://www.herbmedpharmacol.com 31
Pistacia
species Plant part Type of preparaon Type of skin problem Type of study Duraon
of study Posive control Result Suggested responsible
constuents Ref.
P. khinjuk Unripe fruit Fruit methanolic extract
ointment (4% and 8%) Wound Animal model in
rats 20 days Zinc oxide
-Aer the sixth day of treatment: faster epithelizaon in P.
khinjuk group compared with zinc oxide.
- No signicant therapeuc dierence with the control group
Phenolic compounds (30)
P. lenscus8
Fruits Virgin fay oil Burn wounds Animal model in
rabbits 28 days Madecassol® ↑Wound contracon and reduce epithelializaon me
Unsaturated fay acids,
like oleic acid and linoleic
acid
(31)
Fruits
Fay oil, saponiable,
unsaponiable oily fracons
was added to paran oil
(10%, v/v)
Cutaneous wound Animal model in
rats 26 days Madecassol® ↑Wound contracon compared with untreated group - (32)
Fruits Fruit oil (0.56 µL/mm2),
vehicle was Saline soluon
CO2 laser fraconal
burn
Animal model in
rats 8 days CYTOL BASIC®
-Improvement of wound contracon and closure with more
collagen turnover
-Shorter epithelializaon me than other groups
Linoleic acid, β-sitosterol (33)
Fruits
Ointment 30% (v/v) prepared
by adding fruit oil to so
white Vaseline
Wound Animal model in
guinea pigs 21 days Cicaderma® ↑Wound contracon eect,↑Epithelializaon acvity
Oleic acid, linoleic
acid, tocopherols and
carotenoids
(34)
Fruit Mixture of P. lenscus berries
fay oil honey Burn wound Animal model in
rabbits 21 days Cicatryl ® Mixture showed beer eect than Cicatryl® and honey but pure
P. lenscus oil had the best wound contracon eect - (35)
Leaves
Ointment (10% and 30%):
Hydroethanolic extracts was
added to petroleum jelly
Full-thickness
wounds
Animal model in
rats
15
days Cicatryl-bio® ↑healing process, ↑wound contracon and ↓ epithelializaon
me
Phenolic compounds
like gallic acid and
paracoumaric acid
(36)
Leaves
Dislled leaves by-product
5 and 20 mg/mL; and
two isolated glycosylated
avonoids MM and QM with
concentraon of 1 mg/mL
Wound Animal model in
rats 14 days Centasia cream
Dislled leaves by-product (20 mg/mL), MM and QM molecules
exhibited faster wound contracons than the negave control
and the Dislled leaves by-product (5 mg/mL) groups. Higher
collagen biosynthesis, lower level of the CRP, low expression
level of the TNF-α and the CD-31 were detected in Dislled
leaves by-product (20 mg/mL), MM and QM treated groups.
MM, and QM at 100 µg/mL performed the highest elastase
inhibitory eect
Glycosylated avonoids,
MM and QM (37)
Oil was compared with
Wireless network or WIFI
signal (2.45 GHz) exposure
Sutured wounds Animal model in
rabbits 16 days
↑ Collagen deposion
- Ameliorate the general aspect of wounds.
- Extended inammatory phase of wound healing was in the
group of rabbits that received both WIFI and P .lenscus oil
Linoleic acid and
α-tocopherol (38)
Table 1. Continued

Bozorgi et al
Journal of Herbmed Pharmacology, Volume 13, Number 1, January 2024 http://www.herbmedpharmacol.com
32
Pistacia
species Plant part Type of preparaon Type of skin problem Type of study Duraon
of study Posive control Result Suggested responsible
constuents Ref.
Diabec Wound
P. atlanca
Resin Resin oil (250 µL/day) Wound
Streptozotocin-
induced diabec
rats
14 days - Wound healing
↑ Angiogenesis and collagen turnover - (39)
Hulls
Hydroethanolic extracts
of P. atlanca hulls and
Quercus infectoria galls,
alone or together. Qointment
preparaon: 5% of each
extract was added to so
yellow paran
Wound
Streptozotocin-
induced diabec
mice
14 days
- Full-thickness skin wound healing
↓ Inammaon phases, edema, immune cell migraon and
proliferaon stage, ↑ New vessels formaon, broblast
inltraon and collagen synthesis, ↑ GLUT-1
-(40)
Skin allergy (Atopic dermas)
P. lenscus Resin
Ointments (1, 3, 5 and 30%)
were prepared by dissolving
highly puried masc in
caprylic/capric triglycerides
ACD and AD Animal model in
mice 6 weeks
Glycyrrhizic
acid
dipotassium
salt (gk2,
0.1%) in
caprylic/capric
triglycerides
-In ACD: ↓ Inammaon, total IgE levels, lymphocyte
proliferaon in LNs and cytokine producon.
-In AD: Improvement of symptoms, itch behavior and cutaneous
barrier funcon.
-↓ Trans- epidermal water loss
-In vitro: ↓ Producon of IL-33, TSLP, and TARC levels
-(14)
Cutaneous leishmaniasis
P. atlanca
var. kurdica Gum
Cutaneous
leishmaniasis
(Leishmania major)
Animal model in
mice 8 weeks
Meglumine
anmoniate
(Glucanme®)
Reducon in skin lesion size and decrease in parasite survival
α-Pinene, limonene,
α-phellandrene,
β-pinene, β-myrcene,
3-carene, aldehyde
citral, epoxypinene,
limonene oxide, oleanonic
acid, moronic acid,
24Z-mascadienonic acid,
24Z-isomascadienonic
acid, 24Z-mascadienolic
acid, and
24Z-isomascadienolic
acid
(16)
Table 1. Continued

Dermatological eects of Pistacia genus
Journal of Herbmed Pharmacology, Volume 13, Number 1, January 2024
http://www.herbmedpharmacol.com 33
Pistacia
species Plant part Type of preparaon Type of skin problem Type of study Duraon
of study Posive control Result Suggested responsible
constuents Ref.
P. khinjuk Fruits
70% aqueous ethanol extract
In vitro: 0–100 𝜇g/mL In vivo:
Loon (20 and 30%)
Cutaneous
leishmaniasis
In vitro (L. tropica
(MRHO/IR/75/ER
strain) and in vivo
in mice
30 d
Meglumine
anmoniate
(Glucanme)
↓ Growth rate of promasgote (IC50: 58.6 ± 3.2 𝜇g/mL) and
intramacrophage amasgotes (37.3 ± 2.5 𝜇g/mL) of L. tropica
In vivo:↓ the number of parasites (30% extract)
Terpenoids, phenols,
avonoids, fay acids (41)
P. vera Branch
EO, (0.1 mL in 0.97 mL of
normal saline)
in vitro: 3.125 to 100 µg/mL
in vivo: (10, 20, and 30 mg/
mL)
Cutaneous
leishmaniasis
In vitro (L. tropica
(MRHO/IR/75/ER
strain) and in vivo
in mice
30 d
Meglumine
anmoniate
(Glucanme)
↓ Growth rate of amasgote forms (IC50 of 21.3 ± 2.1 µg/mL)
- In vivo: 87.5% recovery and ↓ mean diameter of the lesions
(30 mg/mL)
Limonene, α-pinene and
α-thujene (42)
Hyperpigmentaon disorders
P. vera Hull 80% aqueous methanol
extract Melanoma Human melanoma
SKMEL-3 cell
Tyrosinase
inhibitor (kojic
acid)
-Weak an-tyrosinase eect compared with kojic acid
- Strong anmelanogenic eect (~57%)
Phenolic and avonoid
compounds like gallic acid
and quercen
(43)
P. atlanca Fruit
Dierent fracons (methanol,
n-hexane, dichloromethane,
butanol, ethyl acetate, water)
Melanoma B16F10 murine
melanoma cells
Tyrosinase
inhibitor (kojic
acid)
-Mushroom tyrosinase inhibion
-Melanin synthesis inhibion
-Strong intracellular tyrosinase inhibitory from methanol and
ethyl acetate extracts
Polyphenols and avonoids (44)
P. lenscus Leaves Ethyl acetate extract, puried
QM and MM Melanoma B16 melanoma cells
Tyrosinase
inhibitor (kojic
acid)
-Mushroom tyrosinase inhibion acvity
-Reduced signicantly tyrosinase acvity on B16 cells
Flavonol glycoside, QM,
MM, kaempferol-3-O-
rhamnoside
(13)
MM, myricetin-3-O-rhamnoside; QM, quercetin-3-O-rhamnoside; ACD, Allergic contact dermatitis; AD, Atopic dermatitis; bFGF, basic fibroblast growth factor; VEGF, Vascular endothelial growth factor; MDA, Malondialdehyde; SOD,
superoxide dismutase; CAt, catalase; CD-31, Cluster of Differentiation 31; CRP, C-reactive protein; TNF-α: tumor necrosis factor alpha; GLUT-1, Glucose transporter 1; IgE, immunoglobulin E; LN, lymph node; IL, Interleukin; TSLP, thymic stromal
lymphopoietin; TARC, thymus- and activation-regulated chemokine.
Table 1. Continued

Journal of Herbmed Pharmacology, Volume 13, Number 1, January 2024 http://www.herbmedpharmacol.com
34
Bozorgi et al
Results
Wounds
According to the following, several studies have
investigated the effects of certain Pistacia herbs on wound
healing in several molecular pathways (Figure 2).
Pistacia vera
Using a second-degree burn wound model in rats,
Taghipour et al evaluated the effect of a topical ointment
Table 2. Risk of bias for in vivo studies (SYRCLE’s RoB tool)
Sequence
generaon
Baseline
characteriscs
Allocaon
concealment
Random
housing
Random outcome
assessment Blinding Incomplete
outcome data Others Reference
? Y ? Y ? ? Y Y 14
? Y ? Y ? ? N Y 16
? Y ? Y ? ? y Y 18
? Y ? Y ? ? y Y 19
? Y ? Y ? ? y Y 20
? Y ? Y ? ? y Y 21
? Y ? Y ? ? y Y 22
? Y ? Y ? ? y Y 23
? Y ? Y ? ? y Y 24
? Y ? Y ? ? y Y 25
? Y ? Y ? ? y Y 26
? Y ? Y ? ? y Y 27
? Y ? Y ? ? y Y 28
? Y ? Y ? ? y Y 29
? Y ? Y ? ? y Y 30
? Y ? Y ? ? y Y 31
? Y ? Y ? ? y Y 32
? Y ? Y ? ? y Y 33
? Y ? Y ? ? y Y 34
? Y ? Y ? ? y Y 35
? Y ? Y ? ? y Y 36
? Y ? Y ? ? N Y 37
? Y ? Y ? ? y Y 38
? Y ? Y ? ? y Y 39
? Y ? Y ? ? y Y 40
? Y ? Y ? ? y Y 41
? Y ? Y ? ? y Y 42
“Y”: low risk of bias, “N”: high risk of bias, and “?”: not sufficient information reported.
Note: Scale was adapted according to the use of different in vivo experimental models.
Figure 2. Molecular mechanisms of Pistacia genus in wound healing
based on reviewed studies.
prepared from the extract of Pistacia vera (Pistachio) nut
oil (5% and 10%). In 28 anesthetized animals, second-
degree burn wounds were inflicted using a hot plate.
The animals were treated with Pistachio creams, base
creams, or dexpanthenol for 22 days. Pistachio ointment
significantly improved burn wound healing after 12 days
(10%). After 22 days, no scars were observed in animals
treated with Pistachio ointment (10%). Pistachio ointment
(10%) resulted in denser collagen deposition within the
reticular layer and repaired epithelium (18).
A study was conducted to investigate the wound healing
properties of Algerian and Italian P. vera oleoresins. The
EOs of oleoresins were obtained by hydrodistillation
method. According to gas chromatography – mass
spectrometry (GC-MS) analysis, α-pinene was the main
composition of both EOs. For ointment preparation,
EOs (5%) were separately mixed with petroleum jelly. An
excision wound model was used in rabbits for 16 days and
Cicatryl-Bio was used as a positive control. Algerian and
Italian EOs both showed strong wound healing effects
comparable to the control groups (19). A circular wound
excision model was also used to investigate the efficacy
of Algerian and Italian P. vera resins. Fraction analysis
showed that oleoresins contained high levels of terpenoids.

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Dermatological eects of Pistacia genus
Topical ointments were prepared by adding oleoresins
to Vaseline (5% w/w). Wound excision induced on the
dorsum of rabbits. Both ointments showed remarkable
wound contraction from day 8 to day 16 as compared to
the negative control and no statistically difference was
observed with positive control (Cicatryl). Additionally,
neither of these ointments caused any skin irritation
(20). The phytochemical content of the studied resins
was analyzed and the major compounds were reported as
α-pinene and some oxygenated monoterpenes (Table 1).
In a study the methanol 80% extract of P. vera L. hulls
was fractioned and investigated for wound healing
activity by scratch assay on NIH/3T3 murine fibroblast
cells. Higher wound healing effect was observed from
chloroform fraction and 3-epimasticadienolic acid,
which was determined as main effective compound
using chromatographic methods. 3-Epimasticadienolic
acid (200 µg/mL) significantly enhanced the fibroblast
proliferation and migration and caused 45% reduction of
the scratch area. Considerable inhibitory effect on gene
expression of interleukin 6 (IL-6) and tumor necrosis
factor alpha (TNF-α), and a stimulation effect on NF-κB
gene expression at the same dose was also reported from
this compound (21).
Pistacia atlantica
The efficacy of P. atlantica resin extracts for the treatment
of burn wounds has been studied in thirty-two Wistar
rats. Resin oil was obtained using the hydro-distillation
method. A topical ointment was prepared from resin oil
with concentrations of 5%, 10%, and 20%. A higher resin
oil concentration had a better impact on burn wound
treatment after 14 days. The concentrations of platelet-
derived growth factor and basic fibroblast growth factor
increased with increasing resin oil levels. Further, higher
concentrations of the ointment enhanced angiogenesis.
The chemical composition of the studied extract was
analyzed and the main compounds were reported as
α-Pinene (46.57%) and the other monoterpenes (Table 1)
(22).
Pistacia atlantica resin oil was tested on thirty rats with
burn wounds. Topical use of P. atlant ica resin oil for 14 days
resulted in a significant reduction in wound size compared
to sulfadiazine as a positive control. The mechanisms
involved were vascular endothelial growth factor (VEGF),
hydroxyproline elevation, and malondialdehyde (MDA)
reduction. The α-pinene content of the studied resin oil
enhanced wound healing (23).
In an experiment, Hamidi et al evaluated the
antioxidant activity of P. atlantica fruit oil. Fruit powder
was extracted with n-hexane, and obtained oil (5% and
10%) was added to a gel base. After cutaneous wound
creation, animals received P. atlantica fruit oil gels or
base gel for 21 days. P. atlantica gels (especially gel 10%)
could reduce oxidative stress during wound closure
by improving blood enzyme antioxidants (superoxide
dismutase, catalase and glutathione peroxidase) as well
as lipid peroxidation (plasma MDA) (24). In another
study, Hamidi et al investigated the potential mechanisms
underlying cutaneous wound healing by P. atlantica oil
gels (5 and 10%). Treatment with P. atlantica fruit oil
gel (10%) improved re-epithelialization with continuous
stratum basalis, mature granulation tissue, and adnexa
(hair follicles, sweat glands). Compared to the negative
control, P. atlantica fruit oil gel (10%) enhanced the tensile
strength, ultimate stress, yield strength, and stiffness,
considerably. B oth P. atlant ica fruit oil gels resulted in more
organized collagen fibers and better tissue alignment (25).
The tocopherol and tocotrienol contents of the studied oil
was suggested to enhance wound healing via modulating
the oxidative stress (25).
Pistacia atlantica gum was investigated for its wound
healing activity and its effect on blood serum biochemical
parameters in 40 rabbits. Hydroethanolic extracts (30%
and 60%) were added to distilled water to prepare oral
suspensions. In order to prepare topical ointment (30%
and 60%), EOs were added to Eucerin. A better wound
healing progression was observed in the topically
treated group after 21 days, especially in those who used
ointment 60%. The enhancement of catalase, glutathione
peroxidase, and superoxide dismutase in serum samples
confirmed the antioxidant effects of P. atlantica ointment
(26). The wound healing properties of P. atlantica hull
ointment (1%, 3%, and 5%) were evaluated in white Wistar
male rats. To prepare the ointment, hydroethanolic extract
of P. atlantica hull was added to the base formulation
(Eucerin and Vaseline in 1:3 proportions). Compared
with a negative control, all doses of ointment accelerated
wound healing, facilitated wound contraction, and
enhanced neovascularization after 21 days. P. atlantica
hull also increased collagen deposition by up-regulating
mast cells and distributing fibroblasts. Additionally, no
skin irritation was observed in any of the treated groups
in the acute toxicity test. The high amounts of phenols and
flavonoids found in P. atlantica hull extract may contribute
to its wound healing properties (27).
A combination of P. atlantica hull ointment (2%) with
flaxseed (2%) was used to evaluate wound healing in
rabbits. Nitrofurazone ointment (0.2 %, w/w) was used as
a positive control. Compared to the control group, flaxseed
and pistachio oil ointment accelerated wound healing by
shortening the inflammation phase, elevating cellularity,
and promoting collagen synthesis. Antibacterial and anti-
inflammatory properties of P. atlantica may contribute
to its wound healing abilities. P. atlantica contains a
high concentration of α-pinene (46.57%) and powerful
antioxidant compounds that are known to accelerate
wound healing (28).
The burn wound healing effect of P. atlantica fruit
oil (20%) combined with Sesamum indicum oil (60%),

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Bozorgi et al
Cannabis sativa oil (12%) and Juglans regia oil (8%) was
evaluated in 24 mice for 21 days. As a positive control, silver
sulfa-diazine was used. When compared to the control,
this combination significantly reduced epithelialization
time and stimulated wound contraction. In addition, this
combination resulted in a significant granulation tissue
formation, scattered inflammatory cell infiltration, and
collagenization in the dermis. Oil from P. atlantica fruit
contains oleic, linoleic acids, phenolic compounds, and
pheophytin, which may be responsible for its antioxidant,
anti-inflammatory, and wound healing properties (29).
Topical use of P. atlantica resin oil (250 µL/day) was
also evaluated for burn wound healing activity in thirty
Streptozotocin-induced diabetic rats. After 14 days, a
significant wound healing effect was observed in the P.
atlantica oil-treated group compared with the negative
control group. Improvement in antioxidant status was
reported as one of the involved mechanisms. In addition,
VEGF and hydroxyproline contents were elevated in the
wound area indicating the effect of P. atlantica resin oil on
angiogenesis and collagen turnover (39)
Hydroethanolic extracts of P. atlantica hulls and Quercus
infectoria galls, alone or together, were administered
topically for wound treatment in streptozotocin-induced
diabetic mice. For ointment preparation 5% of each
extract was added to soft yellow paraffin. After 14 days, a
full-thickness skin wound healing effect was observed in
all groups compared with the negative control group. The
involved mechanisms included: reduction in inflammation
phases, edema, immune cell migration, and proliferation
stage, with an increase in new vessel formation, fibroblast
infiltration, and collagen synthesis. In addition, P. atlantica
hulls and Q. infectoria galls significantly increased glucose
transporters (GLUT-1) and glypican-3 (GPC3) expression
(Enhancement of GPC3 expression causes an increase in
fibroblasts and fibrocytes) (40).
Pistacia khinjuk
The wound healing activity of methanolic extract of P.
khinjuk unripe fruit was investigated in Wistar albino male
rats. P. khinjuk fruit extract ointment was applied for 20
days to the animals, whereas zinc oxide ointment was used
as a positive control. On the sixth day of treatment, faster
epithelization was observed in the P. khinjuk ointment
group compared with the control group. Reactive oxygen
species (ROS) can prolong wound healing. The phenolic
compounds of P. khinjuk due to their antioxidant activities
can prevent ROS destructive effects (30).
Pistacia lentiscus
Virgin fatty oil from P. lentiscus fruits was obtained by
the traditional cold-press method and applied topically
to rabbit burn wounds. A comparison was made between
the oil-treated group, the non-treated group, Vaseline
gel, and Madecassol® (cream 1% that contains Centella
asiatica as a main component). Compared to nontreated
and Vaseline-treated groups, Madecassol® and fruit oil
significantly increased wound contraction and reduced
epithelialization time after 28 days. Oil from P. lentiscus
fruit contains unsaturated fatty acids like oleic and
linoleic acids. Compounds like these can help reduce
trans epidermal water loss and promote wound healing by
providing essential lipids (31).
Boulebda et al studied P. lentiscus fruits fatty oil and
its saponifiable and unsaponifiable oily fractions on
cutaneous wound in rats. Oil and fractions added to
paraffin oil (10 %, v/v) as vehicle. Madecassol® was
administered as positive control. After 26 days, P. lentiscus
fruits fatty oil and its unsaponifiable fraction significantly
promoted wound contraction compared with untreated
group (32).
In a rat model, P. lentiscus fruit oil (0.56 L/mm2) was
applied for 8 days to carbon dioxide (CO2) laser fractional
burns. The negative control was the saline solution
(vehicle) while the reference cream was CYTOL BASIC®
(restoring and soothing skin cream based on grape
seed extract). Compared with other groups, P. lentiscus
fruit oil significantly improved wound contraction and
closure by increasing collagen turnover and reducing
epithelialization time. It is possible that linoleic acid
promotes wound healing by promoting epidermis
differentiation. As the main compound of P. lentiscus fruit
oil, sitosterol is capable of improving wound healing and
angiogenesis (33).
Pistacia lentiscus fruit oil was also investigated for its
wound healing effect in guinea pigs. Fruit oil was obtained
using the cold press method. An oil-based ointment of
30% (v/v) was prepared by adding fruit oil to soft white
Vaseline. Cicaderma® was used as a reference ointment.
On the 15th of treatment (duration was 21 days), P.
lentiscus oil-based ointment showed a significant wound
contraction effect compared with reference ointment. A
more significant epithelialization effect resulted from both
P. lentiscus and Cicaderma® compared with the negative
control and vehicle groups. The wound healing effects
may be caused by linoleic acid, oleic acid, tocopherols, and
carotenoids (34).
A mixture of P. lentiscus berries oil (P. lentiscus fatty
oil) and honey was evaluated for the cicatrizing effect on
burn wounds in rabbits. The duration of treatment was
22 days and Cicatryl® was used as a standard drug. In
addition, the effect of the mixture of P. lentiscus oil and
honey (0.5 g) was compared with the use of either honey
(0.5 g) or P. lentiscus oil (0.5 mL) alone. All three groups
significantly improved wound contraction compared to
Cicatryl®. During the inflammatory and proliferative
phases, the effect of pure P. lentiscus oil was better than
honey or mixture. The mixture’s wound contraction
effect was significantly better than honey on the 14th day
of treatment. So, researchers suggested that P. lentiscus

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Dermatological eects of Pistacia genus
berries oil could modify the wound healing effect of
honey during the inflammatory phase of the cicatrizing
process (35).
Hydroethanolic extracts of P. lentiscus leaves (10% and
30%) were added to petroleum jelly and applied to full-
thickness wounds (4 cm2) in rats. Cicatryl-Bio® was used
as a positive control and the duration of treatment was
15 days. P. lentiscus leaf ointments showed an accelerated
healing process compared to control via promoting
wound contraction and reducing epithelialization time.
The antioxidant properties of P. lentiscus leaves phenolic
compounds, such as gallic acid and paracoumaric acid,
can aid in wound healing (36).
The wound healing properties of the by-product of
P. lentiscus leaves after steam distillation (5 and 20 mg/
mL), myricetin-3-O-rhamnoside (MM), and quercetin-
3-O-rhamnoside (QM) at the concentration of 1 mg/
mL were tested in rat models. Centasia cream and
physiological serum were used respectively as positive
and negative controls. After 14 days, distilled leaves by-
product (20 mg/mL), MM and QM molecules exhibited
faster wound contractions than the negative control
and the distilled leaves by-product (5 mg/mL). Higher
collagen biosynthesis, lower level of the C-reactive protein
(CRP), lower expression level of the pro-inflammatory
factor TNF-α, and the angiogenesis marker (Cluster of
differentiation; CD-31) were detected in distilled leaves
by-product (20 mg/mL), MM, and QM treated groups.
In addition, MM, and QM at 100 µg//mL performed the
highest elastase inhibitory effect (37).
A study conducted by Latrach et al, investigated the
effects of topical P. lentiscus oil and wireless network
(WIFI) signal exposure on rabbit sutured wounds. Results
showed that separate use of P. lentiscus oil or WIFI could
accelerate collagen deposition and improve the general
aspect of wounds over 16 days. In contrast, the rabbits
receiving both WIFI and P. lentiscus oil had a prolonged
inflammatory phase of wound healing. Therefore,
researchers suggested that P. lentiscus oil and WIFI signals
should not be used together to treat wounds. Linoleic acid
and α-tocopherol were suggested as the main responsible
components for wound healing activity (38).
Skin allergy (Atopic dermatitis)
Using a murine model of allergic contact dermatitis (ACD)
and atopic dermatitis (AD), P. lentiscus resin was studied in
two steps. Highly purified mastic was dissolved in caprylic/
capric triglycerides to prepare P. lentiscus ointments (1%,
3%, 5%, and 30%). Glycyrrhizic acid dipotassium salt
(gk2, 0.1%) in caprylic/capric triglycerides was used as a
positive control substance. The initial test was performed
on the ACD mouse model. The anti-inflammatory effect of
P. lentiscus ointments (3%) was confirmed by suppression
of ear swelling, histological findings of inflammation, total
immunoglobulin E (IgE) levels, lymphocyte proliferation
in lymph nodes (LNs), and cytokine production. Anti-itch
properties were also observed in the 30% mastic-treated
group. In the second step, mastic ointments (3% and 5%)
were evaluated in an AD murine model, and both products
showed remarkable improvement in AD symptoms, itch
behavior, and cutaneous barrier function. Moreover, these
effects were confirmed by a reduction in trans-epidermal
water loss. Mastic significantly reduced the production
of interleukin-33, thymic stromal lymphopoietin (TSLP),
thymus- and activation-regulated chemokine (TARC)
levels (14).
Photoprotective effect
Twelve healthy volunteers (aged 25-35) were studied
for a photoprotective effect of the extracts from the
seeds and skin of P. vera L. Pistachio skin was extracted
with methanol/water and pistachio decorticated seed
was extracted in two steps with hexane and methanol/
water. Each extract was prepared as an oil/water (O/W)
emulsion (2% concentration) and tocopheryl acetate was
administered as the reference ingredient at the same dose
for an in vivo use. Both extracts, especially the Pistachio
skin extract, reduced UV-B-induced skin erythema with
comparable effects to a positive control. Pistachio skin
extracts showed the highest phenolic level, with cyanidin-
3-O-galactoside identifying as the main compound.
Pistachio skin extract also had the highest antioxidant
activity, which might contribute to its photoprotective
properties (15).
Cutaneous leishmaniasis
Pistacia atlantica var Kurdica gum was investigated for
its effects on the treatment of cutaneous leishmaniasis in
mice. Glucantime® or P. atl antica gum was topically applied
to mice infected with Leishmania major subcutaneously.
P. atlantica gum and Glucantime® reduced skin lesion
size and parasite survival after 8 weeks when compared
with a negative control group (16). Monoterpenes and
triterpenes in the studied gum were suggested as potential
active compounds (16).
Pistacia khinjuk dry fruits were extracted with 70%
aqueous ethanol and evaluated for antileishmanial activity
in vitro and in vivo. The extracts (0–100 g/mL) were used
for in vitro studies against promastigote and intracellular
amastigote forms of L. tropica (MRHO/IR/75/ER). The
lotion (20% and 30%) from P. khinjuk was applied topically
every day for 30 days to mice suffering from cutaneous
leishmaniasis caused by Leishmania major. Meglumine
antimoniate (MA, Glucantime) was used as a positive
control. In vitro assays showed significant inhibition of
the growth rate of promastigote (IC50 58.6 ± 3.2 𝜇g/mL)
and intramacrophage amastigotes (37.3 ± 2.5 𝜇g/mL) of L.
tropica with a dose-dependent manner. Compared to MA,
P. khinjuk extract (30%) caused a significant reduction in
parasite numbers and a 75% recovery in infected mice.

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Bozorgi et al
Terpenoids, phenols, flavonoids, fatty acids, and sterols
were suggested to be responsible for antileishmanial
effects (41).
Pistacia vera branch EO was obtained by hydrodistillation
method and evaluated in vitro (3.125 to 100 µg/mL)
against intracellular amastigote forms of L. tropica
(MHOM/IR/2002/Mash2) and in vivo (10, 20, and 30 mg/
mL) against cutaneous leishmaniasis (L. major) in mice.
MA (Glucantime®) was used as a positive control. The
main EO components were limonene (26.21%), α-pinene
(18.07%), and α-thujene (9.31%). In vitro studies showed
significant inhibition of amastigote growth (IC50 of 21.3 ±
2.1 µg/mL) in a dose-dependent response compared with
the control drug. In the in vivo assay, 87.5% recovery and
a significant reduction in the mean diameter of the lesions
resulted from a concentration of 30 mg/mL of the EO (42).
Skin toxicity resulted from cetuximab
Traditionally made soap from P. terebinthus fruit oil
was evaluated for the treatment of grade 2 and 3 skin
toxicity induced by cetuximab in metastatic colorectal
cancer patients. Fifteen patients who received cetuximab
in combination with chemotherapy and were suffering
from skin toxicity used P. terebinthus soap twice daily
for one week. The complete response rate was 100% in
patients with grade 2 skin lesions. A complete response
was observed in 33% of patients with grade 2 lesions, and
grade 1 lesions were observed in the rest. Skin lesions
reappeared in all patients after stopping using soap (45).
Nipple fissure
An ointment of P. atlantica (Saqez) was prepared with 7
g of Saqez, 7 g of beeswax, and 10 g of ghee, and topically
administered to 100 volunteer mothers suffering from
nipple fissures. The ointment was applied three times a
day for one week in the intervention group. The control
group was advised to apply two to three drops of breast
milk to their nipple fissure. P. atlantica ointment caused
an 83% reduction in fissure severity and an 85 % reduction
in pain severity compared to the control. P. atlantica’s
anti-inflammatory effect was related to α-pinene,
monoterpenoids, and triterpenoids. Moreover, α-pinene
could be responsible for antibacterial activity (46).
Skin hyperpigmentation disorders
Skin hyperpigmentation disorders refer to conditions
where patches of skin become darker than the surrounding
skin due to an excess of melanin (47). A common form
of hyperpigmentation is melasma, which typically affects
women during pregnancy or while taking hormonal
contraceptives (47,48). Pharmacotherapy options
for hyperpigmentation disorders may involve topical
preparations containing ingredients like hydroquinone,
retinoids, or kojic acid (49). Herbal products for improving
hyperpigmentation have gained interest recently (50).
There are herbs such as the Pistacia genus which have
potential to be used in skin lightening formulations with
clinical efficacy.
In a study, P. vera pink and creamy white hulls were
extracted in 80% aqueous/methanol. Assays of mushroom
tyrosinase activity showed weak anti-tyrosinase activity
of P. vera extract compared with tyrosinase inhibitor
(kojic acid). The P. vera extract at a high dose (0.5 mg/
mL) demonstrated significant cytotoxic activity (~63%)
and strong anti-melanogenic effect (~57%) on human
melanoma SKMEL-3 cells after 72 h of incubation.
P. vera extract showed considerable DPPH radical
scavenging activity attributed to its anti-melanogenic
properties. Phenolics and flavonoids like gallic acid and
quercetin were suggested as the main effective antioxidant
compounds (43).
Various fractions (methanol, n-hexane, dichloromethane,
butanol, ethyl acetate, water) and EO of P. atlantica
subsp. Mutica unripe fruit were investigated for anti-
melanogenesis and anti-tyrosinase activities. Mushroom
tyrosinase was significantly inhibited by all extracts in
comparison with Kojic acid (positive control). Different
samples showed a significant inhibitory effect on melanin
synthesis in B16F10 murine melanoma cells. However,
this effect was not observed in EO and butanol extracts.
Methanol and ethyl acetate extracts had strong cellular
tyrosinase inhibitory activity in B16F10 murine melanoma
cells, which was in accordance with melanin reduction. In
addition, P. atlantica samples significantly reduced ROS
in melanoma cells. Polyphenols and flavonoids possess
antioxidant effects and can be attributed to the anti-
melanogenic effect of this plant (44).
Distilled leaves of P. lentiscus were dried and extracted
with ethyl acetate. The main separated phenolic
compounds were QM, MM, and kaempferol-3-O-
rhamnoside. According to a transdermal diffusion study,
MM penetrated the membrane barrier at a greater rate
than other compounds. Comparatively to kojic acid,
MM, and QM inhibit mushroom tyrosinase. Inhibition of
elastase by MM and QM was significant, but lower than
that of ethyl acetate extract. Epigallocatechin gallate was
used as a positive control for the elastase activity assay.
Intracellular tyrosinase inhibitory and cytotoxicity assays
on skin melanoma cells (B16) showed that ethyl acetate
extract, QM, and MM have considerable inhibitory
activities compared to the positive control kojic acid at
non-cytotoxic concentrations (13, 37).
Discussion
It was found that Pistacia genus has been investigated
in several dermatological disorders, including wounds,
hyperpigmentation disorders, cutaneous leishmaniasis,
and AD. Twenty studies have been conducted on wounds,
mainly burn wounds, and two studies on diabetic wound
models. Both diabetic ulcer studies were on P. atlantica.

Journal of Herbmed Pharmacology, Volume 13, Number 1, January 2024
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Dermatological eects of Pistacia genus
According to the chemical compounds in the mentioned
plant parts, different mechanisms could be involved
in wound healing. Generally, in the healing process
of wounds, there are three parallel phases, including
inflammatory, proliferative, and remodeling phases
(51,52).
The most studied plant parts were seeds and fruits.
Oleoresin, the hull, and plant leaves have also been
investigated.
The main compositions of seed oil in this genus are
unsaturated fatty acids. P. vera (53), P. atlantica (54),
and P. lentiscus (55) have been reported with remarkable
contents of oleic acid, linoleic acid, and linolenic acid
followed by other saturated fatty acids and triglycerides.
Linoleic and oleic acids have been shown to have pro-
inflammatory effects during the wound-healing process
by increasing VEGF-alpha and IL-1β levels, in vitro. Also,
oleic acid stimulates the generation of cytokine-induced
neutrophil chemo-attractants in inflammation 2 alpha/
beta (CINC-2alpha/beta) that might accelerate the wound
healing (56). Moreover, it has been shown that in wound
healing, oleic acid modulates the immune response (57).
Oleoresins of the Pistacia genus have also been studied
in wound healing experimental models. The most
prominent chemicals in their EOs are α-pinene and
β-pinene. It has been indicated that alpha-pinene promotes
wound healing by generating scars with sufficient tensile
strength, speeding up wound closure, acting as an
adhesive of primary intention, and forming collagen (58).
Also, some studies have shown antibacterial activity for
these monoterpenes (22,59) which can be effective in
wound healing. α-Pinene was also shown with moderate
anti-inflammatory activity, in vivo (60), and contributed
to wound healing by providing anti-inflammatory effect
in chronic wounds (61) with prolonged inflammatory
response (62). In case of dermatitis, anti-inflammatory
effects of P. lentiscus resin preparation has also been
shown via the regulation of total IgE levels, lymphocyte
proliferation in LNs, and cytokine production. It also
decreased the production of IL-33, TSLP, and TARC
levels, in vitro (14)
Pistacia atlantica hull extrac t has also been reported with
remarkable amounts of total phenolic content, flavonoids,
phenolic acids, resulting in higher antioxidant activities
compared to another parts of the fruits, including shell and
kernel (63). Furthermore, various studies have reported
that the P. lentiscus leaves have significant amounts of
phenolic compounds in addition to EO contents similar
to other parts of the plant (64,65). In wound treatment,
polyphenols are becoming increasingly popular due to
their antimicrobial properties, regenerative capabilities,
and antioxidant properties (66).
It has been indicated that regulating redox balance
through the modulation of antioxidant levels that results
in maintaining ROS in non-toxic levels could accelerate
healing rate of wounds (67,68). In diabetic wound
healing, oxidative stress regulation is also crucial (69).
Phenolic compounds have been shown to affect oxidative
stress, inflammatory process, re-epithelialization, and
angiogenesis. They could mediate several factors and act
on macrophages, fibroblasts, endothelial cells, as well as
inflammatory cytokines (70). Some of the mentioned
mechanisms have been demonstrated in two studies
reporting the healing effect of P. atlantica resin oil and
its hull extract administered topically on wounds in
streptozotocin-induced diabetic animals (23,40).
Among other areas studied regarding the dermatological
effects of Pistacia sp., we can point out their effects
on tyrosinase enzyme activity as well as on cutaneous
leishmaniasis. According to the available literature,
among the different plants of this genus, P. atlantica and
then P. lentiscus species have the most evidence regarding
wound healing. Also, species of P. atlantica, P. vera, and
P. Khinjuk are considerable in terms of anti-leishmaniasis
effects. Although there are several in vitro studies on anti-
leishmaniasis activity of plants in Pistacia genus (71,72)
P. khinjuk, P. vera and P. atlantica have been especially
evaluated in cutaneous leishmaniasis in vitro and in vivo
(16,41,42). Some findings revealed that P. khinjuk initiated
the production of nitric oxide compared to untreated
macrophages (41). Also, an in silico study proposed two
compounds from P. atlantica, 3-methoxycarpachromene
and masticadienonic acid as inhibitors of L. infantum
trypanothione reductase, which has a crucial role against
virulence of these parasites (73).
Conclusion
In general, Pistacia species might play a role in
dermatological disorders management, especially in
wound-healing. The main chemical compounds that
have had a potential for therapeutic effects are α-pinene,
β-pinene, and triterpenoid compounds found in the EOs
of these plants, unsaturated fatty acids in their oils, and also
the phenolic compounds found in the prepared extracts.
This genus probably provides new therapeutic preparations
for skin disorders as adjuvant therapy. Nevertheless, more
human clinical studies should be conducted to found the
optimum drug delivery methods and dosages that would
be helpful for different dermatological conditions. The
herbs reviewed in this study illustrate a great potential
for the development of prescription or over-the-counter
dermatology medications from botanical compounds and
extracts in particular from the genus Pistacia.
Authors’ contributions
Conceptualization: Mahbubeh Bozorgi.
Data curation: Mahbubeh Bozorgi, Zahra Memariani, Ahmad
Ali.
Formal analysis: Mahbubeh Bozorgi, Zahra Memariani,
Maryam Iranzad.

Journal of Herbmed Pharmacology, Volume 13, Number 1, January 2024 http://www.herbmedpharmacol.com
40
Bozorgi et al
Investigation: Zahra Memariani, Maryam Iranzad, Ahmad Ali,
Mahbubeh Bozorgi.
Methodology: Zahra Memariani, Mahbubeh Bozorgi, Maryam
Iranzad
Project administration: Mahbubeh Bozorgi, Zahra Memariani.
Resources: Maryam Iranzad, Ahmad Ali.
Software: Mahbubeh Bozorgi, Zahra Memariani.
Supervision: Zahra Memariani.
Validation: Mahbubeh Bozorgi, Maryam Iranzad, Ahmad Ali.
Visualization: Mahbubeh Bozorgi, Zahra Memariani.
Writing–original draft: Mahbubeh Bozorgi, Zahra Memariani.
Writing–review & editing: Mahbubeh Bozorgi, Zahra
Memariani, Maryam Iranzad, Ahmad Ali.
Conflict of interests
There is no conflict of interest.
Ethical considerations
Not applicable.
Funding/Support
There was no financial support for the conduct of this review
paper.
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