Cetomacrogol - an overview | ScienceDirect Topics (2023)

Brij58 (Polyoxyethylene cetyl ether) with HLB 15.7 has an important feature, since reverse vesicles can be formed easily from this type of surfactant, and those vesicles are useful to study active transport of ions across the cell membrane.

From: Nanostructures for Drug Delivery, 2017

Related terms:

  • Rabeprazole
  • Antiinfective Agent
  • Macrogol
  • Polidocanol
  • Penciclovir
  • Excipient
  • Essential Oil
  • Surfactant
  • Niosome
  • Acne
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Practical Application of Supercritical Fluid Chromatography for Pharmaceutical Research and Development

Paul Ferguson, ... Gesa Schad, in Separation Science and Technology, 2022

Characterization of polyoxyethylene alkyl ethers

Brij-58 (also known as polyoxyl 20 cetyl ether) and Brij S-100 (also known as polyoxyl 100 stearyl ether) are polyoxyethylene alkyl ether nonionic surfactants. They are used in pharmaceuticals as emulsifying agents, gelling/foaming agents, to increase the drug release of suppository formulations or to provide hydrophilicity to polymeric nanoparticles [76]. Analysis of this class of excipient has previously been undertaken using capillary electrophoresis hyphenated to mass spectrometry [87]. SFC was explored for this class of compounds by Lafosse et al. [84] who analyzed the BC 7 ethoxylated surfactant oligomer using ELS detection with a silica stationary phase and a carbon dioxide mobile phase modified with a mixture of methanol, water and triethylamine.

More recently SFC has been used to characterize larger Brij excipients (Brij-58 and Brij S-100) with MS detection. As with the Tween species, separation was achieved using a diol stationary phase and carbon dioxide mobile phase modified with a mixture of methanol, water and ammonium acetate. Fig. 15 shows the separation of the Brij S-100 oligomers alongside a series of polymeric impurities. Note that resolution diminishes as molecular weight increases—an observation common to all polymers under SFC conditions.

Cetomacrogol - an overview | ScienceDirect Topics (1)

Fig. 15. Base peak ion current chromatogram using SFC-MS of Brij S-100. Sample: 2500μg/mL in acetonitrile. Chromatographic conditions as Fig. 13.

Courtesy: S. Cancho-Gonzalez. Unpublished results.

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Drugs and the skin

Thomas K.K. Ha, in Clinical Pharmacology (Eleventh Edition), 2012


These are emulsions of either oil in water (washable; cosmetic ‘vanishing’ creams) or water in oil. The water content allows the cream to rub in well. A cooling effect (cold creams) is obtained with both groups as the water evaporates.

Oil-in-water creams,

e.g. aqueous cream (see emulsifying ointment, below), mix with serous discharges and are especially useful as vehicles for water-soluble drugs. They may contain a wetting (surface tension-reducing) agent (cetomacrogol). Various other ingredients, e.g. calamine, zinc, may be added to it.

Water-in-oil creams,

e.g. oily cream, zinc cream, behave like oils in that they do not mix with serous discharges, but their chief advantage over ointments (below) is that the water content makes them easier to spread and they give a better cosmetic effect. They act as lubricants and emollients, and can be used on hairy parts. Water-in-oil creams can be used as vehicles for lipid-soluble substances.

Creams, being less occlusive and effective at hydrating the stratum corneum, are not as effective for drug delivery as ointments.

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D. Mondal, in Reference Module in Biomedical Sciences, 2016

Basic Chemistry

Penciclovir is a nucleoside analog (guanosine analog).

Chemical structure
CommentsDenavir is available as a 1% cream for topical administration. Each gram of Denavir contains 10mg of penciclovir and the following inactive ingredients: cetomacrogol 1000 BP, cetostearyl alcohol, mineral oil, propylene glycol, purified water, and white petrolatum.
Chemical formulaC10 H15 N5 O3
Physical propertiesPenciclovir is a white to pale yellow solid. It is non-hygroscopic.
Molecular weight253.26
SolubilityAt 20°C, penciclovir has a solubility of 0.2mg/ml in methanol, 1.3mg/ml in propylene glycol, and 1.7mg/ml in water. In aqueous buffer (pH2), the solubility is 10.0mg/ml. The partition coefficient for penciclovir in n-octanol/water at pH7.5 is 0.024.

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Rabeprazole: A comprehensive profile

Ahmed H. Bakheit, ... Salem Albraiki, in Profiles of Drug Substances, Excipients and Related Methodology, 2021

6.3 Solution-phase stability

Ren et al. [75] investigated the chemical stability of a rabeprazole sodium, which was evaluated in a simulated intestinal fluid (pH 6.8) containing various “Generally Recognized As Safe (GRAS)”-listed excipients, including Brij® 58, Poloxamer 188, Cremophor RH40, Gelucire 44/14 and PEG 6000. The quantities of rabeprazole and the thioether-rabeprazole product were quantified by HPLC after incubation at 37 and 60°C. The major degradation component was isolated and characterized by LC/MS. Rabeprazole degradation followed kinetics of the first order. The rate constants (k) obtained at 37 and 60°C was 0.75 and 2.78h−1, respectively. By comparison, its stability was enhanced by incorporating excipients. Brij®58 had the greatest stabilizing effect of several excipients tested in this experiment. At 37 and 60°C, for instance, the k values of Brij®58 decreased to 0.22 and 0.53h−1. In terms of their solubilizing performance and micellar formulation of thioether rabeprazole, the stability mechanisms of these hydrophilic polymer was excellent devices with optimum Hydrophile-lipophile balance (HLB) values explained in detail. In addition, formulations containing sufficient excipients of rabeprazole would improve the stability and bioavailability of the intestinal tract.

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Lipids and inorganic nanoparticles in oral insulin delivery

Thundiparambil Azeez Sonia, Chandra P. Sharma, in Oral Delivery of Insulin, 2014

Charge inducers

Electrostatic stabilization of the niosomes can strongly suppress their aggregation. It can be achieved by inclusion of charge inducers such as dicetyl phosphate, stearylamine and diacylglycerol [104]. The presence of charged groups or inert and bulky surface groups on the niosome surface (by attaching polyelectrolytes, polysaccharides, etc. on the surface) enhances steric repulsion, which leads to improved stability [102].

Pardakhty et al. prepared niosomes of polyoxyethylene alkyl ethers (Brij) for encapsulation of insulin by a film hydration method. Brij 35 and Brij 58 did not form niosomes in the absence of cholesterol, apparently because of relatively large polar head groups in comparison with their alkyl chains. The size of vesicles was found to be dependent on the cholesterol content, charge incorporation or hydrophilicity of surfactants [105]. Encapsulation of insulin in the closed bilayer structure of niosomes protected it against degradation by gastric and intestinal enzymes. The maximum proteolytic activity was found in Brij 92/cholesterol (7:3 molar ratios), in which only 26.3 ± 3.98% of entrapped insulin was released during 24h in simulated intestinal fluid (SIF). The drug release kinetics for formulations could be best explained by the Baker and Lonsdale equation, indicating a diffusion-based delivery mechanism. The above results indicated that niosomes could be formulated as a sustained release oral carrier for the delivery of peptides/proteins such as insulin [105].

Encapsulation of human insulin in lipid vesicular systems such as niosomes was sought as a route to protect this protein against proteolytic enzymes and to improve its oral bioavailability. Recombinant human insulin was entrapped in multilamellar niosomes composed of polyoxyethylene alkyl ether surfactants (Brij 52 and Brij 92) or sorbitan monostearate (Span 60) and cholesterol. The extent and rate of insulin release from Brij 92 and Span 60 vesicles were lower than from Brij 52 niosomes (p < 0.05). Vesicles significantly protected insulin against proteolytic enzymes in comparison with free insulin solution (p < 0.05). Animals treated with oral niosome-encapsulated insulin (100IU/kg) showed decreased levels of blood glucose and elevated serum insulin; in the case of Brij 92 niosomes, the hypoglycaemic effect was significant (p < 0.05).

Niosomes were also stable in solubilizing bile salt solutions and could effectively prolong the release of insulin in both simulated gastric fluid and intestinal fluid (SGF and SIF). Results of this study showed that niosomes may be utilized as oral carriers of insulin; however, to increase bioavailability of insulin, further studies on protease inhibitor co-encapsulation in niosomal formulations might be helpful [106].

Niosomes of sorbitan monoesters (Span 20, 40, 60 and 80) were prepared by the film hydration method without sonication. Span 80 did not form niosomes in the absence of cholesterol. Depending on the cholesterol molar ratio or charge incorporation, the size of vesicles varied. The amount of insulin released in SIF from Span 20 and 80 was higher than from Span 40 and 60 vesicles. Span 60 vesicles showed the highest protection of insulin against gastric and intestinal enzymes and also exhibited good stability in the presence of sodium deoxycholate and storage temperatures [107].

Both hydrophilic and hydrophobic substances can be embedded in niosomal vesicles. The encapsulation of pharmaceutical materials in niosomes can decrease toxicity of the drug, enhance drug absorption, stability or activity, and slow down removal of the drug from the circulation due to slow drug release [94].

In short, studies suggest that niosomes are able to stabilize insulin against enzymatic degradation, and they may be potential candidates as oral carriers of this protein.

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Behind the Alkyl Polyglucoside-based structures: Lamellar liquid crystalline and lamellar gel phases in different emulsion systems

Snezana Savic, ... Jela Milic, in Alkyl Polyglucosides, 2014

2.1 Introduction

As is well known, surfactants show interesting interfacial and bulk properties (Geetha and Tyagi, 2012) and have a wide variety of uses (Paul and Moulik, 2001). If one excludes other potential purposes, surfactants are one of the most exploited raw materials in the formulation of versatile cosmetic products, but also one of the most important classes of pharmaceutical excipients, finding a wide range of uses in pharmaceutical preparations. Depending on the type of formulation, surfactants may play a role in solubilization or stabilization of cosmetic actives/drugs in different liquid preparations, improve physical stability and textural characteristics of emulsion systems and semisolids, or alter the flow properties of powders and granulates in the manufacturing of solid cosmetics or pharmaceutical dosage forms (Corrigan and Healy, 2002). Moreover, surfactants play an important role in the development of colloidal delivery systems for cosmetics and active pharmaceutical ingredients (APIs), such as reverse micelles, vesicles, liquid crystal dispersions, nanoemulsions and nanoparticles (Müller-Goymann, 2004).

In addition, surfactants strongly affect biological membranes, changing their permeability and thus, for instance, influencing the penetration of drugs and cosmetic actives into the skin. This behaviour is strongly related to surfactants’ safety profiles, as they also have the capacity to irritate the skin and damage biological membranes (Savic et al., 2010). Although this phenomenon is mainly concentration-dependent, it is particularly related to the so-called traditional/conventional surfactants/emulsifiers. For example, if one considers the field of dosage forms/drug delivery systems design, though a large number of commercial surfactants are available, a proportionally small group of them are approved as pharmaceutical excipients, and therefore widely accepted by the pharmaceutical industry. From this group, surfactants of particular pharmaceutical importance include anionic sodium lauryl sulphate (SLS/SDS) and non-ionic polyoxyethylated glycol monoethers (e.g. cetomacrogol), sorbitan esters (Span®) and ethoxylated sorbitan esters or polysorbates (Tween®) (DAB 2006; BP 2009; Ph. Eur. 7; USP/NF 35). In fact, it could be said that a whole series of potential uses of surfactants could be perfectly covered by the conventional representatives.

However, increased attention given to the environment over the past few decades has produced a growing interest in the field of the so-called natural surfactants. This term relates, in its broadest sense, to surface-active substances coming from natural raw materials. Generally, there are three categories of natural surfactants: amphiphiles produced by yeast or bacteria, amphiphiles containing a natural polar headgroup, and amphiphiles containing a natural hydrophobic tail. Sugars and amino acids are the two most important examples of surfactant polar headgroups of natural origin (Holmberg, 2001; Johansson and Svensson, 2001;Stubenrauch, 2001). As well as the awareness of environmental protection, there is an increase in demand for natural products, already elaborated in the previous chapter. Still, the range of surfactants suitable for the formulation of authentic natural cosmetics is quite limited (Alkyl Glucosides, Alkyl Glutamates, Alkyl Citrates, Alkyl Lactylates, Alkyl Sulphates, Alkyl Tartrates, protein derivatives, soaps, natural betaines or saponins), according to the standards of non-governmental organizations (NGOs) such as NaTrue (The International Natural and Organic Cosmetic Association), BDIH (Bundersverband der Industrie- und Handelsunternehmen) and COSMOS (cosmetic organic and natural standard). To be part of a natural cosmetic product, all ingredients (including surfactants) should be evaluated not only with respect to their origin, but also taking into account other criteria, such as the applied manufacturing process, by-products, preservation systems, biological degradation and aquatic toxicity (Hauthal, 2012). Although there are certain surfactants that are accepted by all the organizations mentioned, there are still some differences regarding their acceptance criteria. From the aforementioned it is clear that Alkyl Polyglucosides (APGs), also known as Alkyl Glucosides, could be safely used as primary/basic surfactants as well as co-surfactants in the formulation of those cosmetic products declared as natural. Indeed, APGs are commonly defined as a newer class of so-called natural, polyethylene glycol (PEG)-free surfactants, produced from renewable resources (von Rybinski and Hill, 1998;Holmberg, 2001; Stubenrauch, 2001; Tasic-Kostov et al., 2011a). In this vein, their biodegradability, accompanied by their natural origin, means they could be considered as the most important sugar-based surfactants today (Tasic-Kostov et al., 2011a). There is a strong interest in exploring APGs as surfactants for several types of application, since they are multifunctional substances that have proved to be very efficient in different cleaning products. There are also certain indications that some of them could be used as food emulsifiers (Tasic-Kostov et al., 2011a).

On the other hand, APGs were studied as prospective surfactants/emulsifiers for emulsion systems stabilized with lamellar phases of liquid crystalline (Lα) and/or gel crystalline (Lβ) type with high potential for skin moisturization, which could be a useful property for both cosmetic and pharmaceutical products (Savic et al., 2004; Savic et al., 2005a; Savic et al., 2005b; Savic et al., 2006; Savic et al., 2007; Savic et al., 2008a; Savic et al., 2008b; Savic et al., 2009a; Savic et al., 2009b; Savic et al., 2010; Tasic-Kostov et al., 2010; Kovacevic et al., 2011; Savic et al., 2011; Tasic-Kostov et al., 2011a; Tasic-Kostov et al., 2011b; Jaksic et al., 2012; Tasic-Kostov et al., 2012; Lukic et al., 2013). Therefore, APGs will be the focus of this chapter as structure-dependent promoters of lamellar mesophases. The chapter will provide crucial information on their physicochemical characteristics as well.

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Essential oils as topical anti-infective agents: A systematic review and meta-analysis

Serawit Deyno, ... Paul E. Alele, in Complementary Therapies in Medicine, 2019

3 Results

3.1 Characteristics of included studies

A total of 1060 articles were identified of which 883 articles remained after de-duplications. Titles and abstracts screening reduced the number of articles to 849. With further screening for inclusion and exclusion criteria, 33 remained for full-texts examination. Fifteen articles were further excluded based on the predefined inclusion/exclusion criteria. The reasons for exclusion were: dental infection, review articles, study protocols, in vitro study, Spanish language article, head lice infestation, and duplicate publication. Finally, eighteen articles were included among which were five studies on acne,17–21 five on methicilin resistant S. aureus (MRSA) decolonization22–26 and eight on topical fungal infections.13,27–33 A PRISMA flow diagram depicted number of studies retrieved, screened, excluded and included in the study (Fig. 1).

Cetomacrogol - an overview | ScienceDirect Topics (2)

Fig. 1. Flow diagram of retrieved, screened, included and excluded studies.

3.2 Risk of bias assessment of included studies

The quality of included studies ranges from low to moderate in accordance with authors’ risk of bias assessment, Figs. 2 and 3,.

Cetomacrogol - an overview | ScienceDirect Topics (3)

Fig. 2. Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Cetomacrogol - an overview | ScienceDirect Topics (4)

Fig. 3. Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

3.3 Essential oils in the treatment of acne

Five studies enrolled a total of 256 participants in clinical trials. Two studies were placebo controlled,17,18 one placebo and standard treatment controlled,21 one standard treatment controlled19 and the other one was uncontrolled.20 The standards were Lactobacillus-fermented Chamaecyparis obtusa (LFCO)19 and benzoyl peroxide 10% lotion.21 Three studies used Melaleuca alternifolia (tea tree oil (TTO)) while the others used Ocimum gratissimum and copaiba EOs. The primary outcomes included acne surface area reduction, total lesion count, acne severity index, inflammatory acne lesion, non-inflammatory acne lesion and reduction in investigator’s global assessment (IGA). Efficacy was determined using total numbers of facial acne lesions (TLC),20 IGA score20 histopathological changes,19 TLC and ASI,18 reduction in the total surface,17 product activity (reciprocal value of the number of days taken to achieve a 50% reduction in lesion count).21 The characteristic of included studies and summary of the finding is presented in Table 2.

Table 2. Characteristic of the included studies and summary of the finding of Essential oils use for treatment of acne.

StudyStudy durationStudy Design, CountryFindingsAdverse effect
InterventionNo of ptsResult
1da Silva et al, 2012173 wkCCT, India1.0% copaiba10SA reduction = 86.494Not reported
Placebo10SA reduction = 13.931Not reported
2Enshaieh et al, 2007176 wkRCT, South korea5% TTO30Reduction TLC = 43.64 Reduction ASI = 40.49Pruritus (10%), little burning sensation (1) &amp; minimal scaling (1)
Placebo30Reduction TLC = 43.64, Reduction ASI = 14.18minimal pruritus (2) &amp; little burning sensation (2)
3Kwon et al, 2014208 wksRCT, Split-face trial Australia5% TTO34IAC by 38.2% ‘Not reported
5% LFCO34IAL reduced by 65.3%, NIAL reduced by 52.6% &amp; LFCO superior to TTO in onset time of efficacyNot reported
4Malhi et al, 20172012 wksCT, NigeriaTTO gel (200 mg/g) and face wash (7 mg/g) BID14Reduction IGA = 0.5, Reduction TLC = 13moderate scaling, peeling (1) dryness (1), and minor itch (1)
5Orafidiya et al, 2002214 wk2% Ocimum gratissimum oil5% oil in alcohol, gave highest activityMild skin burning’ sensation (98%) &amp; Moderate skin reaction in 5%
10% benzoyl peroxide
PlaceboNo 50% reduction

Where, IGA = Investigator global assessment, TTO = Tea tree oil, RCT = Randomized controlled trial, CCT = Controlled clinical trial, CT = Clinical trial, TLC = Total lesion count, SA = Surface area, ASI = Acne severity index, IAL = Inflammatory acne lesions, NIAL = Non-inflammatory acne lesions, DA = Product activity, wks = weeks, LFCO = Lactobacillus-fermented Chamaecyparis obtuse.

Four of the five studies demonstrated effectiveness of EO in acne treatment and the remaining study demonstrated effectiveness but was inferior to the control. In the uncontrolled study significant improvement were found when baseline and end-of-treatment values were compared.20 Essential oils showed better efficacy compared to placebo in two of the included studies.18,19 Of the included studies, one identified a base with better product activity as alcohol and cetomacrogol blend bases (hydrophilic).21 One study revealed LFCO as rapid and effective for treating acne lesions compared to TTO where histopathological findings correlated well with the clinical acne grade and treatment response.19 The effectiveness of the EOs could be attributed to their antibacterial and anti-inflammatory effect.34 The in vitro antibacterial activity of different EOs were observed against acne-associated bacteria like Propionibacterium acnes and Staphylococcus epidermidis.35 Both antibacterial and anti-inflammatory activities are considerably important in acne therapy. Treatment approaches where antibacterial effects and anti-inflammatory effect were addressed by one component would be future alternative approaches. Evidence-based review of botanicals for dermatologic use reported that TTO could be potentially used in acne treatment12 yet the included studies were of low quality.36 Essential oils could be a future preferred alternative provided the limitations in the included studies are addressed.5

3.4 Essential oils in decolonization of methicilin resistant Staphylococcus aureus

Five studies enrolled and evaluated 620 participants22,23,25,26,37 of which four were randomized controlled trials22,23,26,37 and the remaining, an uncontrolled trial.25 Two studies used routine care (2% mupirocin ointment and+ triclosan body wash or mupirocin 2%, chlorhexidine gluconate 4% soap, silver sulfadiazine 1% cream)23 as control. In two other studies, the saline gauze26 and JBS22 were the controls. The primary outcomes included number of patients cleared of MRSA and with new MRSA. The characteristic of the included studies was summarized in Table 3. Essential oils showed significantly better efficacy in decolonization of MRSA compared to routine care. Control of MRSA within health-care settings and populations poses a problem and is managed by mupirocin.38 Mupirocin and chlorhexidine gluconate are current standard agents for MRSA decolonization.39 MRSA strains have developed resistance to mupirocin,40,41 and chlorhexidine gluconate 42 which call for the search for new treatments.

Table 3. Characteristic of the included studies and summary of the finding of Essential oils in MRSA decolonization.

Design, CountryIntervention of typeDuration of interventionTreatment outcome
No of PatientsNo of Patients cleared of MRSAAdverse effectOther findings
1Blackwood et al., 201322RCT, ICUs, Ireland5% TTOMedian (IOR) 8 (4, 13)195Safe and well tolerated17 new MRSA
JBSMedian (IQR) 6 (3, 11)196Not reported22 new MRSA
2Caelli et al., 200124RCT, Referral hospital, AustraliaICMean (range) 5.6 (2-14)155Mild swelling of nasal mucosa, burning6 new MRSA
RCMean (range) 10.7 (1-34)152Skin tightness (1)8 new MRSA
3Edmondson et al., 201125Case serious, Australia3.3% TTO12 week1111Pain in 3 of 128 healed
4Lee et al., 2014 26RCT, Hong Kong10% TTO4week1614Not reported16 healed M(SD) = 93(201) CFU/ml
Saline gauze4week160M(SD) = 10,312 (3054) CFU/ml
5Dryden et al., 201423Royal Hampshire County Hospital, UK10%TTO cream &amp; 5% body lotion14 days11046Not reportedNasal carriage cleared = 36/74
ST14 days56114Nasal carriage cleared = 58/74

Where = RC = Routine care = 2% mupirocin ointment &amp; triclosan body wash, IC = intervention care (4% TTO ointment &amp; 5% TTO), JBS = Johnson's Baby Soft wash, ST = standard treatment (Mupirocin 2%, chlorhexidine gluconate 4% soap, silver sulfadiazine 1% cream).

Meta-analysis showed the proportion of MRSA cleared in the whole intervention was 55% (95%CI: 35%, 75%), I2 = 88.16%). Though non-significant a higher proportion of MRSA was cleared in EOs (TTO) group compared to routine care (Fig. 4).

Cetomacrogol - an overview | ScienceDirect Topics (5)

Fig. 4. Proportion of MRSA cleared, essential oil TT O versus routine care.

The proportion of new MRSA developed was 21% ([95%CI: 9%, 36%], I2 = 86.59%) in the whole intervention type. Subgroup analysis showed significantly lower level of new MRSA occurrence in the TTO group compared to routine care, Fig. 5. Dryden et al., 2004 showed significantly lower proportion of number of patients with MRSA in TTO (49% [95%CI: 38%, 60%]) compared to standard care (78% [95%CI: 68%, 86%]).

Cetomacrogol - an overview | ScienceDirect Topics (6)

Fig. 5. Proportion of new MRSA emergence in EO (TTO) versus placebo versus routine care.

3.5 Essential oils in the treatment of topical fungal infections

Eight studies enrolled a total of 631 participants with fungal infections for evaluation of EOs effectiveness.13,27–33 Three13,29,31 enrolled participants with dandruff, two with tinea pedis,28,32 one with pityriasis,33 one with toenail onychomycosis,30 and one with seborrheic dermatitis.27 The treatment outcomes of EOs were compared to standard treatment of 2% ketoconazole,13,33 2% butanafine,30 and placebo.27–29,32 The characteristics of included studies were summarized in Table 4. Essential oils showed equal or non-inferior efficacy to standard treatment and better efficacy to a placebo in treating topical fungal infections. Essential oils improved clinical symptoms in all of the included studies and conversion to negative cultures. This study included three or more additional studies yet no conclusive evidence was generated as result of significant heterogeneity and different operationalization of the same outcome. The finding merits future studies with improved quality, standardized formulation, strength, clearly formulated primary outcomes, and duration of follow up. Future studies should primarily generate a standard formulation and focus on clearly defined outcome(s).

Table 4. Characteristic of the included studies and summary of the finding of essential oils in topical fungal infections.

StudyDiseaseDesign, countryInterventionTreatment outcome
DoseNo of participantsResults
1.Carmo et al., 201333Pityriasis versicolorRCT, BrazilForty daysCymbopogon citratus 1.25 μL/mLShampoo 3xweek &amp; cream 2x day4760% cure rate
2% ketoconazole2980% cure rate
2.Chaijan et al., 201813DandruffCT, IranOne monthMyrtus communis L.8x in a month37ASF reduced to 0.62+ from 2.92+0.98 No significant differences between the groups in terms of efficacy, satisfaction rate and side effects
2% ketoconazole8x in a month37ASF reduced to 0.86+0.89 from 2.92+0.98
3.Tong et al.,199232Tinea pedisRCT, Australia10% TTO37Conversion to negative culture = 30% Clinical improvement = 24/37
1% tolnaftate33Conversion to negative culture = 85% Clinical improvement = 19/33
Placebo34Conversion to negative culture = 21% Clinical improvement = 14/34
4.Chaisripipt et al, 201531DandruffRCT, Thailand2 wk10% lemongrass oil3010% lemongrass oil reduced dandruff by 75% at 7 day and 81% at 14 day
5.Syed et al., 199930Toenail onychomycosisRCT16wk5% TTO4080% cured &amp; mild inflammation (4)
2% butenafine20None cured
6.Satchell et al,, 2002a29DandruuffRCT, Sydney4wk5%TTODaily63Total area score = 13.0 + 2.59, Total severity index = 6.9 + 2.04, Whole scalp lesions = 91.0 + 38.0, Scaliness = 48.9 + 19.5, Itchiness = 43.5 + 21.3
PlaceboDaily62Total area score = 13.9 + 2.39, Total severity index = 7.0 + 1.92, Whole scalp lesions = 99.9 + 35.3, Scaliness = 53.6 + 21.9, Itchiness = 49.1 + 24.7
7.Satchell et al, 2002b28Tinea pedis4 wk25% TTO3614 cured
50%TTO3818 cured
Placebo4614 cured
8.Roy et al, 201327Seborrheic dermatitisSkin Diseases Research Center, Iran4 wk5%TTO gel23At 4 wk: Itching% 0.64+0.34, Erythma% 0.69 + 0.7, Scaling% 0.55 + 0.2, Greasy crust % 0.0 + 0.0, Patient Sat.91.5 + 4.1
Placebo19At 4 week:Itching% 2.2+1.0, Erythma% 2.2 + 1.6, Scaling% 1.9 + 0.90, Greasy crust % 1.8 + 0.3, Patient Sat.0.0 + 0.0

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