Natural health products
Place in Therapy
Place in Therapy: Natural Health Products
The evidence is sparse for the use of natural health products for the prevention and/or treatment of diaper dermatitis in infants/children. Studies that investigated the direct effect of natural health products on diaper dermatitis specifically are rare and limited to single, poorly designed trials with no other supporting trials that attempt to duplicate results. The few natural health products that have been investigated in primary literature include vitamin A, hamamelis (witch hazel), aloe, calendurla, honey, olive oil, and beeswax.
Calendula ointment demonstrates the most promise, as it was shown in one reasonably well-designed trial to reduce the severity of diaper dermatitis through its anti-inflammatory and antimicrobial effects in patients less than 3 years of age.<1> Unfortunately, calendula ointment is not available in Canada. Hamamelis ointment, shown to exhibit anti-inflammatory properties, may also improve the severity of diaper dermatitis in patients up to the age of 11 years and is well tolerated.<1> Minimal to no adverse effects were reported for trials utilizing calendula and hamamelis ointments.<1,2>
Evidence for the efficacy of honey, olive oil, and beeswax came from a poorly designed trial of only 12 patients with no control group, making it difficult to attribute the results to the intervention.<3> Similarly, the study on vitamin A in the role of dermatitis prevention was marred by a major confounding factor.<4> Although lacking efficacy, honey, olive oil, and beeswax were not associated with any adverse effects.<3> The safety profile of vitamin A on diaper dermatitis patients is unknown.
Although there is no place for natural health products on their own for diaper dermatitis due to the lack of supporting evidence, they are often found in combination with efficacious pharmacological agents such as petrolatum and zinc oxide. Due to their relatively favorable safety profile (with the exception of vitamin A), the role of the natural health products reviewed are limited to their presence as additives in diaper dermatitis products with a pharmacological medicinal ingredient(s).
References
1. Panahi Y, Sharif MR, Sharif A, et al. A randomized comparative trial on the therapeutic efficacy of topical aloe vera and Calendula officinalis on diaper dermatitis in children. Scientific World Journal. 2012;2012:810234.
2. Wolff HH, Kieser M. Hamamelis in children with skin disorders and skin injuries: results of an observational study. Eur J Pediatr. 2007 Sep;166(9):943-8.
3. Al-Waili NS. Clinical and mycological benefits of topical application of honey, olive oil and beeswax in diaper dermatitis. Clin Microbiol Infect. 2005 Feb;11(2):160-3.
4. Bosch-Banyeras JM, Catala M, Mas P, Simon JL, Puig A. Diaper dermatitis. Value of vitamin A topically applied. Clinical Pediatrics 1988;27(9):448–50.
The evidence is sparse for the use of natural health products for the prevention and/or treatment of diaper dermatitis in infants/children. Studies that investigated the direct effect of natural health products on diaper dermatitis specifically are rare and limited to single, poorly designed trials with no other supporting trials that attempt to duplicate results. The few natural health products that have been investigated in primary literature include vitamin A, hamamelis (witch hazel), aloe, calendurla, honey, olive oil, and beeswax.
Calendula ointment demonstrates the most promise, as it was shown in one reasonably well-designed trial to reduce the severity of diaper dermatitis through its anti-inflammatory and antimicrobial effects in patients less than 3 years of age.<1> Unfortunately, calendula ointment is not available in Canada. Hamamelis ointment, shown to exhibit anti-inflammatory properties, may also improve the severity of diaper dermatitis in patients up to the age of 11 years and is well tolerated.<1> Minimal to no adverse effects were reported for trials utilizing calendula and hamamelis ointments.<1,2>
Evidence for the efficacy of honey, olive oil, and beeswax came from a poorly designed trial of only 12 patients with no control group, making it difficult to attribute the results to the intervention.<3> Similarly, the study on vitamin A in the role of dermatitis prevention was marred by a major confounding factor.<4> Although lacking efficacy, honey, olive oil, and beeswax were not associated with any adverse effects.<3> The safety profile of vitamin A on diaper dermatitis patients is unknown.
Although there is no place for natural health products on their own for diaper dermatitis due to the lack of supporting evidence, they are often found in combination with efficacious pharmacological agents such as petrolatum and zinc oxide. Due to their relatively favorable safety profile (with the exception of vitamin A), the role of the natural health products reviewed are limited to their presence as additives in diaper dermatitis products with a pharmacological medicinal ingredient(s).
References
1. Panahi Y, Sharif MR, Sharif A, et al. A randomized comparative trial on the therapeutic efficacy of topical aloe vera and Calendula officinalis on diaper dermatitis in children. Scientific World Journal. 2012;2012:810234.
2. Wolff HH, Kieser M. Hamamelis in children with skin disorders and skin injuries: results of an observational study. Eur J Pediatr. 2007 Sep;166(9):943-8.
3. Al-Waili NS. Clinical and mycological benefits of topical application of honey, olive oil and beeswax in diaper dermatitis. Clin Microbiol Infect. 2005 Feb;11(2):160-3.
4. Bosch-Banyeras JM, Catala M, Mas P, Simon JL, Puig A. Diaper dermatitis. Value of vitamin A topically applied. Clinical Pediatrics 1988;27(9):448–50.