Dr. Wu published a paper in 2006 on treating rosacea with herbs. This paper highlighted the properties and potential rosacea treatment modalities of licorice, feverfew, green tea, oatmeal, lavender, chamomile, tea tree oil and camphor oil. This just published paper concentrates more on the anti-inflammatory properties of several natural products and reviews the evidence supporting their use in inflammatory skin conditions.

Many rosacea sufferers want to treat their symptoms with natural therapies. This pursuit can be tricky as many natural ingredients are not easily obtained in a useable form. In the end it is sometimes just down to using commercial preparations that contain the active ingredient – and hopefully at the same time no other potentially irritating components. Another option is to try natural ingredients using a homemade mix.

Colloidal Oatmeal

We know from a recent rosacea news article that colloidal oatmeal (Avena sativa) has interesting cleansing, moisturizing, buffering, soothing, protecting and anti-inflammatory properties.

This paper especially highlights one of the active phytochemicals found in colloidal oatmeal – avenanthramides. These have been shown to have strong anti-inflammatory effects. At a concentration of 3%, avanthramides have a similar effect to hydrocortisone 1%.

suggested products: Linda Sy Mild Oatmeal Facial Cleanser, aveeno anti-itch.

Feverfew

Feverfew (Tanacetum parthenium) has a long history as a natural medicine and has potent anti-inflammatory, antioxidant and anti-irritant properties.

One point that I didn’t pick up on when previously writing about aveeno ultra calming with feverfew is that feverfew contains parthenolides which are highly irritating. Thus if you are interested in trying feverfew topically, be sure to look for products that contain Feverfew PFE (Parthenolide-free extract) – such as Aveeno for eg..

Studies show that Feverfew PFE is able to reduce UV induced redness and is beneficial for individuals with sensitive skin; offering improvement in facial redness, blotchiness, overall irritation and the feeling of rough skin and shaving irritation.

The paper cites a 2005 AAD Poster session that states that feverfew has greater inhibitory effect compared to other botanical compounds including green, black and white tea, echinacea, licorice, chamomile and aloe vera by factors of 35 to 1000-fold.

I had missed noting the (7!) posters sessions in 2005 that dealt with Feverfew PFE, but did highlight a more recent session from the 2008 AAD meeting that targeted rosacea more directly ; see Facial tolerance of a feverfew-PFE containing daily moisturizer regimen in mild to moderate rosacea patient.

suggested products: aveeno ultra calming with feverfew

Licorice

The active ingredients in licorice are well known to rosacea sufferers, epescially since the Eucerin Redness Relief range was introduced by Beiersdorf.  The two main actives from licorice are glabridin and licochalcone A which both have anti-irritant and anti-inflammatory properties. The paper cites studies that show that a lotion containing licochalcone A showed improvements in facial redness for those with and without rosacea, shaving induced irritation and UV induced redness.

From Anti-inflammatory Herbs

The dose of licorice is 5 to 15 g daily of cut or powdered roots and should contain 200 to 600 mg of glycyrrhizin. Licorice use is contraindicated in patients with high blood pressure, cardiac diseases, or liver cirrhosis.

suggested products: eucerin redness relief.

Aloe Vera

The active ingredients of interest in Aloe Vera are salicyclic acid, magnesium lactate and gel polysaccharides. Typical properties include aloe vera’s anti-inflammatory, analgesic, antipruritic (see AAD: pruritus), wound healing and anti-oxidant effects.

In clinical trials a 0.5% aloe vera cream was found to statistically improve psoriatic plaques (a symptom of psoriasis) and in other case reports is was found to be effective in reducing burning itching, and scarring that resulted from radiation dermatitis.

suggested products: pure aloe vera gel kept in the refrigerator.

Chamomile

Chamomile is a member of the daisy family – Matricaria recutita. The paper mentions properties of the volatile oil of chamomile as being able to inhibit cyclooxygenase and lipoxeygenase as well as the flavonoids pigenin, luteolin and quercetin which inhibit histamine release.

Topical chamomile is mostly used for the treatment of atopic dermatitis and skin irritation. One study found that the anti-inflammatory effect of topical chamomile was approximately 60% as effective as 0.25% hydrocortisone.

From Anti-inflammatory Herbs

The recommended dose of Matricaria recutita flowers is 3 g three times daily; Matricaria is available as an infusion, a fluid extract, and a tincture (1:5). Allergic hypersensitivity to this herb may occur in rare cases, and the herb can irritate the eyes if applied near them

Turmeric

Circumin is the active compound in Turmeric, and is responsible for the yellow pigment. Circumin has anti-oxidant, anti-inflammatory and chemoprotective properties that means it is is suitable for topcial inflammatory conditions and wound healing. Sadly, even though circumin improves epithelialization and wound contraction, the colour and odour limits its applicability to topicals, especially those applied to the face.

From Anti-inflammatory Herbs

According to Commission E in Germany (the German authority on evaluating herbal preparations), the recommended dose is 1.5 to 3 g of cut root daily; preparations of Curcuma longa are infusion powders, tinctures (1:5), and fluid extracts. The use of curcumin is contraindicated in bile duct obstruction because it enhances the secretion of bile.

Finally, here is the abstract of the paper that inspired this article.

Anti-inflammatory ingredients, Wu J., J Drugs Dermatol. 2008 Jul;7(7 Suppl):s13-6., University of Southern California-Los Angeles, Los Angeles, CA, USA.

There is a growing public awareness and concern among individuals regarding the condition of their skin, with a concomitant desire to use natural products to treat skin conditions. The increased interest in these products has spurred scientific and clinical studies evaluating the composition and clinical usefulness of natural products in the treatment of inflammatory skin dermatoses.

There are numerous natural ingredients that have been demonstrated to possess anti-inflammatory properties that make formulations containing these ingredients attractive treatment options.

This article summarizes the active ingredients, anti-inflammatory properties, clinical effects, and therapeutic potential of colloidal oatmeal, feverfew, licorice, aloe vera, chamomile, and turmeric. Potential therapeutic indications include erythema induced by ultraviolet light, rosacea, atopic dermatitis, sensitive and irritated skin, drug-induced skin eruptions, and psoriasis. These products may be particularly well suited as alternatives to pharmacologic therapies in chronic conditions for which long-term use is required.

Over to you: what related products have you tried ? please leave us all a comment below.

Related Articles

• colloidal oatmeal: a dream ingredient for rosacea sufferers
• Treating Rosacea with Herbs
• Aveeno Ultra Calming with Feverfew
• aveeno ultra calming with feverfew well tolerated
• ocular demodex, tea tree oil as a treatment
• golden chamomile
• lavender, arnica, aloe vera, tea tree oil, and calendula ; do they work ?
• US Pharmacist: Anti-inflammatory Herbs discussed here.

Another paper showing that the licorice extract Licochalcone A can be used to create well tolerated rosacea treatments. The rosacea community is also saying that the Eucerin Redness Relief products are working well as a part of their rosacea-beating regime.

Tolerance and efficacy of a skin care regimen containing licochalcone A for adults with erythematic rosacea and facial redness

Weber TM, Scholermann A, Burger A, Kolbe L, RJ Ceilley, Trookmann NS, Rizer RL (2005)., Beiersdorf Inc, Norwalk, CT; Beiersdorf AG, Hamburg, Germany; University of Iowa, West Des Moines, IA; Rocky Mountain Laser Center, Colorado Springs, CO; TJ Stephens & Associates, Colorado Springs, CO.

European Academy of Dermatology and Venerology, 14th Congress, London, October 2005, EADV 2005, Poster 02.51

Licochalcone A, derived from the root extract of the licorice plant Glycyrrhiza inflata, has been shown to inhibit pro-inflammatory cytokines, eicosanoids and reactive oxygen species in a number of human skin cells as well as to relieve post-shave irritation and UV-induced erythema in vehicle controlled studies.

This poster reports the compatibility and efficacy of a regimen of skin care products containing licochalcone A for individuals with rosacea and persistent facial redness. Redness concealing properties,a reduction of erythema over time, and an improvement of the quality of life are demonstrated benefits in these patients.

Objective: This was an 8-week clinical test to demonstrate the anti irritative efficacy and skin compatibility of a product regimen (Eucerin Anti-Redness) containing licochalcone A for subjects with mild-to-moderate Type I rosacea, and facial redness not attributed to rosacea.

Study Design: Thirty-two subjects with mild-to-moderate erythematotelangiectatic rosacea (1) and 30 subjects with red facial skin not attributed to rosacea were enrolled and completed the study. The subjects were female, aged 20 and 65 years ,with a mean age of 48. All of the subjects used each of the 4 test products daily. The regimen consisted of a cleanser, an SPF 15 moisturizing day care containing green concealing pigments, a cream concealer (with green pigments) and a night moisturizing cream.

Results: Subjects were photographed at the baseline visit, and at weeks 4 and 8. The lighting and photography conditions were carefully controlled and replicated at each photography session. At the baseline visit, standard light photographs were taken before and within 15 minutes of applying the SPF 15 moisturizer and cream concealer, both containing concealing pigments.

Discussion and Conclusion: Licochalcone A is shown to reduce pro-inflammatory mediators in vitro and reduce post-shave and UV-induced skin irritation. In this study,we evaluated the compatibility and suitability of a skin care regimen containing licochalcone A for patients with persistent facial redness.

After daily use for 8 weeks, the products were judged to be gentle enough for every day use and very well tolerated by the subjects. Both photographs and subject questionnaire responses showed that the green concealing pigments in the day care and cream concealer were very effective in neutralizing the appearance of redness.

At both 4 and 8 weeks, there was a statistically significant difference decrease in clinical grading scores for erythema relative to baseline. Differences in facial redness could also be observed in cross-polarized photographs. Compared to the baseline evaluation,there was a significant difference in the QOLI after 8 weeks on the skin care regimen, indicating that the subjects were less affected by their skin condition.

In summary,these results support the daily use of Eucerin Anti-Redness skin care products containing licochalcone A for patients with rosacea and facial redness.They can also be used as complimentary skincare for patients with topical metronidazole or azelaic acid.

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In 2005 a new range of skin care products from Eucerin (Beiersdorf Inc) called Eucerin Redness Relief was released. They are claimed as “Safe for sensitive skin and appropriate for Rosacea”.

The Eucerin Redness Relief system has been clinically proven to provide immediate redness relief, and improve the condition of visibly red skin in four weeks.

The Eucerin Redness Relief products consist of ;

• The Soothing Cleanser is a soap-free formula that gently cleanses redness-prone skin.
• The Daily Perfecting Lotion has an SPF of 15 and is promoted a daytime moisturizer for intensive or daily redness.
• The Soothing Moisture Lotion SPF15 is a daytime moisturizer for mild or occasional facial redness.
• The Soothing Night Creme is an intensive moisturizer with glycerin and lipids.

In the last year or so several members of the rosacea-support group have tried these products.

joann_scanlon2000 says :

I have been using the Eucerin redness relief cleanser for several months works very well for my skin but I didn’t care for the rest of the products in the redness relief line.

minina62 says :

I use Finacea once a day, and use Eucerin Redness Relief line to wash my face and moisturize. So far my skin hasn’t been this good in ages. I used to have flareups once a month and they were so serious that I had to take antibiotics for it. Not any longer.

mandyrain2002 says :

As far as cosmetics are concerned, I use Eucerin Redness Relief stuff
for skin care. It works pretty well, but I’m always on the hunt for
something better.

SimplyPoetic says :

I wear the green sunscreen and the night redness relief cream, and I love it! I wear it and then put zinco on top of it, and feel a strong barrier on my face! I also live in Texas, and as you know we have some HOT weather, and it hasn’t melted off yet. I am sure if you got a good sweat going on, anything would eventually wear off.

At first I didn’t like the green color, but I got pass that, and found if you use it as a base and add to it..you are better off.

Try the night cream it is not green, but has a nice sheer feel to it, and it smells nice.

bjshadder says :

I’ve tried the cleanser, day lotion and soothing night cream. I love the cleanser and night cream – it’s the only cleanser I’ve been able to use without irritation or dryness. It’s a gel cleanser and it’s non-foaming and I have trouble with foaming cleansers – this is really great for me. The Soothing Night Cream is wonderful for me too – it’s the only thing that I’ve found that doesn’t irritate my skin and it actually reversed a really bad episode of irritation and flushing and now my skin is much calmer. The day lotion is okay – it’s not moisturizing enough for me – it has a drier texture and it just doesn’t do much for me. It doesn’t irritate my skin at all though, so if you have oilier skin, it might work well. I was a bit leary of the sunscreen, but I can tolerate it just fine. I’m returning the day lotion though because although the green tint does cancel out the red, I can’t wear it under makeup because it’s not moisturizing enough and I have to wear another moisturizer in addition to it, which is way too much product on my skin at once.

bjshadder followup up with saying :

Last week I wrote a raving review of these products. Well, I hate to say that the honeymoon is over, and I’m seeking an annullment! Yes, they are going back to Walgreen’s today.

They aren’t anything special – the anti-redness properties aren’t making me any less red anymore, and last night after I washed and applied the soothing night cream, I actually had a flare up! So, nope, they are totally out. I also have the day lotion, and while it doesn’t irritate my skin, I am getting oilier than usual during the day and oily skin is one of my triggers, so it’s going back too. They are too expensive for drugstore products not to work.

rjarrell2004 says :

I have tried the Eucerin redness relief line. I love the cleanser and still use it at night because it does a good job of taking off my makeup without overdrying my skin – gently massage on and leave for a minute or two to get a good clean. You probably don’t need to worry about taking off makeup, so you may not need to leave it on as long as I do. The redness relief daily perfecting lotion has a green tint to it and does a pretty good job of neutralizing my redness. It caused my skin to be a bit oily and bumpy, so I’ve stopped using it. The soothing night cream worked well, but I prefer Good Skin All Calm Moisture Lotion as it is a bit less oily and leaves my skin with a great texture. I also use All Calm soothing toner and creamy cleanser in the morning. I didn’t try the Eucerin redness relief stick for spot treatment.

ken972 says :

I tried out the Eucerin Redness relief products myself. The only relief I got was the green tint of those products took some of the redness away. Not much of a breakthrough. And some did sting a little. Seems some of these new products are just about masking the redness instead of actually reducing it.

Erika_in_Michigan says :

I caved in to the pressure & bought the cleanser & night creme (from Rite Aid). Used it for 4 days & returned both items (keep those receipts!). The cleanser made me really red, and I would stay red longer than usual. I was also starting to get a build up of dry skin on my chin. The night cream didn’t calm my skin, & in the morning I’d be a bit pinker & greasier than normal.

NanHIm says :

I have just begun using it within the past couple of weeks. I like the cleanser as it is a foaming type. My face is slightly red after cleansing but it always is, no matter what I use.

I do not like the texture of the moisturizer. The green color does help to tone down redness though.

NanHIm also says :

I have been using these products for about a month and overall am pleased. No miracle cure but they work well enough.

I didn’t like the Daily Perfecting Lotion at first as it doesn’t appear to moisturize very well but it does do a good job of toning down the redness. Now, as I write this, I am wondering if it is even intended to be a moisturizer. Does anyone know?

I do plan to continue using this for the forseeable future, or until someone here writes about some other product that catches my eye.

clpass2000 says :

I have been using the Eucerin Soothing Redness Relief Cleanser for two weeks now with no luck. My redness is the same and I have twice the amount of Papules & Pustules. I will stop using it today….I assume I will have no luck with the rest of their “Rosacea claimed Friendly Line”

beefamerica says :

I like the cleanser well enough. Not sure to what extent it actually “soothes” my skin or relieves redness. But it at least seems not to irritate, which is a rarity. And it rinses off well. My face doesn’t feel tight after washing like it did with the Cetaphil bar soap.

In my ongoing quest for a decent sunblock I looked at the Daily Perfecting Lotion as well, but the tinted formula doesn’t blend in well enough for a dude.

smches says:

I tried this and was not impressed with it. It didn’t do anything for me.

wwwdotchat says:

All their products burn my skin and make me red as a radish

sk8shan5 says:

Sorry, I couldn’t find the original post in my e-mails. Yet, I swear by this line. It’s the only thing that doesn’t make my face burn. The only thing I’d say to avoid is that green cover stick. It covers great, but there is not enough product in it to warrant a purchase. I used it a total of 3 times – not even covering my whole face – before it was empty. The rest of the stuff, especiallly the cleanser seem to work well for me.

polockhart says:

I really like the Eucerin Sensitive Skin wash. It is very gentle and extremely economical. One squirt lathers up nicely so the bottle lasted for several months. I have tried the nighttime Redness Relief cream and like it although I think some people might find it irritating. I also have the sunscreen and like that as well.

I would also recommend the Aveeno Ultra Calming products. They have feverfew in them which really calms down my skin quickly. I really like the Ultra Calming Moisturizer with sunscreen the best of all I have tried. I just bought that last night at Eckerd on sale for $13 minus $2 on a coupon. I don’t like the foaming face wash, it doesn’t really lather up and seems wasteful. The nighttime cream is excellent and I use that more than the Eucerin. All products are over the counter and reasonably priced.

Update:

Since I wrote this article Eucerin has released a new product in the Redness Relief product range. According to Eucerin the Soothing Anti-Aging Serum is the first anti-aging serum specially formulated for red facial skin. They claim that it can visibly reduce red skin with concentrated `skin soothing’ Licochalcone and has proven reduction of fine lines and wrinkles from its usage of Coenzyme Q10.

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Further Reading ;

• Eucerin Redness Relief
• adding `Licochalcone A’ to finacea and metrogel
• dermatitis and licorice extract (glycyrrhizinic acid)
• Beiersdorf rosacea products feature licorice root derivative
• licochalcone A (licorice extract) and skin cells
• Eucerin Redness Relief (Licochalcone A) relieves red face
• aveeno ultra calming with feverfew: product reviews

New Advances in the management of red irritated skin.
…
In addition to topical vitamin C, which I often recommend for its anti-inflammatory properties to treat rosacea associated with a lot of redness, there are currently 3 or 4 other anti-redness products available. The newest ingredient is licochalcone A, found in the Eucerin Redness Relief line (all products in the line contain licochalcone A). The sun protection factor (SPF) day lotion and the spot concealer, in particular, have a green-tinted base to them, which I like. Thus, they have not only an anti-inflammatory component, but also have the added benefit of allowing the patient to immediately cover up the redness. So it’s 1 step, which is very nice. Patients who have facial redness spend a lot of time covering up the redness. With a licochalcone A product, they can medicate and cover at the same time; I think this is brilliant—and one of the advantages of the product.
….
Another study presented at the AAD meeting involved 62 adults with mild-to-moderate erythematic rosacea and facial redness.4 The skin care regimen tested consisted of a cleanser, day lotion with sunscreen and green pigments, spot concealer with green pigments, and night cream, all formulated with licochalcone A. Clinical grading of the redness was done at baseline and after 4 and 8 weeks of daily usage; quality-of-life questionnaires were also assessed. The pigmented products had very good redness-neutralizing properties and reduced erythema over time. Together, these data showed that the skin care regimen used was compatible with the sensitive facial skin of individuals with rosacea and persistent facial redness.
….
Chronic sufferers of rosacea are probably going to be the hardest ones to treat. For these patients, we’d recommend testing a new product on the inside of the arm first for 3 or 4 nights. If they have no problems, then they can apply it to a small area behind the jawline for a week before using it on the entire face. If someone has extensive erythematic seborrheic dermatitis, the dermatitis should be treated first before using a product to cover the redness. The same holds true for rosacea. Treat the underlying disease before trying to camouflage it with any of the new products that are available. I would recommend adding the product with licochalcone A to an existing regimen for an extra advantage in managing red, irritated skin. Treating the disease first, then using OTC products would also help in terms of patient compliance.

• DT Promtional Paper: New Advances in the management of red irritated skin.

The Soothing Cleanser is a soap-free formula that gently cleanses redness-prone skin.

The Daily Perfecting Lotion has an SPF of 15 and provides a light, all-day moisture that subtly conceals red, blotchy skin.

The Tone Perfecting Cream contains green concealing pigments and can be used under makeup.

The Soothing Night Cream is an intensive moisturizer with glycerin and lipids.

Each product is fragrance-free, oil-free, non-comedogenic and non-acnegenic.

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Related Articles:

• Dermatology Times E-News.
• adding `Licochalcone A’ to finacea and metrogel
• dermatitis and licorice extract (glycyrrhizinic acid)
• Eucerin Redness Relief: product reviews

The treatment of atopic dermatitis with licorice gel., Journal of Dermatological Treatment, Volume 14, Number 3, September 2003, Pages: 153 – 157, Saeedi M, Morteza-Semnani K, Ghoreishi MR., Department of Pharmaceutics, Mazandaran University of Medical Sciences, Sari, Iran.

Glycyrrhiza glabra L. has been used in herbal medicine for skin eruptions, including dermatitis, eczema, pruritus and cysts. The effect of licorice extract as topical preparation was evaluated on atopic dermatitis. The plant was collected and extracted by percolation with suitable solvent. The extract was standardized, based on Glycyrrhizinic acid by using a titrimetry method. Different topical gels were formulated by using different co-solvents. After standardizing of topical preparations, the best formulations (1% and 2%) were studied in a double-blind clinical trial in comparison with base gel on atopic dermatitis over two weeks (30 patients in each group). Propylene glycol was the best co-solvent for the extract and Carbopol 940 as gelling agent showed the best results in final formulations. The quantity of glycyrrhizinic acid was determined 20.3% in the extract and 19.6% in the topical preparation. Two percent licorice topical gel was more effective than 1% in reducing the scores for erythema, oedema and itching over two weeks (p<0.05). The results showed that licorice extract could be considered as an effective agent for treatment of atopic dermatitis.

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Compatibility of skin care formulations containing licochalcone A with commonly prescribed medications for rosacea

Teresa Weber, PhD, Beiersdorf Inc, Norwalk, CT, United States; Ronald Rizer, PhD, Thomas J, Stephens & Associates, Colorado Springs, CO, United States; Anette Buerger, PharmD, Andrea Schoelermann, MD, Beiersdorf AG, Hamburg, Germany

Rosacea can often be managed by pharmacologic treatment, the use of appropriate daily skin care products, and the avoidance of flushing triggers. We examined the stability and compatibility of several commonly prescribed pharmaceutical actives with skin care formulations containing licochalcone A. These formulations were previously tested and shown to be suitable for the daily skin care of patients with erythematotelangiectatic (type 1) rosacea. Chemical stability of the active agents metronidazole and azelaic acid was evaluated by HPLC analytical methods after formulation in an SPF 15 moisturizing cream containing green- and redness concealing pigments, and a night moisturizing cream, both containing licochalcone A. The actives were postadded to the formulations at final concentrations of 0.75% for metronidazole and 15% for azelaic acid, respectively. After 2, 4 and 6 weeks, no loss of actives or changes were observed in samples stored at both room temperature and 378C. Skin compatibility of the drug and skin care formulations was also assessed in subjects with mild to moderate type 1 and 2 rosacea who participated in an in-use test. All subjects applied the drug product alone daily two weeks, followed by the drug and the skin care regimen containing licochalcone A for an additional 2 weeks. Clinical grading of erythema and subjective irritation as well as inflammatory lesions (type 2 rosacea subjects) was made at baseline, and at 2 and 4 weeks. The subjects showed improvements in clinical scores compared to baseline at week 2, and further improvements at week 4. We conclude that the skin care formulations with licochalcone A are compatible with metronidazole and azelaic acid, treatments commonly prescribed for patients with rosacea.

Author disclosure: Nothing disclosed at press time. 100% sponsored by Beiersdorf Inc

Poster Discussion Session P1134, American Academy of Dermatology, 64th Annual Meeting, March 3-7 2006, San Francisco.

Supplement to Journal of The American Academy of Dermatology, March 2006, Volume 54, Number 3.

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