Bensal HP Attenuates the Inflammatory Response in Hair Shaving Associated Dermatitis
July 2016 | Volume 15 | Issue 7 | Original Article | 836 | Copyright © July 2016
Anjana Ray PhD,a,* Breanne Mordorski BA,b,* Angelo Landriscina BA,b Jamie Rosen BA,b Joshua Nosanchuk MD,a,c and Adam Friedman MDd
aDepartment of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY
bDivision of Dermatology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
cDivision of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
dDepartment of Dermatology, George Washington School of Medicine and Health Sciences, Washington, DC
*These authors contributed equally to the production of this work.
Shaving is an ubiquitous practice, and cutaneous irritation and inflammation are common sequelae, which may be worsened by underlying skin conditions or poor hair removal techniques. Moisturizing shaving creams and aftershaves are available to help maintain or restore the epidermal barrier; however, many continue to suffer from post-shave redness, itching, and pain. To reduce post-shave inflammation, some products have included botanical and other natural ingredients, which are often favored by consumers. We evaluated Bensal HP, an ointment containing 3% oak bark extract, 3% salicylic acid, and 6% benzoic acid, which has documented anti-inflammatory and antimicrobial properties, in a murine model of shave irritation to determine whether it would be useful in this clinical setting. Shaving dermatitis was simulated using a depilatory agent and electric clippers, and the shaved area was photographed and treated with Bensal HP daily for four days. Compared to untreated controls, mice treated with Bensal HP experienced a visible reduction in skin irritation and inflammation. These findings were mirrored on histology, as Bensal HP-treated areas demonstrated increased epidermal integrity and decreased dermal inflammatory infiltrate compared to untreated skin. Using immunohistochemistry, fewer neutrophils and macrophages were noted, and cytokine analysis also revealed decreased IL-6 in Bensal HP-treated skin at 24 and 96 hours after shaving. These results highlight the potential of Bensal HP as an anti-inflammatory treatment for shave irritation. Given the product’s application against a variety of inflammatory and infectious skin disorders, its use against shave irritation may also improve comorbid skin conditions, such as pseudofolliculitis barbae. J Drugs Dermatol.
Shaving is a widespread practice with both men and women shaving daily or several times per week. Hence, it is not surprising that cutaneous irritation associated with shaving is a common problem, which can be worsened by underlying skin conditions, such as acne or eczema, as well as poor hair removal techniques.1 Shave irritation is caused by rotation and extension of hair shafts within their follicles, local skin displacement, and removal of irregular skin elevations, especially those found around follicular ostia.1 Thus, shaving causes disruption of the epidermal architecture and perturbs the barrier function of the stratum corneum, leading to inflammation as well as increased transepidermal water loss and decreased skin hydration.2 Furthermore, shaving can act as the inciting event for other pathological processes, including pseudofolliculitis barbae, resulting from sharpened hair that curves into the perifollicular skin or pierces the follicle wall, causing an inflammatory foreign body reaction.3
Moisturizing shaving creams and aftershaves are available to help maintain or restore the epidermal barrier after shaving;
however, many consumers continue to suffer from post-shave redness, itching, and pain. Over the counter skincare products are widely used to soothe shaving-associated skin irritation, and recent years have seen increased marketing of products that ascribe their effects to botanicals and natural ingredients. Such products contain natural components ranging from beeswax, to colloidal oatmeal, to coconut oil, and are increasingly desired by consumers.4,5
Bensal HP is a commercially available botanical ointment that contains 6% benzoic acid, 3% salicylic acid, and 3% proprietary oak bark extract (QRB7). Benzoic acid, a natural product found in many plants, is effective against gram-positive and -negative bacteria, as well as dermatophytes Trichophyton mentagrophytes and Epidermophyton floccosum.6,7 Salicylic acid, another natural product isolated from willow tree bark, has keratolytic, bacteriostatic, and fungicidal properties.8 Oak bark extract has been previously used as a natural remedy to convert chronic to actively healing wounds.7 Bensal HP was developed by Dr. Harry Stanley in the 1950’s, and in 1997 Dr. Stanley’s son, R. Thomas Stanley, founded