Efficacy of Garcinia mangostana L. (mangosteen rind extract) to reduce acne severity
Background: In vitro studies showed that extract of mangosteen rind (EMR) (Garcinia mangostana L.) containing xanthones has antibacterial effect against Propionibacterium acnes and also anti-inflammatory effect. The aim of this study is to determine the efficacy of EMR in reducing acne vulgaris (AV).
Methods: A randomized, double-blind, placebo controlled clinical trial was done on 94 subjects (18-30 years) with mild and moderate AV. The treatment group was given 400 mg EMR 3 times daily orally, for 3 weeks and control group was given placebo capsules. As a standard therapy, all subjects were given a topical cream of 0.025% retinoic acid applied on acne lesions during night time. Efficacy was assessed by counting the acne lesion number as well as proportion of subjects with more than 20% decrease in lesion. The decrease of plasma malondialdehyde (MDA) levels were also measured.
Results: After 3 weeks of treatment, acne lesion counts was significantly reduced in both groups [from 934 to 584 lesion (37%) in treatment group, p < 0.001 and from 832 to 608 lesion (27%) in control group, p < 0.001]. Comparison between the two groups revealed a non significant difference (p > 0.55). The proportion of subjects whose acne lesion reduced ≥ 20% was 73% (33 of 45 subjects) in treatment group vs 66% (27 of 41 subjects) in control (p > 0.2). The level MDA was reduced from 1.16 to 1.02 nmol/mL in treatment group and from 1.32 become 1.02 nmol/mL in control (p > 0.48).
Conclusion: Extract of mangosteen rind given orally for 3 weeks clinically reduced acne severity better than placebo, although statistically was not significant. Antioxidant effect of EMR seem to be unspecific in reducing acne severity. (Med J Indones. 2013;22:167-72. doi: 10.13181/mji.v22i3.586)
Keywords: Acne vulgaris, malondialdehyde, mangosteen rind extract, retinoid acid
Collier CN, Harper JC, Cafardi JA, et al. Prevalence of acne in adults 20 years and older. J Am Acad Dermatol. 2008;58(1):56-9. http://dx.doi.org/10.1016/j.jaad.2007.06.045
Shen Y, Wang T, Zhou C et al. Prevalence of acne vulgaris in chinese adolescents and adults. A community-based study of 17,345 subjects in six cities. Acta Derm Venereol. 2012;92(1):40-4. http://dx.doi.org/10.2340/00015555-1164
Perkins AC, Maglione J, Hillebrand GG, Miyamoto K, Kimball AB. Acne vulgaris in women: prevalence across the life span. J Womens Health. 2002;21(2):223-30. http://dx.doi.org/10.1089/jwh.2010.2722
Pappas A, Johnsen S, Liu JC, Eisinger M. Sebum analysis of individuals with and without acne. Dermato-Endocrinology. 2009;1(3):157-61. http://dx.doi.org/10.4161/derm.1.3.8473
Sarici G, Cinar S, Armutcu F, Altnayaza C, Koca R, Tekin NS. Oxidative stress in acne vulgaris. J Euro Acad Dermatol Venereol. 2010;24(7):763-7. http://dx.doi.org/10.1111/j.1468-3083.2009.03505.x
Bowe WP, Logan AC. Clinical implications of lipid peroxidation in acne vulgaris: old wine in new bottles. Lipids Health Dis. 2010; 9:141.
Grotto D, Maria LS, Valentini J, et al. Importance of the lipid peroxidation biomarkers and methodological aspects for malondialdehyde quantification. Quimica Nova. (SociedadeBrasileira de Química). 2009;32(1):169-74. http://dx.doi.org/10.1590/S0100-40422009000100032
Surlinia N. Perbandingan nilai aktivitas glutation peroksidase eritrosit dan kadar malondialdehid darah pasien akne inflammasi dengan individu sehat [Thesis]. Mount Pleasant (MI): Universitas Indonesia; 2002. Indonesian.
Pinto, Sausa ME, Nascimento MSJ. Xanthone derivatives: new insight in biological activities. Curr Med Chem. 2005;12(21):2517-38. http://dx.doi.org/10.2174/092986705774370691
Fang YZ, Yang S, Wu GY. Free radicals, antioxidants, and nutrition. Nutrition. 2002;18(10):872-9. http://dx.doi.org/10.1016/S0899-9007(02)00916-4
Chomnawang MT, Surassmo S, Nukoolkarn VS, Gritsanapan W. Antimicrobial effect of Thai medicinal plants against acne-inducing bacteria. J Ethnopharmacol. 2005;101(1-3):330-3. http://dx.doi.org/10.1016/j.jep.2005.04.038
Chomnawang MT, Surassmo S, Nukoolkarn VS, Gritsanapan W. Effect of Garcinia mangostana on inflammation caused by Propionibacterium acnes. Fitoterapia. 2007;78(6):401-8. http://dx.doi.org/10.1016/j.fitote.2007.02.019
Tug T, Karatas F, Terzi SM, Ozdemir N. Comparison of serum Malondialdehyde levels determined by two different methods in patients with COPD: HPLC or TBARS Methods. Labmedicine. 2005;36(1):41-4.
Adityan B, Kumari R, Thappa DM. Scoring system in acne vulgaris. Indian J Dermatol Venereol Leprol. 2009;75(3):323-6. http://dx.doi.org/10.4103/0378-6323.51258
Hayashi N, Akamatsu H, Kawashima M; Acne Study Group. Establisment of grading criteria for acne severity. J Dermatol. 2008;35(5):255-60. http://dx.doi.org/10.1111/j.1346-8138.2007.00403.x-i1
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