Oregano Extract Ointment for Wound Healing: A Randomized, Double-Blind, Petrolatum-Controlled Study Evaluating Efficacy

October 2011 | Volume 10 | Issue 10 | Original Article | 1168 | Copyright © 2011

Jennifer Ragi MD,a Amy Pappert MD,a Babar Rao MD,a Daphna Havkin-Frenkel PhD,b Sandy Milgraum MDa

aDepartment of Dermatology, University Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Somerset, NJ bDepartment of Plant Pathology and Biology, Rutgers University, New Brunswick, NJ

Abstract

Background: Wound healing is a dynamic and complex process affected by tissue hydration, the presence of bacteria, inflammation, and other variables. Oregano has potent antibacterial, antifungal, antioxidant, and anti-inflammatory properties. Studies of oregano ointment on wound healing are lacking.
Objective: To determine the efficacy of 3% oregano extract ointment on wound healing.
Methods: An investigator initiated, randomized, double-blind, petrolatum-controlled study was performed to determine the effects of oregano ointment on wound healing. Forty patients who underwent surgical excision were enrolled and randomized. Cultures were obtained on day 12 and scars were evaluated using the Patient and Observer Scar Assessment tool on day 12, 45, and 90.
Results: The oregano ointment group had 19 percent of cultures test positive for Staphlococcus aureus compared to 41 percent in the petrolatum group. One patient in the oregano ointment group developed a cellulitis compared to three patients in the petrolatum group. The oregano group had a statistically significant improvement over petrolatum in scar color, pigmentation, and pliability.
Conclusion: Oregano extract ointment decreased bacterial contamination and subsequent infection on post-surgical wounds and had equivalent overall scar appearance compared to petrolatum.

J Drugs Dermatol. 2011;10(10):1168-1172.

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INTRODUCTION

Cutaneous wound healing is a dynamic and complex process that is influenced by multiple variables including the local skin environment. One important variable in epidermal wound healing is the presence of bacteria, because excessive bacterial growth in damaged skin can delay healing.1, 2 Topical antibiotic ointments are frequently used in surgical wound/biopsy aftercare protocols.3 However, topical antibiotic ointments are common sensitizers leading to the development of allergic contact dermatitis which limits their use in wound healing.3,4 Ointments containing bacitracin, neomycin, and polymyxin in various combinations are frequently used for wounds. Both bacitracin and neomycin are listed on the top ten most common allergens identified by the North American Contact Dermatitis Group.5,6

Hydration of the skin is another important variable that can influence wound healing. Studies have shown that maintaining tissue hydration by the application of ointments and occlusive dressings increases epithelial migration and enhances skin re-epithelization. 7-9 Pure petrolatum, which is a hydrating and hypoallergenic product, is another frequently used topical agent for wounds, although it lacks antimicrobial properties. Studies have found that topical antibiotic ointments reduce bacterial infection and enhance wound healing compared to petrolatum or dressing alone,10-13 while other studies have found equal infection rates between petrolatum and topical antibiotic ointment.14-16 Currently, there is in no one standard topical agent used for wound healing, and a need for new, effective topical agents for wound healing exists.

The increasing prevalence of antibiotic resistance highlights the need for new classes of antibiotics.17-20 Moreover, multiple studies have documented the antimicrobial properties of various plant extracts. Oregano is a unique spice herb since it seems to have one of the most potent antibacterial properties along with antifungal, antioxidant, and anti-inflammatory properties.21 Many in vitro and in vivo studies have shown oregano (Origanum vulgare) to have antimicrobial activity against Staphlococcus aureus (S. aureus), including methicillin resistant S. aureus (MRSA), Streptococcus haemolyticus, Listeria monocytogenes, Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, Salmonella typhi; and antifungal properties against Aspergillus niger and Aspergillus flavus.21-26 This study was done with the water-soluble fraction of the oregano plant, obtained after distilling the essential oil,27 because the essential oil component may be irritating when used topically.28-32 According to

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