Our skin has numerous cells with a wide variety of functions. Some of these cells protect the skin’s blood vessels and other cells by fighting against environmental factors. As is well known, the most significant among environmental factors is ultraviolet (UV) radiation, namely sunlight. Particularly, UVA easily penetrates down to the skin’s dermis (the layer containing cells and vessels). It negatively affects the structures here; consequently, the skin wrinkles, dries out, develops blemishes, suffers vascular damage, and can even develop skin cancer.
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If redness, which we refer to as flushing, occurs suddenly due to distress and stress and is not associated with any underlying disease (elevated blood pressure, etc.), the redness is not permanent. Helping the individual regulate their emotional state and utilizing certain creams that improve microcirculation are essential components of the treatment. At the same time, the treatment process can be accelerated through light therapies. If the redness is persistent, other factors should be investigated. When persistent redness is present, rosacea is generally considered.
Rosacea is a condition frequently observed in our country as well; it is a dermatological problem typically seen in fair-skinned individuals, closely associated with the aforementioned environmental factors, and sometimes concurrent with gastric disorders. Rosacea, which often raises aesthetic concerns in patients, has various types ranging from forms that present with ocular redness and dryness alongside skin symptoms, to forms presenting solely with facial erythema, papulopustular forms accompanied by acne-like eruptions, and advanced forms culminating in nasal enlargement (rhinophyma).
In addition to genetic predisposition, rosacea patients are known to have a racial predisposition (Northern European and Mediterranean). It is more frequently observed between the ages of 30–40 and in women compared to men. A parasite known as Demodex and certain symbiotic bacteria are also known to trigger rosacea. Furthermore, recent publications report that free radicals cause rosacea under conditions of diminished cellular defense.
The common point in the management of skin redness and rosacea is the elimination of environmental triggers. Sun protection products containing high concentrations of zinc oxide and octinoxate, which fully block UVA radiation, should be particularly preferred. Attention must be paid to dietary intake of caffeinated, fermented beverages, and especially alcohol consumption. The habit of consuming very hot foods and drinks should be revised. Emotional fluctuations should be brought under control as much as possible. In addition to all these measures, erythematous areas can be alleviated with intense pulsed light (IPL) therapy or vascular lasers.
Among the creams indicated specifically for rosacea are topical formulations containing metronidazole, tetracycline, or doxycycline antibiotics. In refractory cases, isotretinoin therapy may be recommended.
Dear Colleagues, the formula I am sharing with you this week is a formulation prescribed in France for facial erythema, serving as a remedy for issues related to accelerated blood circulation caused by capillary vessels lying structurally closer to the skin surface. Moreover, since this formula contains three distinct herbal tinctures, it holds educational value in refreshing the knowledge of our student colleagues who attended my presentation entitled MAGISTRAL FORMULATION APPLICATIONS IN PHYTOTHERAPY at Marmara University Faculty of Pharmacy in recent months. Let us now examine this dermocosmetic preparation together.
Rp.
Extrait fluide de vigne rouge 0.10 g, soit V (5) gouttes
Extrait fluide d’hamamélis 0.10 g, soit V (5) gouttes
Teinture de calendula 0.80 g, soit XLV (45) gouttes
Acide stéarique 7.50 g
Huile d’amande douce 20.00 g
Glycérine 10.00 g
Triéthanolamine qsp PH 7 2.00 à 3.00 g
Eau purifiée 15.00 g
Ingredients in the formula:
Extrait fluide de vigne rouge- Red vine (Vitis vinifera L.) leaf – Grapevine (Vitis vinifera L.) leaf – Vitis viniferae rubrae folium – Folia Vitis – Weinrebenblätter;
Botanical name: Vitis vinifera, Vitaceae family. Today, it is cultivated in all temperate regions of the world. It has been cultivated by humans primarily in Southern Europe and the Middle East for many centuries. It requires soil rich in clay and silica as well as maximum sunlight.
Its use is recommended for varicose veins, chronic venous insufficiency; cramps, tingling sensations, edema, and anti-aging: supporting collagen synthesis and combating free radical damage. Its leaves, fruits, and seeds are utilized.
Its biological activity is predominantly associated with resveratrol. Studies on cardiovascular protection suggest that grapes and their derivatives (grapes, grape juice, grape seed extract, non-alcoholic wine) exert a positive effect on various risk factors such as cardiovascular diseases, cancer prevention, diabetic retinopathy, and Alzheimer’s disease, primarily due to the polyphenols they contain.
Extrait fluide d’hamamélis- Witch hazel (Hamamelis virginiana L.) leaf – Hamamelis leaf – Hamamelis virginiana e foliis;
Witch hazel leaf (Hamamelidis folium) consists of the dried leaves of witch hazel (Hamamelis virginiana L.), belonging to the family Hamamelidaceae, containing not less than 7% tannins. It is prepared by percolation extraction of the used plant part with a water-alcohol mixture. The crude drug is defined in the European Pharmacopoeia. Hamamelidis folium contains tannins, gallic acid (a bitter principle), and very small amounts of volatile oil. Its main chemical constituents include catechins such as (+)-catechin, (+)-gallocatechin, (-)-epigallocatechin gallate, and cyanidin- and delphinidin-type proanthocyanidins. The drug also contains flavonoids (kaempferol glycosides) alongside proanthcyanidins. Witch hazel leaf (Hamamelidis folium) exhibits astringent and hemostatic effects. It possesses local vasoconstrictive properties. Its ointments and suppositories are used in the treatment of hemorrhoids. Its aqueous distillate is incorporated into creams intended for skin burning and pruritus owing to its astringent and cooling effects. It promotes healing in minor cutaneous wounds and alleviates discomfort in dry, chapped skin. It is used in infant diaper dermatitis, minor burns, and sunburns. Hamamelis virginiana aqueous distillate has also been employed for its hemostatic action. Hamamelidis Folium has likewise been administered internally for the symptomatic management of varicose veins and hemorrhoids.
Witch hazel leaf has no known contraindications. Its administration requires no special warnings or precautions. No drug interactions have been reported.
Calendula teinture – Calendula flower tincture – Marigold flower tincture;
The drug is monograph-defined in the French Pharmacopoeia. It has historically been utilized as a healing ointment for cuts, burns, contusions, verrucae, and pain.
Calendula flower tea has traditionally been used as a gargle for sore throat, laryngitis, tonsillitis, cough, as a demulcent, and against inflammation of the oral and pharyngeal mucosa. In infusion form, it has been used against fever, cramps, and spasms of the gastrointestinal and urogenital systems.
Externally, it is used for skin rejuvenation, wounds, burns, and abrasions. Scientific studies have demonstrated that ointments formulated with calendula extract are particularly effective in non-healing chronic wounds, including difficult-to-heal leg ulcers and pressure ulcers. A recent study confirmed its efficacy in post-cesarean surgical wounds. Another study showed that ear drops containing calendula extract were effective in managing otalgia associated with acute otitis media.
Stearic acid – Octadecanoic acid – Acidum stearicum – Stearic acid – Stearinsäure;
Stearic acid is employed as a lubricant in tablets and capsules, and as an emulsifying and solubilizing agent in topical preparations. Stearic acid is defined in the British Pharmacopoeia (BP 1993) and the United States National Formulary (USPNF XVII) as a mixture of stearic and palmitic acids. In this mixture, the stearic acid content is not less than 40%, and the sum of both acids is not less than 90%. Stearic acid is a white or faintly yellow, slightly glossy, crystalline solid, or a white to yellowish-white powder. It has a faint odor and a taste resembling tallow. It is practically insoluble in water; soluble in ethanol, hexane, and propylene glycol; and freely soluble in benzene, carbon tetrachloride, chloroform, and ether.
Almond oil – Amygdalae oleum virginum – Prunus amygdalus dulcis (sweet almond) oil – Sweet almond oil;
Almond oil is a fixed vegetable oil obtained from Prunus dulcis var. dulcis or var. amara, or from a blend of both. Certain pharmacopoeias define the oil as derived from Prunus dulcis var. amara, var. communis (=var. sativa), or Prunus amygdalus.
Almond oil provides nutritional value and exhibits demulcent properties. It is used to soften the skin and soothe irritation on skin and mucous membranes. It is also instilled into the ear canal to soften cerumen. In certain injectable preparations, it serves as a vehicle.
Almond oil is a pale yellow liquid with a characteristic odor. It has a mild, nutty taste. It is primarily composed of oleic acid triglycerides, with lesser amounts of linoleic and palmitic acid triglycerides. It is obtained by cold expression without the application of heat from bitter or sweet almonds of Prunus dulcis (Prunus amygdalus; Amygdalus communis) var. amara or var. dulcis (Rosaceae). It is slightly soluble in alcohol and miscible with chloroform, ether, and petroleum ether. Almond oil must be stored in well-filled, airtight, tightly closed containers protected from light. Almond oil intended for parenteral administration must be stored in glass containers.
Glycerol – Glycerine – Glycerol – 85%;
Glycerin is a clear, colorless or almost colorless, hygroscopic, syrupy, odorless or nearly odorless liquid with a sweet taste. It is miscible with water and alcohol; slightly soluble in acetone; and practically insoluble in chloroform, ether, fixed oils, and essential oils. Its aqueous solutions are neutral to litmus. According to the United States Pharmacopeia (USP), the pH of Glycerin Oral Solution, USP is between 5.5 and 7.5. Strong oxidizing agents form explosive mixtures when combined with glycerin.
Triéthanolamine – Trolamine – Trolamina – Trolaminum;
It is a colorless, strongly basic, viscous organic compound. It is included in formulations as an emulsifying agent and surfactant. It may cause contact allergy. In addition to being used as a pH stabilizer in a broad range of cosmetic products, it is particularly preferred in cleansing creams and milks for makeup removal, as well as in skin lotions, gels, shampoos, and shaving foams. A 1% solution has an approximate pH value.
Preparation of the formula:
First, the base cream is prepared. The base cream may also be formulated with varying ratios and characteristics depending on the patient’s dermatological needs.
The oil phase is placed in a beaker (Huile d’amande douce + Acide stéarique).
The aqueous phase is placed in another beaker (Eau purifiée + Glycérine).
The oil phase containing stearic acid is kept in a water bath until complete melting and mixing are achieved. After the other beaker is brought to the same temperature in the water bath, the aqueous phase is slowly poured into the oil phase fraction while stirring continuously at each addition until a homogeneous emulsion is obtained, thereby completing the base cream. Triethanolamine is added to the mixture while monitoring with a pH meter or pH indicator strips until a neutral pH (7) is achieved. Finally, the preparation is finalized by incorporating calendula tincture dropwise, followed sequentially by the other tinctures into the cream, stirring thoroughly after each addition.
Wishing you a pleasant week…
References:
1- Cahiers du préparateur en pharmacie
Travaux pratiques de préparation et de conditionnement des médicaments
Jean-Marie FONTENEAU Philippe KLUSIEWICZ
2- RxMediaPharma®2016 Interactive Drug Information Source
