A review on efficacy and tolerability of tea tree oil for acne
Abstract
Acne is common problem acquired generally after puberty. It ranges from mild to moderate: papules, pustules, nodules to severe cyst. Various natural therapy can be employed for treatment of acne including Tea tree oil (TTO). Tea tree oil has wide spectrum anti-microbial agent showing in treatment of acne. Usually it is utilized in various topical preparations. It contains more than 80-90% monoterpenes namely terpinen-4-ol, -cymene, α-terpinene, limonene 1,8-cineol, α-terpineol, terpinolene, 1,8-cineol, sabinene and α-pinene, The European cosmetic Association recommended not more than 1% use of tea tree oil in cosmetic preparations. In this review, we listed various efficacy and tolerability studies along with challenges in application of tea tree oil in cosmetics and dermatological preparations. TTO is a moderate sensitizer and upon oxidation it increases in its allergenic potency. This is a comprehensive review of using Tea tree oil against various microbial species. Various studies revealed the use of TTO as anti-bacterial, anti-fungal, anti- oxidant agent. TTO is effective treatment option that can further be utilized in preparation of novel formulations like liposomes, ethosomes along with combination with other anti-microbial and anti-oxidant agents.
Keywords: Acne, Tea-tree oil, Application, Antioxidant, Nano particles.
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References
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[2] Williams H, Dellavalle R, Garner S. Acne vulgaris. Lancet 2012; 379:361–72.
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[4] Jacob CI, Dover JS, Kaminer MS. Acne scarring: a classification system and review of treatment options. J Am Acad Dermatol. 2001; 45(1):109-17.
[5] Taher RN and Amani A. Nanoemulsions: colloidal topical delivery systems for antiacne agents- A Mini-Review. Nanomed Res J 2017; 2(1):49-56.
[6] Ross JI, Snelling AM, Carnegie E, Coates P, Cunliffe WJ, Bettoli V, Tosti G, Katsambas A, Galvan Perez Del Pulgar JI, Rollman O, Torok L, Eady EA, Cove JH. Antibiotics- Resistance acne: lesson from Europe. Br J Dermatol. 2003; 148(3):467-478.
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[8] Layton AM. Acne vulgaris and similar eruptions. Medicine. 2005; 33(1):44–48.
[9] Truter I. Acne vulgaris. SA Pharmaceutical Journal. 2009; 76(3):12–19.
[10] Southwell, I.A.; Hayes, A.J.; Markham, J.L.; Leach, D.N. The search for optimally bioactive Australian tea tree oil. Acta Hort. 1993; 334:265-275.
[11] Bakkali F, Averbeck S, Averbeck D, Idaomar M. Biological effect of essential oil-a review. Food chem. Toxicol. 2008; 46(2):446-75.
[12] Low WL, Martin C, Hill DJ, Kenward MA. Antimicrobial efficacy of liposome‐encapsulated silver ions and tea tree oil against Pseudomonas aeruginosa,Staphylococcus aureus and Candida albicans. Letter in Appl Micro 2013; 57(1):33-39.
[13] Hart PH, Brand C, Carson CF, Riley TV, Prager RH, Finlay JJJ. Terpinen-4-ol, the main component of the essential oil of Melaleuca alternifolia (tea tree oil), suppresses inflammatory mediator production by activated human monocytes. Inflamm Res 2000; 49(11):619-26.
[14] Ramage G, Milligan S, Lappin DF, Sheery L, Sweeny P, William C, Bagg J, Culshaw S. Antifungal, cytotoxic, and immunomodulatory properties of tea tree oil and its derivative components: potential role in management of oral candidosis in cancer patients. Front Microbiol 2012; 3(1).
[15] Carson CF, Hammer KA, Riley TV. Melaleuca alternifolia (tea tree) oil: a review of antimicrobial and other medicinal properties. Clin Microbiol Rev 2006; 19:50–62.
[16] Markum E, Baillie J. Combination of essential oil of Melaleuca alternifolia and iodine in the treatment of molluscum contagiosum in children. J Drugs Derma- tol 2013; 11:349–54.
[17] Yadav N, Singh A, Chatterjee A, Belemkar S. Evaluation of efficacy and safety of Perfact face gel and Perfact face tablets in management of acne. Clin Exp Dematol Res 2011; 2:118.
[18] Julie ML. 2006. Biological Activity of Tea Tree Oil In: Tea Tree the Genus Melaleuca (Medicinal and Aromatic Plant: Industerial Profiles). Harwood Academic Publisher: Abingdon, United Kingdom
[19] Cox S, Mann C, Markham J, et al. 2000. The mode of antimicrobial action of the essential oil of Melaleuca alternifolia (tea tree oil). J Appl Microbiol 88(1):170–175.
[20] Feinblatt HM. 1960. Cajeput-type oil for the treatment of furunculosis. J Natl Med Assoc 52(1):32–3.
[21] Enshaieh S, Jooya A, Siadat AH, Iraji F. 2007. The efficacy of 5% topical tea tree oil gel in mild to moderate acne vulgaris: a randomized, double-blind placebo-controlled study. Indian J Dermatol Venereol Leprol 73(1): 22–25.
[22] Sharique KE, Noaimi AA, Al-Salih MM. Topical therapy of acne vulgaris using 2% tea lotion in comparison with 5% zinc sulphate solution. Saudi Med J. 2008; 29(12):1757-61
[23] Mazzarello V, Donadu MD, FerrariM, Piga G, Usai D, Zanetti S, and Sotgiu MA. Treatment of acne with a combination of propolis, tea tree oil, and Aloe vera compared to erythromycin cream: two double-blind investigations. Clin Pharmacol. 2018; 10:175–181.
[24] Kwon HH, Yoon JY, Park SY, Min S, Suh DH Comparison of clinical and histological effects between lactobacillus-fermented Chamaecyparis obtusa and tea tree oil for the treatment of acne: an eight-week double-blind randomized controlled split-face study. Dermatology. 2014; 229(2):102-9.
[25] Malhi, H. K., Tu, J., Riley, T. V., Kumarasinghe, S. P., & Hammer, K. A. Tea tree oil gel for mild to moderate acne; a 12 week uncontrolled, open-label phase II pilot study. Australasian Journal of Dermatology, 2016; 58(3):205–21
[26] Bassett IB, Pannowitz DL, Barnetson R: A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. Med J Aust 1990; 153:455±458
[27] Ernst, E., & Huntley, A. Tea Tree Oil: A Systematic Review of Randomized Clinical Trials. Complementary Medicine Research, 2000; 7(1):17–20
[28] Pearce, A. L., Finlay-Jones, J. J., & Hart, P. H. Reduction of nickel-induced contact hypersensitivity reactions by topical tea tree oil in humans. Inflammation Research, 2005; 54(1):22–30.
[29] Joksimovic, N., Spasovski, G., Joksimovic, V., Andreevski, V., Zuccari, C., & Omini, C. F. Efficacy and tolerability of hyaluronic acid, tea tree oil and methyl-sulfonyl-methane in a new gel medical device for treatment of haemorrhoids in a double-blind, placebo-controlled clinical trial. Updates in Surgery, 2012; 64(3):195–201
[30] Asper N, Freeman S. Predictive testing for irritancyand allergenicity of tea tree oil in normal human subjects. Exog dermatol 2003; 2:258-61.
[31] Toholka R, Wang YS, Tate B, Tam M, Cahil J, Palmer A et al. The first Australian baseline series: recommendations for patch testing in suspected contact dermatitis. Australas J dermatol 2014
[32] Hammer KA. Treatment of acne with tea tree oil (melaleuca) products: A review of efficacy, tolerability and potential modes of action. I jour Antimicrobial agent 2015; 45:106-110.
[33] Southwell A and Lowe R. Tea Tree the genus melaleuca. Harwood academic publisher 2005; 206.
[34] Rapp SR, Feldman SR, Graham G, Fleischer AB, Brenes G, Dailey M. The Acne Quality of Life Index (Acne-QOLI): Development and validation of a brief instrument. Am J Clin Dermatol. 2006; 7:185–924
[35] Layton AM. Disorders of sebaceous glands. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook's Textbook of Dermatology. 8th ed. Vol. 42. Oxford: Wiley-Blackwell publication; 2010. pp. 1–89.
[36] Carson CF, Hammer KA, Riley TV. Melaleuca alternifolia (tea tree) oil: a review of antimicrobial and other medicinal properties. Clin Microbiol Rev 2006; 19: 50–62
[37] Kim HJ, Chen F, Wu C, et al. Evaluation of antioxidant activity of Australian tea tree (Melaleuca alternifolia) oil and its components. J Agric Food Chem 2004; 52:2849– 2854
[38] Thompson G, Blackwood B, McMullan R, et al. Arandomized controlled trial of tea tree oil (5%) body wash versus standard body wash to prevent colonization with methicillin-resistant Staphylococcus aureus (MRSA) in critically ill adults: research protocol. BMC Infect Dis 2008; 8:161
[39] Soukoulis S, Hirsch R. The effects of a tea tree oil- containing gel on plaque and chronic gingivitis. Aust Dent J 2004; 49:78–83
[40] Daud FS, Pande G, Joshi M, Pathak R, Wankhede S, A study of Antimicrobial effect of some selected essential oil and Medicinal herbs against acne causing bacteria. International journal of pharmaceutical science Invention 2013; 2(1):27-34.
[41] Hammer K, Carson C, Riley T. In vitro activity of essential oils, in particular Melaleuca alternifolia (tea tree) oil and tea tree oil products, against Candida spp. J Antimicrob Chemother 1998; 42:591–595.
[42] Satchell AC, Saurajen A, Bell C, Barnetson RS. Treatment of interdigital tinea pedis with 25% and 50% tea tree oil solution: a randomized, placebo-controlled, blinded study. Australas J Dermatol 2002; 43:175–178.
[43] Syed TA, Qureshi ZA, Ali SM, et al. Treatment of toenail with 2% butenafine and 5% Melaleuca alternifolia (tea tree) oil in cream. Trop Med Int Health 1999; 4: 284–287.
[44] Van de Sande WW, Fahal AH, et al. In vitro susceptibility of Madurella mycetomatis, prime agent of Madura foot, to tea tree oil and artemisinin.J Antimicrob Chemother 2007; 59:553–555.
[45] Sarkic A and Stappen I. Essential Oils and Their Single Compounds in Cosmetics—A Critical Review. Cosmetics 2018.
[2] Williams H, Dellavalle R, Garner S. Acne vulgaris. Lancet 2012; 379:361–72.
[3] V. Ho, D. Schacter, and R. Miller, “Acne management for the 90s: current treatment guidelines,” The Canadian Journal of Diagnosis, 1995; 12:1–25.
[4] Jacob CI, Dover JS, Kaminer MS. Acne scarring: a classification system and review of treatment options. J Am Acad Dermatol. 2001; 45(1):109-17.
[5] Taher RN and Amani A. Nanoemulsions: colloidal topical delivery systems for antiacne agents- A Mini-Review. Nanomed Res J 2017; 2(1):49-56.
[6] Ross JI, Snelling AM, Carnegie E, Coates P, Cunliffe WJ, Bettoli V, Tosti G, Katsambas A, Galvan Perez Del Pulgar JI, Rollman O, Torok L, Eady EA, Cove JH. Antibiotics- Resistance acne: lesson from Europe. Br J Dermatol. 2003; 148(3):467-478.
[7] Humphrey S. Antibiotics resistance in acne treatment. Skin Therapy Lett. 2012; 17(9):1-3.
[8] Layton AM. Acne vulgaris and similar eruptions. Medicine. 2005; 33(1):44–48.
[9] Truter I. Acne vulgaris. SA Pharmaceutical Journal. 2009; 76(3):12–19.
[10] Southwell, I.A.; Hayes, A.J.; Markham, J.L.; Leach, D.N. The search for optimally bioactive Australian tea tree oil. Acta Hort. 1993; 334:265-275.
[11] Bakkali F, Averbeck S, Averbeck D, Idaomar M. Biological effect of essential oil-a review. Food chem. Toxicol. 2008; 46(2):446-75.
[12] Low WL, Martin C, Hill DJ, Kenward MA. Antimicrobial efficacy of liposome‐encapsulated silver ions and tea tree oil against Pseudomonas aeruginosa,Staphylococcus aureus and Candida albicans. Letter in Appl Micro 2013; 57(1):33-39.
[13] Hart PH, Brand C, Carson CF, Riley TV, Prager RH, Finlay JJJ. Terpinen-4-ol, the main component of the essential oil of Melaleuca alternifolia (tea tree oil), suppresses inflammatory mediator production by activated human monocytes. Inflamm Res 2000; 49(11):619-26.
[14] Ramage G, Milligan S, Lappin DF, Sheery L, Sweeny P, William C, Bagg J, Culshaw S. Antifungal, cytotoxic, and immunomodulatory properties of tea tree oil and its derivative components: potential role in management of oral candidosis in cancer patients. Front Microbiol 2012; 3(1).
[15] Carson CF, Hammer KA, Riley TV. Melaleuca alternifolia (tea tree) oil: a review of antimicrobial and other medicinal properties. Clin Microbiol Rev 2006; 19:50–62.
[16] Markum E, Baillie J. Combination of essential oil of Melaleuca alternifolia and iodine in the treatment of molluscum contagiosum in children. J Drugs Derma- tol 2013; 11:349–54.
[17] Yadav N, Singh A, Chatterjee A, Belemkar S. Evaluation of efficacy and safety of Perfact face gel and Perfact face tablets in management of acne. Clin Exp Dematol Res 2011; 2:118.
[18] Julie ML. 2006. Biological Activity of Tea Tree Oil In: Tea Tree the Genus Melaleuca (Medicinal and Aromatic Plant: Industerial Profiles). Harwood Academic Publisher: Abingdon, United Kingdom
[19] Cox S, Mann C, Markham J, et al. 2000. The mode of antimicrobial action of the essential oil of Melaleuca alternifolia (tea tree oil). J Appl Microbiol 88(1):170–175.
[20] Feinblatt HM. 1960. Cajeput-type oil for the treatment of furunculosis. J Natl Med Assoc 52(1):32–3.
[21] Enshaieh S, Jooya A, Siadat AH, Iraji F. 2007. The efficacy of 5% topical tea tree oil gel in mild to moderate acne vulgaris: a randomized, double-blind placebo-controlled study. Indian J Dermatol Venereol Leprol 73(1): 22–25.
[22] Sharique KE, Noaimi AA, Al-Salih MM. Topical therapy of acne vulgaris using 2% tea lotion in comparison with 5% zinc sulphate solution. Saudi Med J. 2008; 29(12):1757-61
[23] Mazzarello V, Donadu MD, FerrariM, Piga G, Usai D, Zanetti S, and Sotgiu MA. Treatment of acne with a combination of propolis, tea tree oil, and Aloe vera compared to erythromycin cream: two double-blind investigations. Clin Pharmacol. 2018; 10:175–181.
[24] Kwon HH, Yoon JY, Park SY, Min S, Suh DH Comparison of clinical and histological effects between lactobacillus-fermented Chamaecyparis obtusa and tea tree oil for the treatment of acne: an eight-week double-blind randomized controlled split-face study. Dermatology. 2014; 229(2):102-9.
[25] Malhi, H. K., Tu, J., Riley, T. V., Kumarasinghe, S. P., & Hammer, K. A. Tea tree oil gel for mild to moderate acne; a 12 week uncontrolled, open-label phase II pilot study. Australasian Journal of Dermatology, 2016; 58(3):205–21
[26] Bassett IB, Pannowitz DL, Barnetson R: A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. Med J Aust 1990; 153:455±458
[27] Ernst, E., & Huntley, A. Tea Tree Oil: A Systematic Review of Randomized Clinical Trials. Complementary Medicine Research, 2000; 7(1):17–20
[28] Pearce, A. L., Finlay-Jones, J. J., & Hart, P. H. Reduction of nickel-induced contact hypersensitivity reactions by topical tea tree oil in humans. Inflammation Research, 2005; 54(1):22–30.
[29] Joksimovic, N., Spasovski, G., Joksimovic, V., Andreevski, V., Zuccari, C., & Omini, C. F. Efficacy and tolerability of hyaluronic acid, tea tree oil and methyl-sulfonyl-methane in a new gel medical device for treatment of haemorrhoids in a double-blind, placebo-controlled clinical trial. Updates in Surgery, 2012; 64(3):195–201
[30] Asper N, Freeman S. Predictive testing for irritancyand allergenicity of tea tree oil in normal human subjects. Exog dermatol 2003; 2:258-61.
[31] Toholka R, Wang YS, Tate B, Tam M, Cahil J, Palmer A et al. The first Australian baseline series: recommendations for patch testing in suspected contact dermatitis. Australas J dermatol 2014
[32] Hammer KA. Treatment of acne with tea tree oil (melaleuca) products: A review of efficacy, tolerability and potential modes of action. I jour Antimicrobial agent 2015; 45:106-110.
[33] Southwell A and Lowe R. Tea Tree the genus melaleuca. Harwood academic publisher 2005; 206.
[34] Rapp SR, Feldman SR, Graham G, Fleischer AB, Brenes G, Dailey M. The Acne Quality of Life Index (Acne-QOLI): Development and validation of a brief instrument. Am J Clin Dermatol. 2006; 7:185–924
[35] Layton AM. Disorders of sebaceous glands. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook's Textbook of Dermatology. 8th ed. Vol. 42. Oxford: Wiley-Blackwell publication; 2010. pp. 1–89.
[36] Carson CF, Hammer KA, Riley TV. Melaleuca alternifolia (tea tree) oil: a review of antimicrobial and other medicinal properties. Clin Microbiol Rev 2006; 19: 50–62
[37] Kim HJ, Chen F, Wu C, et al. Evaluation of antioxidant activity of Australian tea tree (Melaleuca alternifolia) oil and its components. J Agric Food Chem 2004; 52:2849– 2854
[38] Thompson G, Blackwood B, McMullan R, et al. Arandomized controlled trial of tea tree oil (5%) body wash versus standard body wash to prevent colonization with methicillin-resistant Staphylococcus aureus (MRSA) in critically ill adults: research protocol. BMC Infect Dis 2008; 8:161
[39] Soukoulis S, Hirsch R. The effects of a tea tree oil- containing gel on plaque and chronic gingivitis. Aust Dent J 2004; 49:78–83
[40] Daud FS, Pande G, Joshi M, Pathak R, Wankhede S, A study of Antimicrobial effect of some selected essential oil and Medicinal herbs against acne causing bacteria. International journal of pharmaceutical science Invention 2013; 2(1):27-34.
[41] Hammer K, Carson C, Riley T. In vitro activity of essential oils, in particular Melaleuca alternifolia (tea tree) oil and tea tree oil products, against Candida spp. J Antimicrob Chemother 1998; 42:591–595.
[42] Satchell AC, Saurajen A, Bell C, Barnetson RS. Treatment of interdigital tinea pedis with 25% and 50% tea tree oil solution: a randomized, placebo-controlled, blinded study. Australas J Dermatol 2002; 43:175–178.
[43] Syed TA, Qureshi ZA, Ali SM, et al. Treatment of toenail with 2% butenafine and 5% Melaleuca alternifolia (tea tree) oil in cream. Trop Med Int Health 1999; 4: 284–287.
[44] Van de Sande WW, Fahal AH, et al. In vitro susceptibility of Madurella mycetomatis, prime agent of Madura foot, to tea tree oil and artemisinin.J Antimicrob Chemother 2007; 59:553–555.
[45] Sarkic A and Stappen I. Essential Oils and Their Single Compounds in Cosmetics—A Critical Review. Cosmetics 2018.
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Ahmad S, Afsana , Popli H. A review on efficacy and tolerability of tea tree oil for acne. JDDT [Internet]. 15May2019 [cited 18May2024];9(3):609-12. Available from: https://jddtonline.info/index.php/jddt/article/view/2838
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