Journal of Clinical and Aesthetic Dermatology

OCT 2017

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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37 JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY October 2017 • Volume 10 • Number 10 R E V I E W and other conditions. The use of botanical remedies, such as green tea and tea tree oil, in modern dermatology clinical trials has been reviewed. 59–61 More recent reviews have focused on the use of botanical therapies for specific skin conditions such as rosacea and psoriasis. 62,63 Botanicals and phytochemicals have shown promise in the treatment of skin disorders, and this class of drugs is generally well-received by patients who tend to perceive botanical remedies as being "natural." SAO has been, and continues to be, extensively used as an herbal medicine, particularly in Asia. It is also widely used as an ingredient in many personal care products and fragrances, but at very low concentrations. Its safety profile has been well-characterized and, although a small percentage of the general population is allergic to SAO, it has been shown through extensive Human Repeat Insult Patch Test (HRPIT) testing to be non-irritating and non-sensitizing as a pure oil or when formulated for topical use. In preclinical models, the oil has been shown to have broad anti-inflammatory, anti-infective, and anti-proliferative properties. These properties are likely due to multiple mechanisms of action resulting from the interaction of the many components in the oil with multiple biological targets. The various mechanisms of action of SAO are depicted in Figure 1. Data from initial proof-of-concept clinical studies in acne, warts, Molluscum contagiosum, atopic dermatitis, and psoriasis indicate that SAO is safe, well-tolerated, and has potential for broader use as a novel botanical therapeutic. SAO is now being produced in compliance with Current Good Manufacturing Practices (cGMPs) from sustainably grown cultivated trees and is available for use in commercial drug development programs. Larger, confirmatory clinical trials are underway and, if successful, might pave the way for the introduction of SAO-containing topical drugs for treatment of a variety of skin conditions. FIGURE 1. Sandalwood album oil (SAO) exerts its biological activities via multiple mechanisms of action.

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