Mahonia Extract
Also known as: Oregon grape, Mahonia, Mahonia aquifolium
Overview
Mahonia aquifolium extract, derived from the Oregon grape plant, is a botanical supplement primarily used topically for various skin conditions, most notably psoriasis and atopic dermatitis. Its therapeutic effects are attributed to active alkaloids like berberine, which possess anti-inflammatory and antimicrobial properties. Research on Mahonia extract is moderately developed, with several randomized controlled trials (RCTs) and systematic reviews supporting its topical application for mild to moderate psoriasis. While some studies are well-designed, overall sample sizes tend to be modest, and there's variability in the quality of evidence. It is generally well-tolerated with a low incidence of side effects, making it a promising alternative or adjunctive therapy for specific dermatological conditions.
Benefits
Topical Mahonia aquifolium extract demonstrates statistically significant improvements in mild to moderate psoriasis. Clinical trials have shown reductions in Psoriasis Area and Severity Index (PASI) scores and enhancements in Quality of Life Index (QLI). For instance, one RCT involving 200 patients reported a PASI reduction from 6.93 to 3.35 (p=0.0095) and QLI improvement (p=0.0186) after 12 weeks of topical application. Secondary benefits include improvements in scaling, plaque thickness, and erythema, often observed within one week of treatment. The effect size is moderate, with a relative risk of clinical efficacy versus placebo at 3.37 (95% CI 1.36–8.33) in meta-analyses. These benefits are most pronounced in individuals with mild to moderate psoriasis, with limited data available for severe cases or other populations. Improvements typically manifest within 1-4 weeks and continue over a 12-week period.
How it works
The therapeutic action of Mahonia aquifolium extract is primarily mediated by its active alkaloids, particularly berberine. These compounds exert potent anti-inflammatory effects by inhibiting pro-inflammatory cytokines, which are key mediators in the pathogenesis of psoriasis. Additionally, berberine helps to reduce the excessive proliferation of keratinocytes, a hallmark of psoriatic skin. The extract's antimicrobial properties may also contribute by reducing secondary infections that can occur in skin lesions. When applied topically, the active compounds are absorbed locally, allowing for targeted action. Liposomal formulations are being explored to enhance the bioavailability and efficacy of the extract within the skin.
Side effects
Mahonia aquifolium extract, when used topically, is generally well-tolerated with a low incidence of adverse effects. The most commonly reported side effects are mild and include a transient burning sensation or a localized rash, occurring in less than 1% of users. No serious adverse events have been documented in randomized controlled trials or meta-analyses. Due to its topical application, systemic exposure is minimal, and consequently, no significant drug interactions have been reported. Contraindications are not well-established, but given the limited systemic absorption, major concerns are not anticipated for topical use. Data on special populations, such as pregnant or breastfeeding individuals, are limited, and caution is advised. Overall, its safety profile is considered favorable for mild to moderate psoriasis patients.
Dosage
For optimal efficacy in mild to moderate psoriasis, clinical trials have established a recommended dosage of a 10% proprietary Mahonia aquifolium extract cream, applied twice daily. This regimen should be maintained consistently for a duration of 12 weeks to achieve sustained therapeutic benefits. There is no established maximum safe dose for topical Mahonia extract, as systemic absorption is limited, minimizing concerns about toxicity. Consistent twice-daily application is crucial for maintaining therapeutic levels in the skin. The formulation of the extract can influence its effectiveness; liposome-based emulsions are noted to potentially improve the delivery and overall efficacy of the active compounds within the skin.
FAQs
Is Mahonia extract safe for long-term use?
Current research supports the safety of Mahonia extract for at least 12 weeks of continuous use. Longer-term studies are currently lacking, so prolonged use beyond this period should be discussed with a healthcare professional.
How quickly does it work?
Some patients may observe initial symptom improvement within 1 week of topical application. More significant and noticeable effects typically become apparent after 4 weeks of consistent use.
Can it replace conventional psoriasis treatments?
Mahonia extract may offer comparable efficacy to some conventional topical agents for mild to moderate psoriasis. However, it should be used under medical supervision and may not be suitable as a sole treatment for all cases.
Is it effective for severe psoriasis?
The current evidence for Mahonia extract's efficacy is limited to mild to moderate psoriasis cases. It is not recommended as a monotherapy for severe forms of the disease.
Research Sources
- https://www.semanticscholar.org/paper/Treatment-of-Mild-to-Moderate-Psoriasis-with-a-Bernstein-Donsky/acb87da4d2f72925e3cc25cd0b9821dbaf40f1f6 – This double-blind, placebo-controlled RCT involving 200 patients with mild to moderate psoriasis found significant improvements in PASI and QLI scores with Mahonia cream compared to placebo. The study supports the efficacy of topical Mahonia extract, although it used a proprietary formulation.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6334833/ – This review of RCTs and observational studies, including those with 33-200 patients, suggests that Mahonia cream is comparable or superior to standard topical treatments for psoriasis. It highlights the minimal side effects, supporting the safety and efficacy of the extract.
- https://pubmed.ncbi.nlm.nih.gov/23909714/ – This systematic review and meta-analysis, which included 5 RCTs on Mahonia, concluded that the extract has moderate efficacy in topical psoriasis management. It reported a relative risk of 3.37 (95% CI 1.36-8.33) versus placebo and noted no serious adverse events, while also calling for larger trials.
- https://onlinelibrary.wiley.com/doi/abs/10.1111/bjd.12557 – This source, likely related to the Deng et al. meta-analysis, further supports the moderate efficacy of Mahonia extract in topical psoriasis management. It reinforces the findings of a favorable safety profile and the need for more extensive research to confirm effect sizes.
