INTRODUCTION
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
Methods
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.
