Phytotherapeutics

By definition (according to ESCOP = European Scientific Cooperative on Phytotherapy, see below Phytotherapy), phytotherapeutic medicinal products are those that contain exclusively "plants, parts of plants or plant constituents or combinations thereof, in processed or unprocessed form, as active ingredients. Phytotherapeutics are therefore mixtures of substances and not individual substances. Their effect results from the sum of their ingredients. There is no chemical isolation of a single medicinal substance.

Classical dermatological phytotherapeutics are or were e.g. the various tars (wood tars: Pix betulina, Pix fagi, Pix juniperi, Pix pinaceae or coal tar: Pix lithanthracis or their extracts - Liquor carbonis detergens), ichthyol, podophyllin or the antipsoriatic agent chrysarobin which is no longer used today.

Although a number of current drugs are of plant origin, e.g. the cytostatic drugs vincristine, vinblastine, taxol, digitoxin and atropine, they are not phytotherapeutics in the narrower sense, as only the isolate or its chemical modifications are used medicinally.

In their work "Botanical Dermatology", Mitchell and Rook list > 10,000 species of medicinal plants that have been described as the cause of irritant or allergic contact dermatitis (eczema). In Europe, > 250 contact sensitizing plant ceramics are known, of which > 200 come from the composite family. Their content of sesquiterpenlactones plays a decisive role. Allergologically they are also relevant:

• Primrose plants
• Bulbous plants
• Lily plants (see e.g. garden tulip below)
• umbelliferous plants (see e.g. caraway seeds below)
• Orchids
• Gesneria plants.

• Some herbal medicines are listed in the guidelines , particularly for gastrointestinal disorders such as chronic constipation, ulcerative colitis, andirritable bowel syndrome, as well as for the treatment of cystitis. 
• Monographs are developed, for example, by the Committee forHerbal Medicinal Products ( HMPC), the European Medicines Agency (EMA), and the WHO. In addition, collections of materials from various associations (e.g., at the European level, the Euro-monographs of the “European Scientific Cooperative on Phytotherapy— ESCOP”) are taken into account. In EU member states, herbal finished medicinal products must, in principle—just like other finished medicinal products—be approved by the regulatory authorities prior to marketing in accordance with the provisions of pharmaceutical law. To this end, their quality, efficacy, and safety must be demonstrated.
• The quality of clinical studies is usually classified according to a “level of evidence (LOE)” ranging from A to D.
  • A = highest level, involving randomized, clinically controlled trials and cohort studies
  • B = conclusive, retrospective, or exploratory cohort studies, case-control studies, and follow-up studies from category A
  • C = case reports or follow-up studies from category B
  • D = expert opinion without a scientific basis, purely laboratory research.
• The decision regarding which preparation to prescribe depends on the practitioner’s personal perspective on disease, disease mechanisms, and medicinal plants or their active ingredients.
• Selected phytotherapeutic agents relevant to dermatology:
  • Araroba tree (Goa powder—chrysarobin)
  • Avocado
  • Aloe vera
  • Balloon vine (Cardiospermum)
  • Birch
  • Bittersweet (Dulcamara)
  • Borage (borage seed oil)
  • Beech
  • Calendula ( marigold)
  • Cayenne pepper
  • Ivy
  • Eucalyptus ( eucalyptus oil)
  • Fennel
  • Tannins
  • Ginkgo biloba
  • Ginkgo biloba
  • Witchhazel
  • Hesperidin
  • Wood tars (birch wood tar, beech wood tar) / coal tar (see “Tar” below)
  • ^Ichthyol®
  • St. John's wort
  • Chamomile
  • Chestnut (horse chestnut)
  • Coriander
  • Onion
  • Cumin (black cumin—eczema, atopic)
  • Larch turpentine (boils, carbuncles)
  • Lavender (lavender oil)
  • Arborvitae (Thuja)
  • Mahonia
  • Lemon balm(Melissa)
  • Myrrh (oral canker sores, gingivitis)
  • Evening primrose (evening primrose oil)
  • Peruvian balsam
  • Podophyllin
  • Polypodium leucotomos (Heliocare)
  • Rosemary (Itchy Scalp, Dandruff)
  • Sage
  • Horsetail
  • White willow (Salix alba)
  • Sunflower
  • Licorice root (Glycyrrhiza glabra, licorice)
  • Green tea
  • Black tea
  • Tea tree (tea tree oil)
  • Frankincense
  • Red vine leaves
  • Wheat (wheat bran).

1. Arberer, W. (2008) Contact Allergy and Medicinal Plants. JDDG 6: 15–24
2. Mitchell, JC, et al. (1979) Botanical Dermatology. Vancouver, Greengrass
3. https://arzneipflanzenlexikon.info/
4. Utz S et al. (2024) Which phytotherapeutics are considered in German medical guidelines for the treatment of gastroenterological diseases? Z Phytother; 45(06): 248–256. DOI: 10.1055/a-2442-2204
5. German Society of Urology, AWMF. S2K Guideline on the Diagnosis and Treatment of Interstitial Cystitis (IC/IBS) – Version: 1.0. AWMF Register No.: 043-050, as of: September 15, 2018. https://register.awmf.org/de/leitlinien/detail/043-050
6. German Society of Urology, AWMF. S3 Guideline on the Epidemiology, Diagnosis, Treatment, Prevention, and Management of Uncomplicated, Bacterial, Community-Acquired Urinary Tract Infections in Adult Patients – Version: 2.0. AWMF Register No.: 043-044, as of April 30, 2017. https://register.awmf.org/de/guidelines/detail/043-044