Onion Extract Gel

 

17. J Drugs Dermatol. 2010 May;9(5):514-8.  A comparative study evaluating the tolerability and efficacy of two topical therapies for the treatment of keloids and hypertrophic scars.  Perez OA, Viera MH, Patel JK, Konda S, Amini S, Huo R, Zell D, Tadicherla S, Berman B.  Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. 

 BACKGROUND: Onion extract gel (OE) and 0.5% hydrocortisone, silicone and vitamin  E lotion (HSE) are two over-the-counter preparations used to enhance the cosmesis of keloids and hypertrophic scars. OBJECTIVE: To determine the tolerability and efficacy of OE versus HSE versus placebo in subjects with keloids and hypertrophic scars. METHODS: Thirty subjects (> or =18 years) with keloids or hypertrophic scars were randomly assigned to one of three study preparations for 16 weeks. Scar volume was measured at baseline and weeks 4, 8, 12 and 16. Subjects and blinded investigators assessed scar parameters (induration, erythema, pigmentation alteration, pain, itching, tenderness and cosmetic appearance) and patient satisfaction at each visit using a visual analog scale (VAS). Data analysis included: mean percentage change (MPC) for subjects completing the study (n = 15); the mixed model test to determine differences between the groups over time;  and the Kruskal-Wallis test for the analysis of differences in subjects' satisfaction within the three groups over 16 weeks for subjects who completed at  least one follow-up visit (n = 21). RESULTS: All three preparations were well tolerated with the exception of a mild  acneiform-like eruption in one OE patient. Significant improvements were obtained with OE in volume, length, width and induration and with HSE in volume, length, induration, erythema and pigmentation alteration. There was a trend showing that  a higher percentage of subjects were satisfied with OE than with HSE or placebo.  The Mix Model Analysis (MMA) showed significant improvements with OE over placebo in investigator cosmetic assessment, lesion induration, pigmentation and tenderness and with HSE over placebo in investigator cosmetic assessment, lesion  induration, pigmentation and erythema. Improvements in erythema and pigmentation  were significantly greater in HSE than in OE. CONCLUSION: Both OE and HSE were more effective than placebo in the management of hypertrophic scars and keloids.  PMID: 20480794  [PubMed - indexed for MEDLINE]  

16. Dermatol Surg. 2008 Nov;34(11):1507-14. Epub 2008 Sep 15.  An open, randomized, controlled, comparative study of the combined effect of intralesional triamcinolone acetonide and onion extract gel and intralesional triamcinolone acetonide alone in the treatment of hypertrophic scars and keloids.  Koc E, Arca E, Surucu B, Kurumlu Z.  Department of Dermatology, School of Medicine Etlik, Gulhane Military Medical Academy, Ankara, Turkey. drerolkoc@yahoo.com 

 BACKGROUND: Various treatment regimens have been used in scars. The literature offers little consensus about appropriate therapy. OBJECTIVE: To compare intralesional triamcinolone acetonide (TAC) alone or combined with onion extract in keloidal and hypertrophic scars. MATERIALS AND METHODS: Fourteen patients were treated with intralesional TAC and  onion extract gel, and 13 patients were treated with intralesional TAC alone. Findings were recorded and graded at each visit (weeks 0, 4, 12, and 20). The scores before treatment and at week 20 were compared. RESULTS: Twenty-seven patients [17 men (63%) and 10 women (37%) aged 15 to 73 (average age 28.1 +/- 11.7)] were enrolled in the study. At baseline, the difference in the two treatment groups was not statistically significant (p>.05). At week 20, there was statistically significant improvement in both treatment groups (p<.05). TAC with onion extract was more effective than TAC alone in terms of pain-sensitiveness, itching, and elevation but not in erythema and induration. Treatment was well tolerated, without any adverse effect. CONCLUSION: Treatment with intralesional TAC and onion extract and TAC alone were effective. Combined with onion extract gel, intralesional TAC appears to be superior to TAC alone in the treatment of keloids and hypertrophic scars.  PMID: 18798752  [PubMed - indexed for MEDLINE] 

15. J Cosmet Dermatol. 2008 Jun;7(2):101-4.  The ability of onion extract gel to improve the cosmetic appearance of postsurgical scars.  Draelos ZD.  Dermatology Consulting Services, High Point, NC 27262, USA. zdraelos@northstate.net 

 Superior wound healing with excellent cosmesis is critical in superficial dermal  wounds created when cosmetically unacceptable lesions are removed from the body.  Dermatologists frequently remove seborrheic keratoses, nevi, and angiomas from the body with a superficial shave excision. The excision is designed to minimize  dermal scarring while removing the unsightly skin growth. This study was undertaken to evaluate the ability of an onion extract gel to improve the appearance of scars following excision. Sixty subjects with symmetrical seborrheic keratoses at least 8 mm in diameter on the right and left upper chest  were enrolled. The lesions were removed with a scalpel shave, following local anesthesia with 2% lidocaine plus epinephrine. The surgical sites were allowed to heal for 2 to 3 weeks, at which time the subjects returned to the research center for randomization to either the onion gel treatment group or the no-treatment group. Forty-seven subjects in the active treatment group were further randomized as to the site of study product application. Thirteen control subjects applied nothing to either side. Subjects returned to the study center at weeks 2, 4, 6, and 10 for photography, subject evaluations, and investigator assessments. The study showed that the onion extract gel significantly improved scar softness, redness, texture, and global appearance at the excision site at study weeks 4, 6, and 10 as assessed by the blinded investigator.  PMID: 18482012  [PubMed - indexed for MEDLINE] 

14. J Wound Care. 2007 Jun;16(6):251-4.  The effects of onion extract on hypertrophic and keloid scars.  Hosnuter M, Payasli C, Isikdemir A, Tekerekoglu B.  Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Zonguldak  Karaelmas University, Zonguldak, Turkey. 

 OBJECTIVE: To evaluate the therapeutic activity of topical onion extract in gel form on hypertrophic and keloid scars, focusing on problems such as elevation, redness, hardness, itching and pain. METHOD: This comparative prospective study assigned 60 patients to three groups.  Group I was treated with onion extract alone, group 2 with silicon gel sheet alone and 3 group with a combination of onion extract and silicon gel sheet. RESULTS: In the group comparisons, a significant difference was observed at the end of six months in the colour parameter between group I and group 2 and in the  height parameter between group I and group 3 (ANOVA post-hoc Tukey's test, p<0.01 and p<0.05 respectively). The onion extract was more effective in relation to scar colour, while the silicon gel sheet was superior in decreasing the height of scar (paired sample t-test, p<0.001). In addition, the most effective therapeutic results were obtained when the silicon gel sheet treatment was combined with onion extract in group 3. CONCLUSION: Onion extract improved hypertrophic and keloids scars via multiple mechanisms. However, it was statistically ineffective in improving scar height and itching. For this reason, onion extract therapy should be used in combination with an occlusive silicon dressing to achieve a satisfying decrease in scar height.  PMID: 17722521  [PubMed - indexed for MEDLINE] 

13. Dermatol Surg. 2006 Jul;32(7):891-6.  Use of onion extract, heparin, allantoin gel in prevention of scarring in chinese patients having laser removal of tattoos: a prospective randomized controlled trial.  Ho WS, Ying SY, Chan PC, Chan HH.  Department of Surgery, The Chinese University of Hong Kong, and Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong SAR, China. howsclinic@yahoo.com.hk 

 BACKGROUND: With rapid advancement in cutaneous laser therapy, Q-switched lasers  have become the standard treatment for tattoo removal. The longer wavelength Q-switched Nd:YAG laser is used when removing tattoos in darker skin patients to  avoid scarring and permanent pigment changes. Nevertheless, the local experience  revealed that nearly 25% of the Chinese patients developed scarring. Meanwhile, multiple clinical studies have shown that Contractubex gel (Merz Pharma, Frankfurt, Germany) was effective in the treatment and prevention of hypertrophic scars and keloids. OBJECTIVE: To evaluate the efficacy of Contractubex gel in the prevention of scarring after laser removal of tattoos in Chinese patients. METHODS: A total of 120 Chinese patients with 144 professional blue-black tattoos were recruited into the study. They were randomly assigned into the Contractubex  group or the control group. All patients were treated with a QS 1,064-nm Nd:YAG laser using a 3-mm spot size, a 10-Hz repeat rate, a pulse duration of 6 nanoseconds, and fluences that ranged from 3.6 to 4.8 J/cm2 (mean fluence, 4.2 J/cm2). The treated areas were assessed 3 months after the last treatments for clinical clearance and complications. RESULTS: Fifty-two patients with 61 tattoos in the Contractubex group were able to achieve a mean clearing rate of 82.3+/-11.6%. There were 7 tattoos in 7 patients that developed scarring, 4 patients had permanent hypopigmentation, and  3 patients had transient hyperpigmentation. In contrast, 55 patients with 68 tattoos in the control group had a mean clearing rate of 80.4+/-11.3%. Among them, 16 tattoos in 14 patients developed scarring, 4 patients had permanent hypopigmentation, and 5 patients had transient hyperpigmentation. Although there  was no significant difference in age, sex, fluence, treatment session, and clinical clearance between the two groups, the Contractubex group had a statistically significantly lower rate of scarring than the control group (p<.05). CONCLUSION: Contractubex gel is effective in scar prevention in Chinese patients  having laser removal of tattoos.  PMID: 16875470  [PubMed - indexed for MEDLINE] 

12. Dermatol Surg. 2006 Feb;32(2):193-7.  Onion extract gel versus petrolatum emollient on new surgical scars: prospective  double-blinded study.  Chung VQ, Kelley L, Marra D, Jiang SB.  Dermatologic Surgery Unit, Beth Israel Deaconess Medical Center, Harvard Medical  School, Boston, MA 02215, USA. 

 BACKGROUND: Cutaneous scars resulting from surgical procedures can be erythematous, hypertrophic, pruritic, painful, or cosmetically unacceptable. An onion extract-based topical gel (Mederma, Merz Pharmaceuticals, Greensboro, NC, USA) has been marketed as a product to improve scar appearance and texture. However, few data are available to substantiate these claims. OBJECTIVE: To compare the efficacy between the onion extract gel and a petrolatum-based emollient (Aquaphor, Beiersdorf, Inc., Wilton, CT, USA) in improving the appearance and symptoms of new surgical scars. METHODS: Twenty-four patients with new surgical wounds of at least 4 cm in length were enrolled in the study. Using a randomized, double-blinded, split-scar study  design, each scar was divided into two equal portions, and each half was assigned treatment with either onion extract gel or petrolatum ointment at the time of suture removal. Each product was applied three times daily for 8 weeks, and patients were evaluated at 2, 8, and 12 weeks following initiation of treatment.  A follow-up telephone interview was conducted at least 11 months postoperatively. RESULTS: Scar halves were evaluated by blinded investigators for overall cosmetic appearance, erythema, and hypertrophy. Patients also independently rated side-specific erythema, pruritus, burning, and pain. Using the paired t-test and  the Wilcoxon signed rank test, we found no statistically significant difference (p < .1) between the two treatment groups in any of the outcome variables studied. CONCLUSION: Petrolatum-based topical agents constitute standard therapy in the management of postoperative wounds. In this side-by-side, randomized, double-blinded, split-scar study, the onion extract gel did not improve scar cosmesis or symptomatology when compared with a petrolatum-based ointment.  PMID: 16442038  [PubMed - indexed for MEDLINE]  

 

Quercetin

 

11. Eur J Pharm Biopharm. 2008 Aug;69(3):948-57. Epub 2008 Jan 20.  Quercetin in w/o microemulsion: in vitro and in vivo skin penetration and efficacy against UVB-induced skin damages evaluated in vivo.  Vicentini FT, Simi TR, Del Ciampo JO, Wolga NO, Pitol DL, Iyomasa MM, Bentley MV, Fonseca MJ.  Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil. 

 The present study evaluated the potential of a w/o microemulsion as a topical carrier system for delivery of the antioxidant quercetin. Topical and transdermal delivery of quercetin were evaluated in vitro using porcine ear skin mounted on a Franz diffusion cell and in vivo on hairless-skin mice. Skin irritation by topical application of the microemulsion containing quercetin, and the protective effect of the formulation on UVB-induced decrease of endogenous reduced glutathione levels and increase of cutaneous proteinase secretion/activity were also investigated. The w/o microemulsion increased the penetration of quercetin into the stratum corneum and epidermis plus dermis at 3, 6, 9 and 12h post-application in vitro and in vivo at 6h post-application. No transdermal delivery of quercetin occurred. By evaluating established endpoints of skin irritation (erythema formation, epidermis thickening and infiltration of inflammatory cells), the study demonstrated that the daily application of the w/o microemulsion for up to 2 days did not cause skin irritation. W/o microemulsion containing quercetin significantly prevented the UVB irradiation-induced GSH depletion and secretion/activity of metalloproteinases.  PMID: 18304790  [PubMed - indexed for MEDLINE] 

10. J Photochem Photobiol B. 2006 Jul 3;84(1):21-7. Epub 2006 Feb 21.  Protective effect of topical formulations containing quercetin against UVB-induced oxidative stress in hairless mice.  Casagrande R, Georgetti SR, Verri WA Jr, Dorta DJ, dos Santos AC, Fonseca MJ.  Department of Pharmaceutical Science, Faculty of Pharmaceutical Sciences of Ribeirao Preto - USP, Av. do Café s/n, CEP 14040-903, Ribeirao Preto, SP, Brazil. rubiacasa@yahoo.com.br 

 UV radiation-induced skin damages may result in pre-cancerous and cancerous skin  lesions, and acceleration of skin aging. It involves an imbalance of the endogenous antioxidant system that leads to the increase of free radical levels and inflammation. Therefore, antioxidant supplementation might inhibit such imbalance. In this regard, quercetin is a promising drug, this plant derived lipophilic flavonoid presents the higher antioxidant activity among flavonoids and multiple antioxidant mechanisms. Thus, the present study investigated the possible beneficial effects of topical formulations containing quercetin to inhibit UVB irradiation-induced oxidative damages. Quercetin was administered on  the dorsal skin of hairless mice using two formulations, formulation 1 (non-ionic emulsion with high lipid content) and formulation 2 (anionic emulsion with low lipid content). The UVB irradiation (0.31-3.69 J/cm(2)) induced a dose-dependent  increase in the myeloperoxidase (MPO) activity (4-2708%) and depletion of reduced glutathione (GSH) (22-68%) in the skin of hairless mice after 6h. These results demonstrated that the UVB doses are not excessive, and additionally, they are lower than the doses used in other similar studies. Proteinases secretion/activity, detected by the qualitative sodium dodecyl sulphate polyacrylamide gel electrophoresis substrate-embedded enzymography (zymography),  was also enhanced in the same manner as MPO activity using the UVB dose of 1.23J  /cm(2). Formulations 1 and 2 inhibited the MPO activity increase (62% and 59%, respectively), GSH depletion (119% and 53%, respectively) and proteinases secretion/activity. To our knowledge, this is the first study to demonstrate the  effectiveness of topical formulations containing quercetin to inhibit the UVB irradiation-induced skin damages. Thus, these data suggest the possible usefulness of topical formulations containing quercetin to prevent UVB radiation  skin damages.  PMID: 16495072  [PubMed - indexed for MEDLINE] 

9. Egyptian Dermatology Online Journal 1 (1): 5, June 2005. Effect of Quercetin on Excessive Dermal Scarring. Maha F. El Goweini, MD*; Nagwa M. Nour El Din, MD.Department of Dermatology and Andrology, Department of Pharmacology, Faculty of Medicine, Alexandria University, Alexandria, Egypt

 

Objective: Quercetin is a bioflavonoid noted for its antihistamine release and antiproliferative effects. These properties could theoretically prove beneficial in reversing the inflammatory and proliferative responses in hypertrophic scars. The aim of this study was to evaluate both preventive and curative effect of quercetin on animal model of hypertrophic scars.
Materials and Methods: Full thickness four circular excisional wounds were performed on each ear of ten rabbits. Quercetin cream was applied immediately on one wound for four weeks as a preventive treatment and for eight weeks on one hypertrophic scar as a curative treatment. Placebo cream was used for the other two wounds.
Results: Clinically, after four weeks, hypertrophic scars were developed in all non-treated and placebo-treated wounds. On the other hand, only 40% of quercetin-treated wounds healed with hypertrophic scars. The level of histamine and hydroxyproline was significantly increased in placebo-treated wounds in the preventive group. However, their levels in quercetin-treated wounds were significantly decreased. In the curative group, after eight weeks treatment with quercetin, only 20% of hypertrophic scars were flattened. While histamine level was significantly decreased in quercetin-treated scars, hydroxyproline level was insignificantly decreased as compared to placebo-treated scars.
Conclusion: Due to its antihistamine effect beside its antifibrotic effect, quercetin could be an effective preventive and to lesser extent an adjuvant curative treatment for hypertrophic scars.

8. J Trauma. 2004 Nov;57(5):1032-7.  Suppression of transforming growth factor beta/smad signaling in keloid-derived fibroblasts by quercetin: implications for the treatment of excessive scars.  Phan TT, Lim IJ, Chan SY, Tan EK, Lee ST, Longaker MT.  Department of Plastic Surgery, Singapore General Hospital. surptt@nus.edu.sg 

 BACKGROUND: Keloids are characterized by abnormal proliferation and overproduction of extracellular matrix. Quercetin, a dietary compound, has strong antioxidant and anticancer properties. Previous studies by the authors have shown that quercetin inhibits fibroblast proliferation, collagen production, and contraction of keloid and hypertrophic scar-derived fibroblasts. Quercetin also blocks the signal transduction of insulin-like growth factor-1 in keloid fibroblasts. This study assessed the effects of quercetin on the transforming growth factor (TGF)-beta/Smad-signaling pathway in keloid-derived fibroblasts, which may be an important biologic mechanism of this proliferative scarring. METHODS: Keloid fibroblasts were isolated from keloid tissue specimens. Cells were treated with quercetin at different concentrations, then harvested, and subjected to immunoblotting analysis. RESULTS: Quercetin significantly inhibited the expression of TGF-beta receptors 1 and 2 in keloid fibroblasts at three concentrations (low, medium, and high). Quercetin also strongly suppressed the basal expression of Smad2, Smad3, and Smad4 as well as the phosphorylation of Smad2 and Smad3 and the formation of the  Smad2-Smad3-Smad4 complex. CONCLUSIONS: Taken together, these data suggest that quercetin effectively blocks the TGF-beta/Smad-signaling pathway in keloid fibroblasts. These data indicate that quercetin-based therapies for keloids should be investigated further.  PMID: 15580028  [PubMed - indexed for MEDLINE] 

7. J Dermatol Sci. 2003 Dec;33(3):192-4.  Quercetin inhibits fibronectin production by keloid-derived fibroblasts. Implication for the treatment of excessive scars.  Phan TT, Lim IJ, Sun L, Chan SY, Bay BH, Tan EK, Lee ST.  PMID: 14643528  [PubMed - indexed for MEDLINE] 

6. J Trauma. 2003 Jun;54(6):1212-24.  Dietary compounds inhibit proliferation and contraction of keloid and hypertrophic scar-derived fibroblasts in vitro: therapeutic implication for excessive scarring.  Phan TT, Sun L, Bay BH, Chan SY, Lee ST.  Department of Plastic Surgery, Singapore General Hospital, National University of Singapore. surptt@nus.edu.sg 

 BACKGROUND: Keloid and hypertrophic scars commonly occur after injuries. Overproliferation of fibroblasts, overproduction of collagen, and contraction characterize these pathologic scars. Current treatment of excessive scars with intralesional corticosteroid injections used individually or in combination with  other methods often have unsatisfactory outcome, frustrating both the patient and the clinician. The phytochemical compounds are well known as potential anticancer agents. We have investigated the inhibitory effects of compounds on keloid fibroblasts (KF) and hypertrophic scar-derived fibroblasts (HSF). METHODS: Fibroblasts were cultured from nontreated earlobe keloids and burn hypertrophic scars. Ten compounds (three hydroxybenzoic and four hydroxycinnamic  acid derivatives, two flavonols [quercetin and kaempferol], and turmeric curcumin) were tested with fibroblasts. The inhibitory effects of compounds on fibroblasts was assessed by proliferation assays, fibroblast-populated collagen lattice (FPCL) contraction, and electron microscopy. RESULTS: The phytochemicals significantly inhibited KF and HSF proliferation in a dose- and time-dependent manner. In the hydroxybenzoic and flavonol groups, increasing inhibitory effects seemed to depend on increasing numbers of hydroxyl  groups in their chemical structures. This phenomenon was not observed in the hydroxycinnamic acid group. The phytochemicals inhibited fibroblast proliferation by inducing cell growth arrest but not apoptosis. The reversibility of growth inhibition occurred when the compounds were removed from the culture and fresh media was replaced. Slower reversibility of growth inhibition was observed in the groups treated with quercetin, chlorogenic acid, or curcumin. The compounds quercetin, gallic acid, protocatechuic acid, and chlorogenic acid were the strongest inhibitors of FPLC contraction by HTFs. When the compounds were washed  out of the lattices and replaced by fresh medium, the FPCL contraction was resumed. The resumption of FPCL contraction was slowest in the quercetin-treated  group, indicating again the strong inhibitory effect of quercetin. CONCLUSION: From this in vitro study, quercetin seemed to have good potent effects to inhibit proliferation and contraction of excessive scar-derived fibroblasts.  PMID: 12813346  [PubMed - indexed for MEDLINE] 

5. Br J Dermatol. 2003 Mar;148(3):544-52.  Suppression of insulin-like growth factor signalling pathway and collagen expression in keloid-derived fibroblasts by quercetin: its therapeutic potential  use in the treatment and/or prevention of keloids.  Phan TT, See P, Tran E, Nguyen TT, Chan SY, Lee ST, Huynh H.  Department of Plastic Surgery, Singapore General Hospital, Singapore. 

 BACKGROUND: Keloids are characterized by abnormal proliferation of fibroblasts and overproduction of collagen. Insulin-like growth factor (IGF)-I is mitogenic for fibroblasts and a stimulatory factor for collagen synthesis. OBJECTIVES: We have assessed the in vitro effects of quercetin on proliferation,  collagen synthesis and the expression of the IGF system in keloid-derived fibroblasts. METHODS: Fibroblasts were isolated from earlobe keloids and exposed to quercetin  at different concentrations. The inhibitory effects of quercetin on fibroblast proliferation were assayed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, Western and Northern blot analyses. RESULTS: Quercetin inhibited keloid fibroblast (KF) proliferation in a dose-dependent manner. Significant growth inhibition was observed on day 2 of culture. The dose required for 50% growth inhibition was approximately 25 microg  mL-1. Collagen 1 expression was significantly decreased while collagen 3 was almost undetectable following quercetin treatment. Basal levels of IGF-I receptor (IGF-IR) beta subunits, p85 subunit of phosphatidylinositol 3-kinase, c-Raf, phospho-Raf-1, phospho-MEK 1/2, phospho-mitogen-activated protein kinase, phospho-Elk-1 and phospho-Akt-1 were significantly reduced when KF cells were exposed to quercetin for 24 h. Blocking IGF-IR activity with IGF-IR antibody or neutralizing endogenous IGF-I activity with IGF-I antibody led to significant growth inhibition suggesting the role of IGF-I in regulation of KF proliferation. CONCLUSIONS: Because the IGF system plays an important part in fibroblast cell proliferation and collagen production, the described activities of quercetin on the IGF system and collagen expression may provide a novel approach for the use of quercetin in treatment and/or prevention of hypertrophic scar and keloid.  PMID: 12653748  [PubMed - indexed for MEDLINE]  

4. J Appl Toxicol. 2002 Sep-Oct;22(5):303-9.  Protective effects of quercetin on ultraviolet A light-induced oxidative stress in the blood of rat.  Kahraman A, Inal ME.  Department of Biochemistry, The Medical School, Afyon Kocatepe University, Afyon-03200, Turkey. ahmetkah@aku.edu.tr 

 The oxidative effects of ultraviolet A (UVA) light (320-400 nm) and the antioxidant effects of quercetin were examined in rat blood. For this purpose, rats were divided into three groups: control, ultraviolet (UV) and ultraviolet +  quercetin (UV + Q). The UV and UV + Q groups were irradiated for 4 h a day with UVA light (1.25 mW cm(2)) during periods of 3, 6 and 9 days. Quercetin (50 mg kg(-1) body wt.) was administered intraperitoneally in the UV + Q group rats before irradiation periods. Blood was taken 3, 6 and 9 days post-treatment. Plasma malondialdehyde (MDA) levels significantly increased after 9 days of daily exposure to UVA. Whole blood glutathione (GSH) levels significantly declined after 3-9 days of irradiation. Glutathione peroxidase activity on days 6 and 9 and glutathione reductase activities on days 3, 6 and 9 post-irradiation were diminished significantly. Superoxide dismutase and catalase activities decreased  significantly 3-9 days post-irradiation. The administration of quercetin before the 9-day period of irradiation significantly reduced the increase in plasma MDA  value. Whole blood GSH levels significantly decreased with the administration of  quercetin on all days. Quercetin significantly increased antioxidant enzymes diminished by UVA irradiation. Exposure of rats to UVA light leads to oxidative stress, reflected by increased MDA and reduced antioxidant enzyme levels. The administration of quercetin appears to be a useful approach to reduce the damage  produced by UVA radiation.  Copyright 2002 John Wiley & Sons, Ltd.  PMID: 12355559  [PubMed - indexed for MEDLINE] 

3. Clin Exp Dermatol. 2001 Sep;26(6):536-9.  Beneficial effects of quercetin on oxidative stress induced by ultraviolet A.  Erden Inal M, Kahraman A, Köken T.  Department of Biochemistry, The Medical School, Osmangazi University, Turkey. 

 Cells exposed to ultraviolet A (UVA) radiation can induce the production of reactive oxygen species (ROS) that may damage cellular elements. By contrast, antioxidants can reduce production of ROS. To assess these cellular events in a model system, rats were divided into three groups comprising control (C), ultraviolet exposed (UV), and ultraviolet exposed and quercetin-treated (UV + Q). UV and UV + Q group rats were irradiated 4 h/day with UVA radiation (1.25 mW/cm2) for 9 days. In the UV + Q group rats quercetin (50 mg/kg body weight) was administered intraperitoneally before irradiation. The levels of malondialdehyde  (MDA) were increased significantly following irradiation (P < 0.001). In the UV + Q group MDA levels declined significantly compared with the UV group (P < 0.001). With respect to levels of glutathione (GSH), no statistically significant changes were found between the control and the UV group. The GSH levels in the UV + Q group were slightly higher than those of the control and UV groups, but not significantly so. The enzyme activities of glutathione peroxidase, glutathione reductase, catalase and superoxide dismutase decreased significantly after irradiation (P < 0.001). In the UV + Q group all of these enzyme activities were  found to be considerably higher than those in the UV group (P < 0.001). This study demonstrates that exposure of rats to UVA leads to oxidative stress as reflected by increased MDA levels and reduced enzymatic antioxidant levels. It also shows that quercetin may be useful in reducing or preventing photobiologic damage.  PMID: 11678884  [PubMed - indexed for MEDLINE]  

2. Toxicology. 2000 Nov 23;154(1-3):21-9.  The protective effect of flavonol quercetin against ultraviolet a induced oxidative stress in rats.  Erden Inal M, Kahraman A.  Department of Biochemistry, The Medical School, Osmangazi University, Eskisehir-26480, Turkey. 

 Ultraviolet A (UVA) light exposed cells can induce the production of reactive oxygen species (ROS) which can damage the cellular elements. Antioxidants can interfere with the production of ROS. In this study, malondialdehyde (MDA), reduced glutathione (GSH), glutathione reductase (GSSGR), glutathione peroxidase  (GPx), catalase (CAT) and superoxide dismutase (SOD) levels were measured in the  liver of rats exposed to UVA light in various doses. The effects of quercetin were determined as antioxidant on those parameters. Rats were divided into three  groups as control, ultraviolet (UV), and ultraviolet+quercetin (UV+Q). UV and UV+Q group rats were irradiated 4 h per day with UVA light (1.25 mW/cm(2)) during periods of 0,3,6,9 days. Thus, on days 0,3,6 and 9, the rats have received 0,54,108,162 W/cm(2) light, respectively. Quercetin (50 mg/kg body wt.) was administered intraperitoneally before each irradiation period in the UV+Q group rats. MDA level in the UV group increased significantly on day-9 when compared to the control group (P<0.05). The MDA levels in the UV+Q group decreased significantly on day-6 and 9 in comparison with the UV group (P<0.05, P<0.001, respectively). GSH levels in all groups were not significantly different. GSSGR and GPx activities in the UV group were significantly lower on day-6 and 9 than in the control group (P<0.001). On all days these enzyme activities in the UV+Q group were significantly higher than in the UV group and higher than in the control group (P<0.001). SOD and CAT activities in the UV group decreased significantly on day-3, 6, and 9 in comparison with the control group (P<0.001).  These enzyme activities also increased significantly in the UV+Q group on all days when compared to the UV group (P<0.001). This study demonstrated that the exposure of rats to UVA led to oxidative stress as reflected by increased MDA levels and reduced enzymic antioxidant levels, quercetin may be useful by reducing or preventing photobiologic damage.  PMID: 11118667  [PubMed - indexed for MEDLINE] 

1. Free Radic Biol Med. 1997;22(4):669-78.  Quercetin protects cutaneous tissue-associated cell types including sensory neurons from oxidative stress induced by glutathione depletion: cooperative effects of ascorbic acid.  Skaper SD, Fabris M, Ferrari V, Dalle Carbonare M, Leon A.  Researchlife S.c.p.A., Castelfranco Veneto, Italy. 

 Oxidation reactions are essential biological reactions necessary for the formation of high-energy compounds used to fuel metabolic processes, but can be injurious to cells when produced in excess. Cutaneous tissue is especially susceptible to damage mediated by reactive oxygen species and low-density lipoprotein oxidation, triggered by dysmetabolic diseases, inflammation, environmental factors, or aging. Here we have examined the ability of the flavonoid quercetin to protect cutaneous tissue-associated cell types from injury induced by oxidative stress, and possible cooperative effects of ascorbic acid. Human skin fibroblasts, keratinocytes, and endothelial cells were cultured in the presence of buthionine sulfoximine (BSO), an irreversible inhibitor of glutathione (GSH) synthesis. Depletion of intracellular levels of GSH leads to an accumulation of cellular peroxides and eventual cell death. Quercetin concentration-dependently (EC50: 30-40 microM) reduced oxidative injury of BSO to all cell types, and was also effective when first added after BSO washout. BSO caused marked decreases in the intracellular level of GSH, which remained depressed in quercetin-protected cells. Ascorbic acid, while by itself not cytoprotective synergized with quercetin, lowered the quercetin EC50 and prolonged the window for cytoprotection. The related flavonoids rutin and dihydroquercetin also decreased BSO-induced injury to dermal fibroblasts, albeit  less efficaciously so than quercetin. The cytoprotective effect of rutin, but not that of dihydroquercetin, was enhanced in the presence of ascorbic acid. Further, quercetin rescued sensory ganglion neurons from death provoked by GSH depletion.  Direct oxidative injury to this last cell type has not been previously demonstrated. The results show that flavonoids are broadly protective for cutaneous tissue-type cell populations subjected to a chronic intracellular form  of oxidative stress. Quercetin in particular, paired with ascorbic acid, may be of therapeutic benefit in protecting neurovasculature structures in skin from oxidative damage.  PMID: 9013129  [PubMed - indexed for MEDLINE] 

 

Onion

 

17: Perez OA, Viera MH, Patel JK, Konda S, Amini S, Huo R, Zell D, Tadicherla S, Berman B. A comparative study evaluating the tolerability and efficacy of two topical therapies for the treatment of keloids and hypertrophic scars. J Drugs Dermatol. 2010 May;9(5):514-8. PubMed PMID: 20480794. preexisting 

16: Koc E, Arca E, Surucu B, Kurumlu Z. An open, randomized, controlled, comparative study of the combined effect of intralesional triamcinolone acetonide and onion extract gel and intralesional triamcinolone acetonide alone in the treatment of hypertrophic scars and keloids. Dermatol Surg. 2008 Nov;34(11):1507-14. Epub 2008 Sep 15. PubMed PMID: 18798752. preexisting 

15: Draelos ZD. The ability of onion extract gel to improve the cosmetic appearance of postsurgical scars. J Cosmet Dermatol. 2008 Jun;7(2):101-4. PubMed  PMID: 18482012. surgery  

14: Hosnuter M, Payasli C, Isikdemir A, Tekerekoglu B. The effects of onion extract on hypertrophic and keloid scars. J Wound Care. 2007 Jun;16(6):251-4. PubMed PMID: 17722521. preexisting  

13: Ho WS, Ying SY, Chan PC, Chan HH. Use of onion extract, heparin, allantoin gel in prevention of scarring in chinese patients having laser removal of tattoos: a  prospective randomized controlled trial. Dermatol Surg. 2006 Jul;32(7):891-6. PubMed PMID: 16875470. surgery   

12: Chung VQ, Kelley L, Marra D, Jiang SB. Onion extract gel versus petrolatum emollient on new surgical scars: prospective double-blinded study. Dermatol Surg. 2006 Feb;32(2):193-7. PubMed PMID: 16442038. surgery

 

Quercetin

11: Vicentini FT, Simi TR, Del Ciampo JO, Wolga NO, Pitol DL, Iyomasa MM, Bentley  MV, Fonseca MJ. Quercetin in w/o microemulsion: in vitro and in vivo skin penetration and efficacy against UVB-induced skin damages evaluated in vivo. Eur  J Pharm Biopharm. 2008 Aug;69(3):948-57. Epub 2008 Jan 20. PubMed PMID: 18304790. 

10: Casagrande R, Georgetti SR, Verri WA Jr, Dorta DJ, dos Santos AC, Fonseca MJ.  Protective effect of topical formulations containing quercetin against UVB-induced oxidative stress in hairless mice. J Photochem Photobiol B. 2006 Jul  3;84(1):21-7. Epub 2006 Feb 21. PubMed PMID: 16495072. 

9. Maha F. El Goweini, MD*; Nagwa M. Nour El Din, MD.  Effect of Quercetin on Excessive Dermal ScarringEgyptian Dermatology Online Journal 1 (1): 5, June 2005

8: Phan TT, Lim IJ, Chan SY, Tan EK, Lee ST, Longaker MT. Suppression of transforming growth factor beta/smad signaling in keloid-derived fibroblasts by quercetin: implications for the treatment of excessive scars. J Trauma. 2004 Nov;57(5):1032-7. PubMed PMID: 15580028. 

7: Phan TT, Lim IJ, Sun L, Chan SY, Bay BH, Tan EK, Lee ST. Quercetin inhibits fibronectin production by keloid-derived fibroblasts. Implication for the treatment of excessive scars. J Dermatol Sci. 2003 Dec;33(3):192-4. PubMed PMID:  14643528.  

6: Phan TT, Sun L, Bay BH, Chan SY, Lee ST. Dietary compounds inhibit proliferation and contraction of keloid and hypertrophic scar-derived fibroblasts in vitro: therapeutic implication for excessive scarring. J Trauma. 2003 Jun;54(6):1212-24. PubMed PMID: 12813346.  

5: Phan TT, See P, Tran E, Nguyen TT, Chan SY, Lee ST, Huynh H. Suppression of insulin-like growth factor signalling pathway and collagen expression in keloid-derived fibroblasts by quercetin: its therapeutic potential use in the treatment and/or prevention of keloids. Br J Dermatol. 2003 Mar;148(3):544-52. PubMed PMID: 12653748.  

4: Kahraman A, Inal ME. Protective effects of quercetin on ultraviolet A light-induced oxidative stress in the blood of rat. J Appl Toxicol. 2002 Sep-Oct;22(5):303-9. PubMed PMID: 12355559.  

3: Erden Inal M, Kahraman A, Köken T. Beneficial effects of quercetin on oxidative stress induced by ultraviolet A. Clin Exp Dermatol. 2001 Sep;26(6):536-9. PubMed PMID: 11678884.  

2: Erden Inal M, Kahraman A. The protective effect of flavonol quercetin against  ultraviolet a induced oxidative stress in rats. Toxicology. 2000 Nov 23;154(1-3):21-9. PubMed PMID: 11118667.  

1: Skaper SD, Fabris M, Ferrari V, Dalle Carbonare M, Leon A. Quercetin protects cutaneous tissue-associated cell types including sensory neurons from oxidative stress induced by glutathione depletion: cooperative effects of ascorbic acid. Free Radic Biol Med. 1997;22(4):669-78. PubMed PMID: 9013129.    

 

 

Advanced skin care research has shown that quercetin has properties that make it useful as an antioxidant, an anti-inflammatory, for acne care, scar care, and for protection from the suns harmful rays

Quercetin research