Letter to the Editor

Skin Pharmacol Physiol 2012;25:162163

DOI: 10.1159/000337936

Received: December 30, 2011

Accepted after revision: March 8, 2012
Published online: April 3, 2012

Tea Tree Oil as a Novel Antipsoriasis

Weapon
Nader Pazyar Reza Yaghoobi

Key Words
Tea tree oil Melaleuca alternifolia Psoriasis

Abstract
Psoriasis is a clinical skin disease that is characterized by erythematous scaling plaques and involves the extensor site of
the extremities, the scalp and other surfaces of the skin. Tea
tree oil (TTO) is considered an essential oil, obtained by
steam distillation of the leaves and terminal branchlets of
Melaleuca alternifolia. Notably, terpinen-4-ol, the major TTO
constituent, has been found to have potent anti-inflammatory properties. It is suggested that terpinen-4-ol may be a
novel potential agent against psoriasis. This article draws attention to the antipsoriatic effect of TTO and provides a theoretical molecular approach.
Copyright 2012 S. Karger AG, Basel

Psoriasis is a devastating clinical disorder that affects

approximately 24% of the worlds population [1]. It usually presents with scaling plaques ranging widely in size
on the scalp, elbows, knees and other surfaces of the skin
[2]. Histologically, psoriasis is characterized by epidermal hyperproliferation, anomalous keratinocyte differentiation, angiogenesis, and inflammatory cell infiltration [3].
2012 S. Karger AG, Basel
16605527/12/02530162$38.00/0
Fax +41 61 306 12 34
E-Mail karger@karger.ch
www.karger.com

Accessible online at:

www.karger.com/spp

Tumor necrosis factor (TNF)- is a proinflammatory

cytokine that can induce antiapoptotic proteins and endothelial cell activation factors in psoriasis [1]. Importantly, TNF- is unanimously believed to be the most
essential cytokine involved in the immunopathogenesis
of psoriasis [4]. It has been recognized that interleukin
(IL)-1 production and the physical contact between keratinocytes and activated, infiltrating T cells may be important for the development of chronic inflammatory
skin conditions such as psoriasis [5]. Notably, IL-8 has
been suggested to take part in the pathophysiology of
psoriasis mainly through the neutrophil attraction. Keratinocytes have traditionally been considered to be the
main source of IL-8 in psoriasis. Studies have confirmed
the IL-8 production by T lymphocytes in inflammatory
skin psoriasis [6]. Michel et al. [7] investigated the biosynthesis of prostaglandin E2 (PGE2) from exogenous arachidonic acid in psoriatic epidermis. They found that PGE2
production was high in psoriatic epidermis and its metabolism might play an important role in the pathogenesis of the disease. Morphometric analysis has demonstrated the dermal vasodilatation within psoriatic lesions.
Furthermore, several studies have shown that the expansion of the dermal capillary occurs early in the progression of a lesion before epidermal hyperplasia [8].
Tea tree oil (TTO) is an essential oil, obtained by steam
distillation of the leaves and terminal branchlets of MeNader Pazyar, MD
Department of Dermatology, Imam Hospital
Azadegan Street
Ahvaz 61335-4156 (Iran)
Tel. +98 918 861 7133, E-Mail dr.pazyar@gmail.com

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Department of Dermatology, Jundishapur University of Medical Sciences, Ahvaz, Iran

laleuca alternifolia in the states of New South Wales and

Queensland in Australia [9]. Terpinen-4-ol is the major
TTO component which exhibits potent anti-inflammatory properties [10]. Importantly, it has been illustrated that
terpinen-4-ol is able to decrease TNF-, IL-1, IL-8, and
PGE2 production. Additionally, terpinen-4-ol can modulate the vasodilatation and plasma extravasation [11].
TTO preparations are extensively used as topical agents
for acne treatment [12]. Enshaieh et al. [13] evaluated the
efficacy of 5% TTO gel in the treatment of mild to moderate acne vulgaris. They demonstrated that 5% TTO had
a significant effect with minimal side effects in ameliorating the acne lesions by decreasing inflammation. It is
noteworthy that ascaridole (CAS 512-85-6) is a monoterpene that is originated from oxidized -terpene and regarded a proposed sensitizer for allergic contact dermatitis to TTO [14]. Importantly, as yet, contact allergy to terpinen-4-ol has not been reported in medical literature
following the use of TTO.
In summary, given the inhibitory role of TTO on
TNF-, IL-1, IL-8, PGE2 and vasodilatation, it could be

suggested that TTO (terpinen-4-ol) might be a potential

addition to the antipsoriasis arsenal. Moreover, it could
be employed topically even in high concentrations without producing the unwelcome systemic effects. An in vivo
study conducted by Khokhra and Diwan [15] revealed
that a microemulsion system of 5% TTO could be a promising vehicle for the transdermal drug delivery in the
treatment of psoriasis disease. Combining TTO with topical corticosteroids could potentiate the therapeutic response of the latter while treating a psoriatic patient suffering from this condition. Our commentary justifies and
encourages the conduction of clinical trials on the subject.

Disclosure Statement
The authors have no conflicts of interest to reveal.

References

Tea Tree Oil: Antipsoriasis Weapon

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