SKIN CARE 29 n No treatment n Mediterranean botanical blend formulation n Biafine formulation 5
4 3 a,b a 2
1
0
Figure 3: RTOG visual scoring results comparing the non-treated control group against the Mediterranean botanical blend formulation and the Biafine formulation at the end of the study (week 8). The data demonstrates that at p<0.01 (a) data points are statistically different than the non-treated site, and (b) that the Mediterranean botanical blend sites were not statistically different compared to the Biafine treated sites at p>0.05.
The other ointment was prepared with
the ingredients shown in Table 1 and contained 3% of the Mediterranean botanical blend discussed above and was used by 26 of the volunteers. One group of participants comprising 18 volunteers were asked not to use any topical treatments and acted as the untreated group. The participants using the ointments had to wait 4 hours after their radiation treatments before applying the ointments. This is important as the volunteers needed to allow time for the radiation to be effective before topical treatments could be incorporated into the regimen. The study progressed for 8 weeks and the erythema of the skin was measured using reflectance spectrophotometry, a reliable and non- invasive technique to measure skin erythema and barrier disruption.18
In
addition, the participants, who were under constant medical supervision, were also assessed by the attending dermatologist who graded the skin’s redness using an updated radiation therapy oncology group (RTOG) scoring system developed by Wells et al.19
As can be seen in Figure 2, the
treatment of the participants who employed the topical ointments showed significant benefits compared to the volunteer participants who did not apply topical anti-inflammatories. Interestingly, the participants who used the skin cream containing the Mediterranean botanical blend demonstrated a superior reduction in skin redness as measured by the reflectance spectroscopy compared to the group who used the commercial Trolamine cream. The results of the RTOG visual scoring also indicated that the Mediterranean botanical blend and the Biafine
November 2019
formulations worked well to reduce erythema compared to the non-treated site, but the differentiation between the Biafine (Trolamine) treatment and the Mediterranean botanical blend treatment was not seen to be statistically different, Figure 3. This indicates that, visually, the trained dermatologist could not distinguish the difference in redness between the commercial pharmaceutical product and the botanical blend demonstrating that the Mediterranean blend is quite potent at reducing redness in irradiated skin. Instead, the instrumental technique allowed to highlight differences in skin erythema not visible to the naked eye.
The data demonstrate that by carefully blending three botanical extracts with previously proven skin benefits, the mixture provides a significant advantage for reducing skin erythema and irritation due to treatments as harsh as radiation therapy.
Mediterranean botanical blend in cosmetic applications
Most individuals reading this paper will unlikely need to undergo radiotherapy treatments for cancer. The benefits noted in the very interesting study conducted by the University of Catania might be thought to be of limited practical applications in cosmetics. However, radiotherapy functions by increasing the formation of free radicals in the areas around the irradiation sites. The formation of free radicals helps to kill residual cancer cells which are typically also made more sensitive to the radiation treatment by prior chemotherapy treatments. When the x-rays used in radiotherapy treatment pass through the skin, the impact on the skin cells in the epidermis and dermis is very
similar to the effects of UV radiation on the skin, although in terms of energy impact, the x-rays commonly used in radiotherapy are more highly focused and are of a higher energy even than UVC radiation. Fortunately, unlike in radiotherapy
treatments, individuals using cosmetics can apply products that have been formulated to contain sunscreens. It is common now to find high end and mass skin care ingredients using sunscreens to help minimise the potential for skin inflammatory responses.20
Likewise, individuals who
experience acne disruptions can apply OTC topical treatments containing active ingredients like salicylic acid that can help to ameliorate the disruptions and improve the barrier function of the skin.21 It seems likely that the extracts of the Mediterranean botanical blend function through various pathways to control the inflammatory response. Most prevalent would be control of free radicals that would be generated by the radiation exposure and for this reason, the correlation between the data found with the studies on breast cancer radiation treatments and the kinds of inflammation customers might experience from extended sun exposure or from skin inflammatory problems like acne would respond to the benefits of topical treatments containing the Mediterranean botanical blend. Also, treatments that can result in skin erythema such as alpha-hydroxy acid treatments or even, perhaps, laser skin treatments, would likely respond well to the ingredients in this blended botanical product. Redness associated with insect bites has also been a topical target for formulations employing the Mediterranean botanical blend.
PERSONAL CARE ASIA PACIFIC
RTOG visual score
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