Efficacy and Safety of Sunflower Oil for Mild to Moderate Plaque-type Psoriasis: A Double-blind, Randomized Controlled Trial
Franchesca Marie D. Ilagan, Eleanor L. Letran, Bernardita O. Policarpio
Dec 2021 DOI 10.35460/2546-1621.2019-0068 Access
Background: Psoriasis is a chronic, complex, inflammatory disease that needs safe and effective treatment options to decrease its disease burden.
Objectives: To determine the efficacy and safety of sunflower oil in mild to moderate plaque-type psoriasis at the outpatient department of a tertiary hospital.
Methods: This was an 8-week, single-center, randomized, double-blind controlled trial that compared the efficacy and safety of sunflower oil + placebo cream (Group SO), betamethasone valerate cream + placebo oil (Group BC), sunflower oil + betamethasone valerate cream (Group SO-BC) in mild to moderate plaque-type psoriasis. Psoriasis Area Severity Index (PASI) was used to measure the extent of psoriasis by assessing the erythema, induration, scaling, and body surface area involvement. The difference from baseline PASI was recorded. The Dermatology Life Quality Index (DLQI) questionnaire was used to measure the impact of psoriasis on the patient’s quality of life.
Results: Fifty-one patients were randomized and blinded to three treatment arms; evaluated at baseline, week 4 and 8. The proportion of patients who achieved PASI ≥50 at week 4 was 29% in Group SO, 38% in Group BC, and 60% in Group SO-BC. By week 8, Groups SO and BC achieved 80% while Group SO-BC achieved 93%. There was significant decline of PASI at week 4 and week 8 compared to baseline. The mean percentage change of PASI was highest at Group SO-BC followed by Group BC and lastly Group SO at week 4 and week 8. The mean reduction in score for scaling was significantly higher in Group SO-BC. Mean reduction in induration and erythema was not statistically significant across the three groups. There was 40-50% improvement in DLQI scores in all groups. There were no adverse events.
Conclusion: This study showed that sunflower oil is effective and safe in mild to moderate plaque-type psoriasis.
Key words: sunflower oil, randomized controlled trial, psoriasis
- Michalek I, Loring B. Global report on PSORIASIS. World Health Organization. 2016.
- Raychaudhuri SK, Maverakis E, Raychaudhuri SP. Diagnosis and classification of psoriasis. Autoimmunity Reviews [Internet]. 2014 Apr;13(4–5):490–5. Available from: http://dx.doi.org/10.1016/j.autrev.2014.01.008
- Gonzales NG, Guevara BK, Visitaction LR. Patient preference on psoriasis treatment in a Philippine tertiary hospital: A conjoint analysis. J Phil Dermatol Soc. 2017. ISSN: 2094-201X
- Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis. Journal of the American Academy of Dermatology [Internet]. 2009 Apr;60(4):643–59. Available from: http://dx.doi.org/10.1016/j.jaad.2008.12.032
- Samarasekera EJ, Sawyer L, Wonderling D, Tucker R, Smith CH. Topical therapies for the treatment of plaque psoriasis: systematic review and network meta-analyses. British Journal of Dermatology. 2013;168:954–67.
- Li AW, Yin ES, Antaya RJ. Topical corticosteroid phobia in atopic dermatitis. JAMA Dermatol [Internet]. 2017 Oct 1;153(10):1036. Available from: http://dx.doi.org/10.1001/jamadermatol.2017.2437
- Song SY, Jung S-Y, Kim E. Steroid phobia among general users of topical steroids: a cross-sectional nationwide survey. Journal of Dermatological Treatment [Internet]. 2018 Sep 3;30(3):245–50. Available from: http://dx.doi.org/10.1080/09546634.2018.1508817
- Press M, Hartop Peter J, Prottey C. Correction of essential fatty-acid deficiency in man by the cutaneous application of sunflower-seed oil. The Lancet [Internet]. 1974 Apr;303(7858):597–9. Available from: http://dx.doi.org/10.1016/s0140-6736(74)92653-1
- Piccirilli A, Choulot JC, Piccardi N, Msika P. Sunflower oil oleo distillate for atopy treatment: an in vitro and clinical evaluation. Journal of Investigative Dermatology. 2001;117(2):418.
- Pal D. Sunflower (Helianthus annuus L.) Seeds in health and nutrition. In: Nuts and Seeds in Health and Disease Prevention [Internet]. Elsevier; 2011. p. 1097–105. Available from: http://dx.doi.org/10.1016/B978-0-12-375688-6.10130-6
- Stoia M, Oancea S. Selected evidence-based health benefits of topically applied sunflower oil. App. Sci. Report. 2015;10(1):45–9.
- Danby SG, Alenezi T, Sultan A, Lavender T, Chittock J, Brown K, e al. Effect of olive oil and sunflower seed oil on the adult skin barrier: implications for neonatal skin care. Pediatric Dermatology. 2013;30(1):42–50.
- Molin L, Cutler TP, Helander I, Nyfors B, Downes N. Comparative efficacy of calcipotriol (MC903) cream and betamethasone 17-valerate cream in the treatment of chronic plaque psoriasis. A randomized, double-blind, parallel group multicentre study. British Journal of Dermatology [Internet]. 1997 Jan;136(1):89–93. Available from: http://dx.doi.org/10.1046/j.1365-2133.1997.d01-1148.x
- Thawornchaisit P, Harncharoen K. A comparative study of tar and betamethasone valerate in chronic plaque psoriasis: A study in Thailand. J Med Assoc Thai. 2007;90(10):1997–2002.
- Wu J, Feldman S, Lebwohl M. Therapy for Severe Psoriasis. E-book: Expert Consult. 2017:113. Accessed 10 January 2022. Available from: https://books.google.com.tw/books?hl=en&lr=&id=NIilDQAAQBAJ&oi=fnd&pg=PP1&dq=Wu+J,+Feldman+S,+Lebwohl+M.+Therapy+for+Severe+Psoriasis+pdf&ots=hjOm14La7h&sig=ddn_p8GPRfN1nnz_QkYysWlFysk&redir_esc=y#v=onepage&q=Wu%20J%2C%20Feldman%20S%2C%20Lebwohl%20M.%20Therapy%20for%20Severe%20Psoriasis%20pdf&f=false
- Bale T, Burden D, Coates L, Hadoke T, MacMahon E, Murphy R, et al. Guidelines for biologic therapy for psoriasis. British Association of Dermatologists guidelines. 2017.
- Informed Health Online. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006. Eczema: Steroids and other topical medications. 10 January 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK424899/
- Cabrera S, Chinniah N, Lock N, Cains GD, Woods J. Inter-observer reliability of the PASI in a clinical setting. Australasian Journal of Dermatology [Internet]. 2015 Mar 5;56(2):100–2. Available from: http://dx.doi.org/10.1111/ajd.12280
- Carlin CS, Feldman SR, Krueger JG, Menter A, Krueger GG. A 50% reduction in the Psoriasis Area and Severity Index (PASI 50) is a clinically significant endpoint in the assessment of psoriasis. J Am Acad Dermatol. 2004;50(6):859–66.
- Feldman SR. Psoriasis assessment tools in clinical trials. Annals of the Rheumatic Diseases [Internet]. 2005 Mar 1;64(suppl_2):ii65–8. Available from: http://dx.doi.org/10.1136/ard.2004.031237
- Armstrong AW, Parsi K, Schupp CW, Mease PJ, Duffin KC. Standardizing training for psoriasis measures: effectiveness of an online training video on psoriasis area and severity index assessment by physician and patient raters. JAMA Dermatol. 2013;149(5):577–82.
- Berth-Jones J, Grotzinger K, Rainville C, Pham B, Huang J, Daly S, et al. A study examining inter- and intrarater reliability of three scales for measuring severity of psoriasis: Psoriasis Area and Severity Index, Physician’s Global Assessment and Lattice System Physician’s Global Assessment. British Journal of Dermatology [Internet]. 2006 Jun 12;155(4):707–13. Available from: http://dx.doi.org/10.1111/j.1365-2133.2006.07389.x
- Basra MKA, Fenech R, Gatt RM, Salek MS, Finlay AY. The Dermatology Life Quality Index 1994-2007: a comprehensive review of validation data and clinical results. British Journal of Dermatology [Internet];159(5), 997-1035. 2008 Sep; Available from: http://dx.doi.org/10.1111/j.1365-2133.2008.08832.x
- Kamal T, Haroon T, Hussain Ijaz. Comparative efficacy of topical calcipotriol with betamethasone valerate in chronic plaque psoriasis. Journal of Pakistan Association of Dermatologists. 2004;14:16–22.
- Rivier M, Safonova I, Lebun P, Griffiths CE, Alihaud G, Michel S. Differential expression of peroxisome proliferator-activated receptor subtypes during the differentiation of human keratinocytes. The Society for Investigative Dermatology, Inc. 1998;111(6):1116–21.
- Sheu MY, Fowler AJ, Kao J, Schmuth M, Fluhr JW, Man MQ, et al. Topical peroxisome proliferator activated receptor-activators reduce inflammation in irritant and allergic contact dermatitis models. The Society for Investigative Dermatology, Inc. 2002;118(1):94–101.
- Rim JH, Jo SJ, Park JY, Park BD, Youn JI. Electrical measurement of moisturizing effect on skin hydration and barrier function in psoriasis patients. Clin Exp Dermatol [Internet]. 2005 Jul;30(4):409–13. Available from: http://dx.doi.org/10.1111/j.1365-2230.2005.01773.x
- Fluhr JW, Cavallotti C, Berardesca E. Emollients, moisturizers, and keratolytic agents in psoriasis. Clinics in Dermatology [Internet]. 2008 Jul;26(4):380–6. Available from: http://dx.doi.org/10.1016/j.clindermatol.2008.01.015
- Eichenfield LF, McCollum A, Msika P. The benefits of sunflower oleodistillate (SOD) in pediatric dermatology. Pediatric Dermatology [Internet]. 2009 Nov;26(6):669–75. Available from: http://dx.doi.org/10.1111/j.1525-1470.2009.01042.x
- Guo S, Ge Y, Na Jom K. A review of phytochemistry, metabolite changes, and medicinal uses of the common sunflower seed and sprouts (Helianthus annuus L.). Chemistry Central Journal [Internet]. 2017 Sep 29;11(1):95. Available from: http://dx.doi.org/10.1186/s13065-017-0328-7
- Darmstadt GL, Saha SK, Ahmed AS, Ahmed S, Chowdhury A, Law PA, et al. Effect of skin barrier therapy on neonatal mortality rates in preterm infants in Bangladesh: a randomized, controlled, clinical trial. Pediatrics 2008;121:522–9.
- Thawornchaisit P, Harncharoen K. A comparative study of tar and betamethasone valerate in chronic plaque psoriasis: a study in Thailand. J Med Assoc Thai. 2007;90:1997–2002.
- Choonhakarn C, Busaracome P, Sripanidkulchai B, Sarakarn P. A prospective, randomized clinical trial comparing topical aloe vera with 0.1% triamcinolone acetonide in mild to moderate plaque psoriasis. Journal of the European Academy of Dermatology and Venereology [Internet]. 2010 Feb;24(2):168–72. Available from: http://dx.doi.org/10.1111/j.1468-3083.2009.03377.x
- Jacobi A, Mayer A, Augustin M. Keratolytics and emollients and their role in the therapy of psoriasis: a systematic review. Dermatol Ther (Heidelb) [Internet]. 2015 Jan 21;5(1):1–18. Available from: http://dx.doi.org/10.1007/s13555-015-0068-3
- Evangelista MTP, Abad-Casintahan F, Lopez-Villafuerte L. The effect of topical virgin coconut oil on SCORAD index, transepidermal water loss, and skin capacitance in mild to moderate pediatric atopic dermatitis: a randomized, double-blind, clinical trial. Int J Dermatol [Internet]. 2013 Dec 10;53(1):100–8. Available from: http://dx.doi.org/10.1111/ijd.12339
- Agero AL, Verallo-Rowel VM. A randomized double-blind controlled trial comparing extra virgin coconut oil with mineral oil as a moisturizer for mild to moderate xerosis. Dermatitis: contact, atopic, occupational, drug. 2004;15(3):109–16.
- Brown AC, Koett J, Johnson DW, Semaskvich NM, Holck P, Lally D, et al. Effectiveness of kukui nut oil as a topical treatment for psoriasis. Int J Dermatol [Internet]. 2005 Aug;44(8):684–7. Available from: http://dx.doi.org/10.1111/j.1365-4632.2005.02634.x
- Gabros S, Zito PM. Topical Corticosteroids. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. Accessed 10 January 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532940/#_NBK532940_pubdet_
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