Natural Products for Treatment of Skin and Soft Tissue Disorders

Eczema is not a condition but a group of skin diseases that causes skin inflammation and irritation. It exists in several different forms, and each form has its signs and symptoms. Eczema is also referred to as Atopic dermatitis (AD), which is its most prevalent and popular form, with a high global burden in morbidity and healthcare costs. It is a chronic recurrent skin inflammatory disorder that is characterized by itching, redness, burning sensation of dark or light patches, papular bumps and weeping or crusting eruptions of the skin. Pathophysiology of AD is complex and multifactorial, involving genetic predisposition, skin barrier defects, immunological dysfunction and regulation, microbial colonisation, neuroinflammation, altered lipid composition, food allergies and other environmental risk factors. Currently, available treatment regimens, which include corticosteroids, calcineurin inhibitors, antibiotics, immunomodulatory agents, UV therapy, may offer some relief to patients, but there is no permanent cure for the disease. Specific cases may additionally need psychosomatic counselling (in stress induces exacerbations), Monoclonal antibodies targeting T-helper 2 pathways and aeroallergens, which may improve the condition of associated asthma or rhinitis. To minimize the side-effects caused by conventional treatments such as skin atrophy, telangiectasia, lymphomas and malignancies, Novel jakus kinase (JAK) receptor inhibitors are under development which are believed to show promising effects in treating AD. Traditional Chinese herbs, used widely, have revealed some supplementary activity in reducing the severity of AD. Tapinarof, a naturally derived stilbene that activates aryl hydro carbon receptor (AHR) and triggers inflammation, has shown significant results in AD and psoriasis patients. Homeopathy, aroma therapy, essential oils, essential fatty acids, vitamins and minerals, have also been exemplified to aid clinical AD treatment.

Superficial mycoses of the skin, nails and hair caused by dermatophytes, non-dermatophyte molds, yeasts and yeast-like fungi are among the most common morbidity of the skin, especially in tropical regions of the world. Various antifungal agents, including polyenes, fluoropyrimidines, echinocandins, and azoles, have been commonly used, topically and/or orally, for the treatment of superficial mycoses. Nevertheless, the conventional treatment guideline is not always successful due to drug resistance as well as the possibility of drug interactions and side effects. Recently, the search for new antifungal compounds, such as naphthoquinones, anthraquinones, terpenoids, saponins and flavonoids from medicinal plants toward novel drug development, has attracted a lot of attention. This chapter describes the common superficial mycoses as well as their pathophysiology, epidemiology and current treatment options. Promising herbal extracts or phytochemicals and their products used as therapeutic alternatives for combating superficial mycosis are also highlighted.

Acne vulgaris is one of the most skin diseases related to the sebaceous gland, characterized by multiple pathogenic factors. The treatment strategies involve the blockage of these pathological factors. Conventional therapies for the treatment of Acne vulgaris in controlling its pathological factors are still inadequate in providing therapeutic effectiveness and exhibit remarkable side effects. New therapeutic agent development for acne treatment is still stagnant. Recently, researchers have been focusing and seeking great interest in the treatment of acne through natural products – as a new therapeutic option. In this regard, multiple natural products have been evaluated for their potential to treat acne, including berberine, α-mangostin, curcumin, ampelopsin, fustin, ellagic acid, gallic acid, myricetin, lupeol and many more. These natural products have been reported as suitable candidates for blocking multiple pathogenic factors associated with acne. In addition, the nanotechnology-based delivery of natural products is a new platform and treatment option for Acne vulgaris. Natural products nano-based delivery resolves many other issues concerned with natural products apart from treatment aid. Natural products, therefore, pose a precious source in determining new agents for the treatment of acne. However, reported studies are preclinical, and to obtain reliable and conclusive results, further clinical studies are required to uplift natural products from bench top to clinical setup in treating the worst consequences of Acne vulgaris. 

Vitiligo is an abiding acquired skin disorder caused by the epidermal disappearance of pigment cells of localized and general skin mucosa, characterized by the appearance of symmetrical patches on the skin. The exact cause of this disorder is unknown, but genetic susceptibility, melanocyte growth factor deficiency, autoimmunity, and some neurological and environmental factors are believed to play a triggering role. Although no drugs are completely successful in managing this disorder, many different approaches, such as topical corticosteroids, calcineurin inhibitors, transplantation, newly emerged phototherapy, or the combination approaches, however, have shown positive results and have helped to restore skin tone in people with small areas of depigmentation. The association of the adverse effects such as redness, itching, burning, pruritis, xerosis cutis, or potential risk of skin cancer and the high treatment cost with these therapies has necessitated the development of other newer treatment approaches such as phytotherapy for vitiligo. Also, novel drugs are being developed that either stimulate the melanocytes, like afamelanotide, or help control or protect the melanocytes. Many herbal drugs have been reported beneficial in the treatment of vitiligo, which has been shown to stimulate melanogenesis, proliferation or migration of melanocytes or have immunomodulatory properties. Further research on herbal drugs should be extended to develop safe, effective and affordable treatments for vitiligo. 

Atopic dermatitis (AD) is a common inflammatory skin disorder characterized by recurrent eczematous lesions and intense itch. More precisely, the earliest lesion is a small erythematous papule or papulovesicle. These papules may then later become erythematous plaques with clinical features of weeping, crusting, or scaling, depending on the severity of the lesions. The most problematic symptom of AD is itch. The “itch-scratch” cycle involves the act of scratching affected areas of the skin to relieve AD-associated itch, which can further worsen the disease. This skin disorder affects people of all ages and ethnicities, has a substantial psychosocial impact on patients and relatives, and is the leading cause of the global burden of skin disease. Moreover, AD persistence has been reported in 60% of adults who had the disease as children. AD is associated with an increased risk of multiple comorbidities, including food allergy, asthma, allergic rhinitis, and mental health disorders. The pathophysiology is complex and involves a strong genetic predisposition, epidermal dysfunction, and T-cell-driven inflammation. There is increasing evidence that AD involves multiple immune pathways. Currently, there is no cure, but increasing numbers of innovative targeted therapies hold promise for achieving disease control. As effective medical treatments for this condition are limited in number, many patients have turned to alternative therapies, including so-called natural products, such as herbs and algae. In this chapter, we summarized and discussed advances in the understanding of the disease and its implications for prevention, management, and future research, with a focus on natural solutions. 

Skin diseases are common public health problems in developing countries. The prevalence is universal and can cause a significant economic burden. Additionally, it is a common cause of morbidity among vulnerable groups, such as children, and affects people of all ages and ethnicities. However, the impact of skin disease on the national public healthcare system is complex and poorly studied, particularly in developing countries. A number of factors, including population aging, genetics, and environment, have contributed to the change in skin disease trends. The combined effects of these factors have severe health implications for people, and their dynamics are not fully understood. It is thus necessary to improve diagnostic techniques in order to provide new therapeutic resources in dermatology in the wake of the scientific revolution and technological innovations. To understand the changes in the prevalence of skin disease age-specific distributions and associated mortality, this study provides comprehensive information on vulnerable populations, epidemiological characteristics, and geographic distributions. Furthermore, the study provides a baseline for the management of skin disorders using medicinal plants. Surveillance, burden, diagnostics, and treatments of skin disease are essential components of developing measurable, influential, and sustainable intervention programs to reduce disease infections. Furthermore, these approaches assist in understanding the pathogenesis and disease process and assist with the development of new therapeutic strategies and preventive measures against morbidity in underdeveloped and developing countries, as well as establishing a baseline for medicinal plants that contribute significantly to the treatment.

Background and Aim: Global advancement is facing a huge threat due to the increased number of skin cancer cases and potential health-system costs. Perception of skin cancer prevalence is important for the treatment, prevention strategies, and administration of medical allowances. In addition to fair and tanned skin, the risk factor for the development of disease is sedentary lifestyle habits, and the reduction in physical activities has risen the mortalities worldwide. This effort signifies information on incidence, risk factors, and mortality rates across six continents. Methodology: The scientific literature was illustrated to find the correlation between the risk factors and resulting data to map, the approaches practiced concerning certain prevention strategies, in particular to alteration in behaviors such as reduction to UV-light exposure, screening and prevention in the progression of the disease. Results: The incidence of the disease is highest in Australia and New Zealand and lowest in Asian countries. A global survey was done on disease burden in 2018, in which signposts Incidence and mortality are 33.3 ASR and 4.8 ASR, respectively, in New Zealand and 33.6 ASR and 3.2 ASR, respectively, in Australia for melanoma skin cancer. The resistance of skin cancer to topical chemotherapy has turned the attention to natural therapeutics, including herbs, plant extracts and nutraceuticals. Conclusion: In difficult circumstances, a change in adaptive behavior and cognitive development can reduce the disease burden worldwide. Natural therapeutics can be used to exert anti-inflammatory, anti-proliferative and anti-tumorigenic by modulating the signaling pathways and other physiological effects.

 A skin ulcer is a type of open wound on the skin caused by injury, poor circulation, pressure, or infection. Specific forms of wounds are described using distinct terms, such as surgical incision, burn, and laceration. Skin ulcers can be extremely painful and take a long time to heal. They can become infected and cause other medical complications if left untreated. Treatment for skin ulcers is determined on the basis of the ulcer condition as well as the underlying cause. However, there is still a shortage of effective and safe medications for skin ulcer since current treatment guidelines for wound management consists only of wound dressing, antibiotics, and pain control. Wound healing and anti-inflammatory agents used for treating skin ulcers are quite limited. Recent revelations about natural compounds and their multifunctional pharmacological attributes, especially those with anti-inflammatory, antibacterial, antioxidant and wound-healing activities, have been very encouraging for therapeutic skin ulcer development. Various phytochemicals, such as curcuminoids, flavonoids, xanthones, polyphenolic compounds, saponins, and terpenoids, were reportedly used as alternative agents for the treatment of skin ulcers. This chapter describes skin ulcers, their pathophysiology, as well as current therapeutic protocols. In addition, some selected phytochemicals and herbal extracts with strong prospects as well as their commercially available products for the treatment of skin ulcers, are highlighted.