Review of the Efficacy and Safety of Topical Mahonia aquifolium for the Treatment of Psoriasis and Atopic Dermatitis.

Background: Due to the emerging trend of alternative medicine, patients inquire about natural remedies to alleviate their symptoms. Dermatologists should be aware of the efficacy and safety of topical botanical treatments available on the market. Mahonia aquifolium, native to the United States, has been recently shown to have anti-inflammatory properties useful in cutaneous disorders. Objective: Our aim was to review clinical trials that assess the efficacy and safety of Mahonia aquifolium in cutaneous disorders. Design: We searched PubMed, MEDLINE, and the Web of Science databases and performed a manual search of clinical trials in the references. We excluded in vivo and in vitro animal trials. Risk of bias was assessed using the Cochrane Risk of Bias Tool. Results: Of the 502 articles identified, eight met the inclusion criteria. Specifically, seven trials studied the effects of Mahonia aquifolium in psoriasis and one studied that in atopic dermatitis. Clinical trials have not been identified in any other cutaneous disorder using this plant extract. Risk of bias of included trials were either unclear or low risk. Five of seven studies showed a statistically significant improvement with Mahonia aquifolium in psoriasis, while one study showed efficacy in the treatment of atopic dermatitis. Conclusion: Several studies have shown that Mahonia aquifolium leads to a statistically significant improvement of symptoms in psoriasis and atopic dermatitis with minimal side effects.