The Efficacy of Topical 2% Green Tea Lotion in Mild-to-Moderate Acne Vulgaris
April 2009 | Volume 8 | Issue 4 | Original Article | 358 | Copyright © 2009
Mohamed L. Elsaie MD MBA,a,b Mahmoud F. Abdelhamid MD PhD,b
Lotfy T. Elsaaiee MD PhD FACTM,c and Hanaa M. Emam MD PhD b
a. Department of Dermatology and Cutaneous Surgery, University of Miami, FL USA
b. Department of Dermatology and Venereology Research, National Research Centre (NRC), Cairo, Egypt
c. Department of Dermatology, Venereology and Andrology, Al Azhar Universityy, Cairo, Egypt
Background: Botanical extracts and preparations have been used in different pathological conditions with success. An important group of phytochemical phenolic compounds are the catechins found in green tea. Acne is a widely occurring inflammatory condition that is estimated to affect 40 to 50 million Americans. Finding an effective, safe, cost-effective and well-tolerated treatment is the challenge.
Objective: To determine the efficacy of 2% green tea lotion in mild-to-moderate acne vulgaris.
Methods: Twenty patients fulfilling enrolment criteria were included. Green tea was given and applied twice daily for a period of 6 weeks. The patients were seen every 2 weeks to evaluate the lesions and any side effects. To determine efficacy on acne severity, the authors used both total lesion count (TLC) and their devised severity index (SI). Total lesions count (TLC) was calculated as papules + pustules while SI was scaled with numbers (1, 2 or 3) correlating to TLC in order of increasing intensity. TLC < 10 was given an SI of 1, TLC 10-20 was given an SI of 2 and TLC > 20 was given an SI of 3.
Results: The mean total lesion count (TLC) decreased from 24 before the treatment to 10 after 6 weeks after treatment, a reduction of 58.33%. The difference was statistically significant (P < 0.0001, 95% confidence interval [CI] of the difference = 8.58 – 19.42). The mean severity index (SI) decreased from 2.05 before treatment to 1.25 after 6 weeks treatment, a decrease of 39.02%. The difference was statistically significant (P < 0.0001, confidence interval [CI] of the difference = 0.54-1.26).
Conclusion: Topical 2% green tea lotion is an effective, cost-effective treatment for mild-to-moderate acne vulgaris.
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Acne is a chronic inflammatory disease of the pilosebaceous units. It is characterized by seborrhea, the formation of comedones, erythematous papules and pustules, less frequently by nodules and pseudocysts, and in some cases is a accompanied by scarring. Major factors involved in the pathogenesis of acne are increased sebum production which is dependent on androgenic sex hormones, hypercornification of the pilosebaceous duct, abnormality of the microbial flora and the production of inflammation.1
Non-mainstream (complementary and alternative, or CAM) medicinal practices have been expanding very rapidly in western countries. Green tea extracts are among the most widely used ancient medicinal agents, while androgens are probably the oldest drugs used in a purified form in Traditional Chinese Medicine (TCM).2 It is now clear that a specific green tea catechin, epigallocatechin-3-gallate (EGCG), can modulate the production and biological actions of androgens and other hormones.
Moreover, these compounds have shown antibacterial, antioxidant and immune-modulating activity. Modulation of androgenic activity, anti-inflammatory and antioxidant activities via EGCG may be useful for the treatment of various hormone-related abnormalities, such as benign prostatic hyperplasia (BPH), baldness and acne.3
This study was conducted in Cairo, Egypt, in the Dermatology and Venereology outpatient clinic of the National Research Centre from May 2007 to February 2008. A total of 20 patients were enrolled in this study and their ages ranged from 15-36 years; there were six males and 14 females. A full history was taken from each patient regarding age, gender and duration of the disease. Ethical committee clearance was approved and toxicity studies demonstrated safety of the product. Physical examination was carried out on a screening visit to determine the possibility of enrollment in the study and evaluate the severity of acne. Qualifying candidates fulfilling inclusion and exclusion criteria were provided the green tea lotion and their baseline photographs were taken. Participants were instructed to apply the green tea lotion twice daily for 6 weeks with follow-up every 2 weeks.
At each 2-week evaluation, patients were examined to assess lesions and any unwanted side effects. To determine the lotion’s efficacy on acne severity, the authors used both total lesion count (TLC) and our devised severity index (SI). TLC was calculated as papules + pustules while SI was scaled with numbers (1, 2 or 3) correlating to TLC in order of increasing intensity. TLC < 10 was given an SI of 1, TLC 10-20 was given an SI of 2 and TLC > 20 was given an SI of 3.