Licorice in the Treatment of Acne Vulgaris and Postinflammatory Hyperpigmentation: A Review
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Abstract
Clinical advantages of licorice (Glycyrrhiza spp.) have been investigated for several years. It has been traditionally used for a variety of disorders. Different constituents with various characteristics have been isolated from Glycyrrhiza spp. extracts. This review aimed to summarize the current knowledge on the pharmacological efficacy and safety of licorice extract constituents to treat the pathophysiology of acne vulgaris (AV) and the associated postinflammatory hyperpigmentation (PIH). Anti-androgenic, antimicrobial, anti-inflammatory, antioxidant, depigmenting, and skin-turnover-accelerating properties have been identified for licorice extract which could be effective against AV and PIH through multiple pharmacological mechanisms. The active compounds responsible for these pharmacological activities, molecular mechanisms, safety profile, as well as the in vitro, in vivo, animal, and clinical studies are discussed. Licorice extract possesses broad-spectrum activity and could be considered as an effective and safe option in the treatment of AV and its associated PIH. However, evidence-based clinical trials are required to prove its efficacy as well as safety. We hope this paper can provide new insights for further studies, particularly large controlled clinical trials.
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2. Song NR, Kim JE, Park JS, et al. Licochalcone A, a polyphenol present in licorice, suppresses UV-induced COX-2 expression by targeting PI3K, MEK1, and B-Raf. Int J Mol Sci 2015;16(3):4453-70.
3. Fukuchi K, Okudaira N, Adachi K, et al. Antiviral and antitumor activity of licorice root extracts. In Vivo 2016;30(6):777-85.
4. Chen X, Liu Z, Meng R, Shi C, Guo N. Antioxidative and anticancer properties of licochalcone A from licorice. J Ethnopharmacol 2017;198:331-7.
5. Tang ZH, Li T, Tong YG, et al. A systematic review of the anticancer properties of compounds isolated from licorice (gancao). Planta Med 2015;81(18):1670-87.
6. Ayeka PA, Bian Y, Githaiga PM, Zhao Y. The immunomodulatory activities of licorice polysaccharides (Glycyrrhiza uralensis Fisch.) in CT 26 tumor-bearing mice. BMC Complement Altern Med 2017;17(1):536.
7. Wang ZF, Liu J, Yang YA, Zhu HL. A review: the anti-inflammatory, anticancer, antibacterial properties of four kinds of licorice flavonoids isolated from licorice. Curr Med Chem 2020;27(12):1997-2011.
8. Rossi T, Benassi L, Magnoni C, Ruberto AI, Coppi A, Baggio G. Effects of glycyrrhizin on UVB-irradiated melanoma cells. In Vivo 2005;19(1):319-22.
9. Wang L, Yang R, Yuan B, Liu Y, Liu C. The antiviral and antimicrobial activities of licorice, a widely-used Chinese herb. Acta Pharmaceutica Sinica B 2015;5(4):310-5.
10. Guo A, He D, Xu HB, Geng CA, Zhao J. Promotion of regulatory T cell induction by immunomodulatory herbal medicine licorice and its two constituents. Sci Rep 2015;5:14046.
11. Gong H, Zhang BK, Yan M, et al. A protective mechanism of licorice (Glycyrrhiza uralensis): isoliquiritigenin stimulates detoxification system via Nrf2 activation. J Ethnopharmacol 2015;162:134-9.
12. Ghalayani P, Emami H, Pakravan F, Nasr Isfahani M. Comparison of triamcinolone acetonide mucoadhesive film with licorice mucoadhesive film on radiotherapy-induced oral mucositis: A randomized double-blinded clinical trial. Asia Pac J Clin Oncol 2017;13(2):e48-e56.
13. Sadra A, Kweon HS, Huh SO, Cho J. Gastroprotective and gastric motility benefits of AD-lico/Healthy Gut Glycyrrhiza inflata extract. Anim Cells Syst (Seoul) 2017;21(4):255-62.
14. Hajiaghamohammadi AA, Zargar A, Oveisi S, Samimi R, Reisian S. To evaluate of the effect of adding licorice to the standard treatment regimen of Helicobacter pylori. Braz J Infect Dis 2016;20(6):534-8.
15. Fukai T, Marumo A, Kaitou K, Kanda T, Terada S, Nomura T. Anti-Helicobacter pylori flavonoids from licorice extract. Life Sci 2002;71(12):1449-63.
16. Krausse R, Bielenberg J, Blaschek W, Ullmann U. In vitro anti-Helicobacter pylori activity of Extractum liquiritiae, glycyrrhizin and its metabolites. J Antimicrob Chemother 2004;54(1):243-6.
17. Momeni A, Rahimian G, Kiasi A, Amiri M, Kheiri S. Effect of licorice versus bismuth on eradication of Helicobacter pylori in patients with peptic ulcer disease. Pharmacognosy Res 2014;6(4):341-4.
18. Ji S, Li Z, Song W, et al. Bioactive constituents of Glycyrrhiza uralensis (licorice): discovery of the effective components of a traditional herbal medicine. J Nat Prod 2016;79(2):281-92.
19. Tanemoto R, Okuyama T, Matsuo H, Okumura T, Ikeya Y, Nishizawa M. The constituents of licorice (Glycyrrhiza uralensis) differentially suppress nitric oxide production in interleukin-1β-treated hepatocytes. Biochem Biophys Rep 2015;2:153-9.
20. Xu C, Liang C, Sun W, Chen J, Chen X. Glycyrrhizic acid ameliorates myocardial ischemic injury by the regulation of inflammation and oxidative state. Drug Des Devel Ther 2018;12:1311-9.
21. Zhang X, Zhu P, Zhang X, et al. Natural antioxidant-isoliquiritigenin ameliorates contractile dysfunction of hypoxic cardiomyocytes via AMPK signaling pathway. Mediators Inflamm 2013;2013:390890.
22. Somjen D, Knoll E, Vaya J, Stern N, Tamir S. Estrogen-like activity of licorice root constituents: glabridin and glabrene, in vascular tissues in vitro and in vivo. J Steroid Biochem Mol Biol 2004;91(3):147-55.
23. Fuhrman B, Buch S, Vaya J, et al. Licorice extract and its major polyphenol glabridin protect low-density lipoprotein against lipid peroxidation: in vitro and ex vivo studies in humans and in atherosclerotic apolipoprotein E-deficient mice. Am J Clin Nutr 1997;66(2):267-75.
24. Belinky PA, Aviram M, Fuhrman B, Rosenblat M, Vaya J. The antioxidative effects of the isoflavan glabridin on endogenous constituents of LDL during its oxidation. Atherosclerosis 1998;137(1):49-61.
25. Vaya J, Belinky PA, Aviram M. Antioxidant constituents from licorice roots: isolation, structure elucidation and antioxidative capacity toward LDL oxidation. Free Radic Biol Med 1997;23(2):302-13.
26. Rosenblat M, Belinky P, Vaya J, et al. Macrophage enrichment with the isoflavan glabridin inhibits NADPH oxidase-induced cell-mediated oxidation of low density lipoprotein a possible role for protein kinase C. J Biol Chem 1999;274(20):13790-9.
27. Yang R, Wang LQ, Yuan BC, Liu Y. The pharmacological activities of licorice. Planta Med 2015;81(18):1654-69.
28. Takeuchi T, Nishii O, Okamura T, Yaginuma T. Effect of paeoniflorin, glycyrrhizin and glycyrrhetic acid on ovarian androgen production. Am J Chin Med 1991;19(01):73-8.
29. Shi P, Mo R, Liu Q, et al. Clinical efficacy and safety of compound glycyrrhizin in the treatment of post-adolescent acne in women. Southern China Journal of Dermato-Venereology 2008;15(3):133-136.
30. Sakamoto K, Wakabayashi K. Inhibitory effect of glycyrrhetinic acid on testosterone production in rat gonads. Endocrinol Jpn 1988;35(2):333-42.
31. Kambara T, Zhou Y, Kawashima Y, et al. A new dermatological availability of the flavonoid fraction from licorice roots-effect on acne. Journal of Society of Cosmetic Chemists of Japan 2003;37(3):179-86.
32. Armanini D, Mattarello MJ, Fiore C, et al. Licorice reduces serum testosterone in healthy women. Steroids 2004;69(11-12):763-6.
33. Zamansoltani F, Nassiri-Asl M, Sarookhani M, Jahani-Hashemi H, Zangivand AA. Antiandrogenic activities of Glycyrrhiza glabra in male rats. Int J Androl 2009;32(4):417-22.
34. Armanini D, Bonanni G, Palermo M. Reduction of serum testosterone in men by licorice. N Engl J Med 1999;341(15):1158.
35. Zhou T, Deng X, Qiu J. Antimicrobial activity of licochalcone E against Staphylococcus aureus and its impact on the production of staphylococcal alpha-toxin. J Microbiol Biotechnol 2012;22(6):800-5.
36. Rohinishree YS, Negi PS. Effect of licorice extract on cell viability, biofilm formation and exotoxin production by Staphylococcus aureus. J Food Sci Technol 2016;53(2):1092-100.
37. Wijesundara NM, Rupasinghe HPV. Bactericidal and anti-biofilm activity of ethanol extracts derived from selected medicinal plants against Streptococcus pyogenes. Molecules 24;24(6):1165.
38. Siriwattanasatorn M, Panthong S, Itharat A. Antimicrobial activities of medicinal plants mostly used for acute pharyngitis treatment. J Med Assoc Thai 2016;99 Suppl 4:S144-52.
39. Irani M, Sarmadi M, Bernard F, Ebrahimi Pour GH, Shaker Bazarnov H. Leaves antimicrobial activity of Glycyrrhiza glabra L. Iran J Pharm Res 2010;9(4):425-8.
40. Astafeva OV, Sukhenko LT. Comparative analysis of antibacterial properties and chemical composition of Glycyrrhiza glabra L. from Astrakhan region (Russia) and Calabria region (Italy). Bull Exp Biol Med 2014;156(6):829-32.
41. Nam C, Kim S, Sim Y, Chang I. Anti-acne effects of Oriental herb extracts: a novel screening method to select anti-acne agents. Skin Pharmacol Appl Skin Physiol 2003;16(2):84-90.
42. Nand P, Drabu S, Gupta R. Phytochemical and antimicrobial screening of medicinal plants for the treatment of acne. Indian J Nat Prod Resour 2012;3(1):28-32.
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| Files | ||
| Issue | Vol 8, No 4 (Autumn 2020) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/jpc.v8i4.5242 | |
| Keywords | ||
| Acne Vulgaris; Complementary Therapies; Glycyrrhiza; Hyperpigmentation; Fabaceae | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Raoufinejad K, Rajabi M, Sarafian G. Licorice in the Treatment of Acne Vulgaris and Postinflammatory Hyperpigmentation: A Review. J Pharm Care. 2020;8(4):186-195.
