Mary Ruth Buchness, MD
Arch Dermatol. 2011;147(11):1282. doi:10.1001/archdermatol.2011.322

Bedi MK, Shenefelt PD. Herbal therapy in dermatology. Arch Dermatol. 2002;138(2):232-242.

In this article, Bedi and Shenefelt present a comprehensive review of evidence-based uses of herbs in dermatology. Consumers are increasingly interested in treatment with “natural” remedies either because of the failure of conventional therapy or because of the belief that natural treatments lead to fewer adverse effects. By disease, the authors list the herbal treatments that have been studied in humans and animals, effective doses, hypothesized mechanism of action, and potential adverse effects. In a second section, they review cutaneous and systemic adverse effects, including fatalities, that can occur with the use of herbal treatments for dermatologic diseases as well as drug-herb interactions.

Unfortunately, Bedi and Shenefelt’s excellent review article cannot serve as an herbal treatment formulary because herbal treatments are considered to be dietary supplements, not drugs, by the Food and Drug Administration and therefore are not regulated or standardized. This lack of regulation puts the practitioner in the difficult position of knowing what may be effective without knowing where to send the patient to get it. In the analysis of various herbal products, not only has the active ingredient been found to be absent in some brands, but, in some cases, the product itself has been found to be adulterated with prescription medications or heavy metals. In the end, the article serves as a caveat against choosing natural over pharmaceutical treatment.