Skin integrity is restored by a physiological process aimed at repairing the damaged tissues. The healing process proceeds in four phases: hemostasis, inflammation, proliferation and remodeling. Phytomedicine presents remedies, which possess significant pharmacological effects. It is popular amongst the general population in regions all over the world. Phytotherapeutic agents have been largely used for cutaneous wound healing. These include Aloe vera, mimosa, grape vine, Echinacea, chamomile, ginseng, green tea, jojoba, tea tree oil, rosemary, lemon, soybean, comfrey, papaya, oat, garlic, ginkgo, olive oil and ocimum. Phytotherapy may open new avenues for therapeutic intervention on cutaneous wounds. This article provides a review of the common beneficial medicinal plants in the management of skin wounds with an attempt to explain their mechanisms.

1.
Ranjani M, Rajan S, Brindha P: Antioxidant and antibacterial potentials of aloe vera juice extract against wound isolates. J Pure Appl Microbiol 2010;4:2733-2739.
2.
Araújo LU, Grabe-Guimarães A, Mosqueira VC, Carneiro CM, Silva-Barcellos NM: Profile of wound healing process induced by allantoin. Acta Cir Bras 2010;25:460-466.
3.
Dorai AA: Wound care with traditional, complementary and alternative medicine. Indian J Plast Surg 2012;45:418-424.
4.
Shah JM, Omar E, Pai DR, Sood S: Cellular events and biomarkers of wound healing. Indian J Plast Surg 2012;45:220-228.
5.
Lee YS, Wysocki A, Warburton D, Tuan TL: Wound healing in development. Birth Defects Res C Embryo Today 2012;96:213-222.
6.
Buganza Tepole A, Kuhl E: Systems-based approaches toward wound healing. Pediatr Res 2013;73:553-563.
7.
Park SI, Sunwoo YY, Jung YJ, Chang WC, Park MS, Chung YA, Maeng LS, Han YM, Shin HS, Lee J, Lee SH: Therapeutic effects of acupuncture through enhancement of functional angiogenesis and granulogenesis in rat wound healing. Evid Based Complement Alternat Med 2012;2012:464586.
8.
Lademann O, Kramer A, Richter H, Patzelt A, Meinke MC, Czaika V, Weltmann KD, Hartmann B, Koch S: Skin disinfection by plasma-tissue interaction: comparison of the effectivity of tissue-tolerable plasma and a standard antiseptic. Skin Pharmacol Physiol 2011;24:284-288.
9.
Hübner NO, Matthes R, Koban I, Rändler C, Müller G, Bender C, Kindel E, Kocher T, Kramer A: Efficacy of chlorhexidine, polihexanide and tissue-tolerable plasma against Pseudomonas aeruginosa biofilms grown on polystyrene and silicone materials. Skin Pharmacol Physiol 2010;23(suppl):28-34.
10.
Hammann A, Huebner NO, Bender C, Ekkernkamp A, Hartmann B, Hinz P, Kindel E, Koban I, Koch S, Kohlmann T, Lademann J, Matthes R, Müller G, Titze R, Weltmann KD, Kramer A: Antiseptic efficacy and tolerance of tissue-tolerable plasma compared with two wound antiseptics on artificially bacterially contaminated eyes from commercially slaughtered pigs. Skin Pharmacol Physiol 2010;23:328-332.
11.
Lademann J, Richter H, Schanzer S, Patzelt A, Thiede G, Kramer A, Weltmann KD, Hartmann B, Lange-Asschenfeldt B: Comparison of the antiseptic efficacy of tissue-tolerable plasma and an octenidine hydrochloride-based wound antiseptic on human skin. Skin Pharmacol Physiol 2012;25:100-106.
12.
Calixto JB: Efficacy, safety, quality control, marketing and regulatory guidelines for herbal medicines (phytotherapeutic agents). Braz J Med Biol Res 2000;33:179-189.
13.
Saad B, Azaizeh H, Abu-Hijleh G, Said O: Safety of traditional Arab herbal medicine. Evid Based Complement Alternat Med 2006;3:433-439.
14.
Pribitkin ED, Boger G: Herbal therapy: what every facial plastic surgeon must know. Arch Facial Plast Surg 2001;3:127-132.
15.
Feily A, Namazi MR: Aloe vera in dermatology: a brief review. G Ital Dermatol Venereol 2009;144:85-91.
16.
Tarameshloo M, Norouzian M, Zarein-Dolab S, Dadpay M, Mohsenifar J, Gazor R. Aloe vera gel and thyroid hormone cream may improve wound healing in Wistar rats. Anat Cell Biol 2012;45:170-177.
17.
Zippel J, Deters A, Hensel A: Arabinogalactans from Mimosa tenuiflora (Willd.) Poiret bark as active principles for wound-healing properties: specific enhancement of dermal fibroblast activity and minor influence on HaCaT keratinocytes. J Ethnopharmacol 2009;124:391-396.
18.
Kokane DD, More RY, Kale MB, Nehete MN, Mehendale PC, Gadgoli CH: Evaluation of wound healing activity of root of Mimosa pudica. J Ethnopharmacol 2009;124:311-315.
19.
Hemmati AA, Aghel N, Rashidi I, Gholampur-Aghdami A: Topical grape (Vitis vinifera) seed extract promotes repair of full thickness wound in rabbit. Int Wound J 2011;8:514-520.
20.
Khanna S, Venojarvi M, Roy S, Sharma N, Trikha P, Bagchi D, Bagchi M, Sen CK: Dermal wound healing properties of redox-active grape seed proanthocyanidins. Free Radic Biol Med 2002;33:1089-1096.
21.
Speroni E, Govoni P, Guizzardi S, Renzulli C, Guerra MC: Anti-inflammatory and cicatrizing activity of Echinacea pallida Nutt. root extract. J Ethnopharmacol 2002;79:265-272.
22.
Rousseau B, Tateya I, Lim X, Munoz-del-Rio A, Bless DM: Investigation of anti-hyaluronidase treatment. J Voice 2006;20:443-451.
23.
Srivastava JK, Shankar E, Gupta S: Chamomile: a herbal medicine of the past with bright future. Mol Med Rep 2010;3:895-901.
24.
Rügge SD, Nielsen M, Jacobsen AS, Vang O, Jemec GB: Evidence of dermatological effects of chamomile (in Danish). Ugeskr Laeger 2010;172:3492-3496.
25.
Nayak BS, Raju SS, Rao AV: Wound healing activity of Matricaria recutita L. extract. J Wound Care 2007;16:298-302.
26.
Pazyar N, Omidian M, Jamshydian N: Ginseng as a potential novel addition to the antikeloid weaponry. Phytother Res 2012;26:1579-1580.
27.
Pazyar N, Yaghoobi R: Ginseng: potential for the antileishmanial arsenal? Sao Paulo Med J 2013;131:279-280.
28.
Pazyar N, Yaghoobi R: A rationale of ginseng as a novel addition to the antihirsutism armamentarium. J Altern Complement Med 2012;18:210-211.
29.
Kimura Y, Sumiyoshi M, Kawahira K, Sakanaka M: Effects of ginseng saponins isolated from red ginseng roots on burn wound healing in mice. Br J Pharmacol 2006;148:860-870.
30.
Sandulache VC, Chafin JB, Li-Korotky HS, Otteson TD, Dohar JE, Hebda PA: Elucidating the role of interleukin-1β and prostaglandin E2 in upper airway mucosal wound healing. Arch Otolaryngol Head Neck Surg 2007;133:365-374.
31.
Pazyar N, Feily A, Kazerooni A: Green tea in dermatology. Skinmed 2012;10:352-355.
32.
Klass BR, Branford OA, Grobbelaar AO, Rolfe KJ: The effect of epigallocatechin-3-gallate, a constituent of green tea, on transforming growth factor-β1-stimulated wound contraction. Wound Repair Regen 2010;18:80-88.
33.
Pazyar N, Yaghoobi R, Ghassemi MR, Kazerouni A, Rafeie E, Jamshydian N: Jojoba in dermatology: a succinct review. G Ital Dermatol Venereol 2013;148:1-2.
34.
Ranzato E, Martinotti S, Burlando B: Wound healing properties of jojoba liquid wax: an in vitro study. J Ethnopharmacol 2011;134:443-449.
35.
Edmondson M, Newall N, Carville K, Smith J, Riley TV, Carson CF: Uncontrolled, open-label, pilot study of tea tree (Melaleuca alternifolia) oil solution in the decolonisation of methicillin-resistant Staphylococcus aureus positive wounds and its influence on wound healing. Int Wound J 2011;8:375-384.
36.
Pazyar N, Yaghoobi R, Bagherani N, Kazerouni A: A review of applications of tea tree oil in dermatology. Int J Dermatol 2013;52:784-790.
37.
Pazyar N, Yaghoobi R: Tea tree oil as a novel antipsoriasis weapon. Skin Pharmacol Physiol 2012;25:162-163.
38.
Jandera V, Hudson DA, de Wet PM, Innes PM, Rode H: Cooling the burn wound: evaluation of different modalities. Burns 2000;26:265-270.
39.
Sayorwan W, Ruangrungsi N, Piriyapunyporn T, Hongratanaworakit T, Kotchabhakdi N, Siripornpanich V: Effects of inhaled rosemary oil on subjective feelings and activities of the nervous system. Sci Pharm 2013;81:531-542.
40.
Abu-Al-Basal MA: Healing potential of Rosmarinus officinalis L. on full-thickness excision cutaneous wounds in alloxan-induced-diabetic BALB/c mice. J Ethnopharmacol 2010;131:443-450.
41.
Valdés F: Vitamin C. Actas Dermosifiliogr 2006;97:557-568.
42.
Lee YH, Chang JJ, Chien CT, Yang MC, Chien HF: Antioxidant sol-gel improves cutaneous wound healing in streptozotocin-induced diabetic rats. Exp Diabetes Res 2012;2012:504693.
43.
Anisimova IuN, Borovskiĭ VR, Bychkova NG, Ratushniak VV, Klimenko LA, Osadchaia LA, Osadchaia OI, Bychkova SA: Role of enteral feeding mixture based on soy in correction of immune status of patients with burn wounds (in Russian). Lik Sprava 2005;56-62.
44.
Xu L, Choi TH, Kim S, Kim SH, Chang HW, Choe M, Kwon SY, Hur JA, Shin SC, Chung JI, Kang D, Zhang D: Anthocyanins from black soybean seed coat enhance wound healing. Ann Plast Surg 2013;71:415-420.
45.
Benedek B, Ziegler A, Ottersbach P: Absence of mutagenic effects of a particular Symphytum officinale L. liquid extract in the bacterial reverse mutation assay. Phytother Res 2010;24:466-468.
46.
Araújo LU, Grabe-Guimarães A, Mosqueira VC, Carneiro CM, Silva-Barcellos NM: Profile of wound healing process induced by allantoin. Acta Cir Bras 2010;25:460-466.
47.
Araújo LU, Reis PG, Barbosa LC, Saúde-Guimarães DA, Grabe-Guimarães A, Mosqueira VC, Carneiro CM, Silva-Barcellos NM: In vivo wound healing effects of Symphytum officinale L. leaves extract in different topical formulations. Pharmazie 2012;67:355-360.
48.
Mikhal'chik EV, Ivanova AV, Anurov MV, Titkova SM, Pen'kov LY, Kharaeva ZF, Korkina LG: Wound-healing effect of papaya-based preparation in experimental thermal trauma. Bull Exp Biol Med 2004;137:560-562.
49.
Nayak BS, Ramdeen R, Adogwa A, Ramsubhag A, Marshall JR: Wound-healing potential of an ethanol extract of Carica papaya (Caricaceae) seeds. Int Wound J 2012;9:650-655.
50.
Pazyar N, Yaghoobi R, Kazerouni A, Feily A: Oatmeal in dermatology: a brief review. Indian J Dermatol Venereol Leprol 2012;78:142-145.
51.
Akkol EK, Orhan IE, Keles H, Kan A, Coksari G: Assessment of dermal wound healing and in vitro antioxidant properties of Avena sativa L. J Cereal Sci 2011;53:285-290.
52.
Boisnic S, Branchet MC, Ermosilla V: Healing effect of a spray containing Rhealba oat colloidal extract in an in vitro reconstitution model of skin. Int J Tissue React 2005;27:83-89.
53.
Feily A, Namazi MR, Pazyar N, Saboktakin M, Saboktakin M: Garlic extract as a novel addition to antikeloid armamentarium: an untested hypothesis. J Altern Complement Med 2009;15:1153-1154.
54.
Ejaz S, Chekarova I, Cho JW, Lee SY, Ashraf S, Lim CW: Effect of aged garlic extract on wound healing: a new frontier in wound management. Drug Chem Toxicol 2009;32:191-203.
55.
Pazyar N, Yaghoobi R: Ginkgo biloba extract: a novel addition to antipsoriasis ammunition? J Altern Complement Med 2012;18:316-317.
56.
Bairy KL, Ganesh SB, Adiga MS, Shalini A: Impaired wound healing due to cyclophosphamide (CLP) alleviated by supplemental Ginkgo biloba (GB). J Nat Med 2006;6:31-34.
57.
Fitó M, de la Torre R, Farré-Albaladejo M, Khymenetz O, Marrugat J, Covas MI: Bioavailability and antioxidant effects of olive oil phenolic compounds in humans: a review. Ann Ist Super Sanita 2007;43:375-381.
58.
Kim HS, Noh SU, Han YW, Kim KM, Kang H, Kim HO, Park YM: Therapeutic effects of topical application of ozone on acute cutaneous wound healing. J Korean Med Sci 2009;24:368-374.
59.
Goel A, Kumar S, Singh DK, Bhatia AK: Wound healing potential of Ocimum sanctum Linn. with induction of tumor necrosis factor-alpha. Indian J Exp Biol 2010;48:402-406.
60.
Shetty S, Udupa S, Udupa L, Somayaji N: Wound healing activity of Ocimum sanctum Linn. with supportive role of antioxidant enzymes. Indian J Physiol Pharmacol 2006;50:163-168.
61.
Udupa SL, Shetty S, Udupa AL, Somayaji SN: Effect of Ocimum sanctum Linn. on normal and dexamethasone suppressed wound healing. Indian J Exp Biol 2006;44:49-54.
62.
Parente LM, Andrade MA, Brito LA, Moura VM, Miguel MP, Lino-Júnior Rde S, Tresvenzol LF, Paula JR, Paulo NM: Angiogenic activity of Calendula officinalis flowers L. in rats. Acta Cir Bras 2011;26:19-24.
63.
Parente LM, Lino Júnior Rde S, Tresvenzol LM, Vinaud MC, de Paula JR, Paulo NM: Wound healing and anti-inflammatory effect in animal models of Calendula officinalis L. growing in Brazil. Evid Based Complement Alternat Med 2012;2012:375671.
64.
Duran V, Matic M, Jovanovć M, Mimica N, Gajinov Z, Poljacki M, Boza P: Results of the clinical examination of an ointment with marigold (Calendula officinalis) extract in the treatment of venous leg ulcers. Int J Tissue React 2005;27:101-106.
65.
Wu F, Bian D, Xia Y, Gong Z, Tan Q, Chen J, Dai Y: Identification of major active ingredients responsible for burn wound healing of Centella asiatica herbs. Evid Based Complement Alternat Med 2012;2012:848093.
66.
Hsiao CY, Hung CY, Tsai TH, Chak KF: A study of the wound healing mechanism of a traditional Chinese medicine, Angelica sinensis, using a proteomic approach. Evid Based Complement Alternat Med 2012;2012:467531.
67.
Lau KM, Lai KK, Liu CL, Tam JC, To MH, Kwok HF, Lau CP, Ko CH, Leung PC, Fung KP, Poon SK, Lau CB: Synergistic interaction between Astragali radix and Rehmanniae radix in a Chinese herbal formula to promote diabetic wound healing. J Ethnopharmacol 2012;141:250-256.
68.
Sung MJ, Davaatseren M, Kim SH, Kim MJ, Hwang JT: Boehmeria nivea attenuates LPS-induced inflammatory markers by inhibiting p38 and JNK phosphorylations in RAW264.7 macrophages. Pharm Biol 2013;51:1131-1136.
69.
TrivellatoGrassi L, Malheiros A, Meyre-Silva C, Buss Zda S, Monguilhott ED, Fröde TS, da Silva KA, de Souza MM: From popular use to pharmacological validation: a study of the anti-inflammatory, anti-nociceptive and healing effects of Chenopodium ambrosioides extract. J Ethnopharmacol 2013;145:127-138.
70.
Wu XB, Luo XQ, Gu SY, Xu JH: The effects of Polygonum cuspidatum extract on wound healing in rats. J Ethnopharmacol 2012;141:934-937.
71.
Shirwaikar A, Somashekar AP, Udupa AL, Udupa SL, Somashekar S: Wound healing studies of Aristolochia bracteolata Lam. with supportive action of antioxidant enzymes. Phytomedicine 2003;10:558-562.
72.
Oztürk N, Korkmaz S, Oztürk Y: Wound-healing activity of St. John's Wort (Hypericumperforatum L.) on chicken embryonic fibroblasts. J Ethnopharmacol 2007;111:33-39.
73.
Okoli CO, Akah PA, Okoli AS: Potentials of leaves of Aspilia africana (Compositae) in wound care: an experimental evaluation. BMC Complement Altern Med 2007;7:24.
74.
Pieters L, De Bruyne T, Van Poel B, Vingerhoets R, Totté J, Vanden Berghe D, Vlietinck A: In vivo wound healing activity of Dragon's Blood (Croton spp.), a traditional South American drug, and its constituents. Phytomedicine 1995;2:17-22.
75.
Pandith H, Zhang X, Thongpraditchote S, Wongkrajang Y, Gritsanapan W, Baek SJ: Effect of Siam weed extract and its bioactive component scutellarein tetramethyl ether on anti-inflammatory activity through NF-κB pathway. J Ethnopharmacol 2013;147:434-441.
76.
Rodero MP, Khosrotehrani K: Skin wound healing modulation by macrophages. Int J Clin Exp Pathol 2010;3:643-653.
77.
Calapai G, Caputi AP: Herbal medicines: can we do without pharmacologist? Evid Based Complement Alternat Med 2007;4(suppl 1):41-43.
78.
Duraz AY, Khan SA: Knowledge, attitudes and awareness of community pharmacists towards the use of herbal medicines in Muscat region. Oman Med J 2011;26:451-453.
79.
Ke F, Yadav PK, Ju LZ: Herbal medicine in the treatment of ulcerative colitis. Saudi J Gastroenterol 2012;18:3-10.
80.
Modak M, Dixit P, Londhe J, Ghaskadbi S, Paul A, Devasagayam T: Indian herbs and herbal drugs used for the treatment of diabetes. J Clin Biochem Nutr 2007;40:163-173.
81.
Ke F, Yadav PK, Ju LZ: Herbal medicine in the treatment of ulcerative colitis. Saudi J Gastroenterol 2012;18:3-10.
82.
Oreagba IA, Oshikoya KA, Amachree M: Herbal medicine use among urban residents in Lagos, Nigeria. BMC Complement Altern Med 2011;11:117.
83.
Yuan SM, Jing H: Insights into the monomers and single drugs of Chinese herbal medicine on myocardial preservation. Afr J Tradit Complement Altern Med 2011;8:104-127.
84.
Zaid H, Silbermann M, Ben-Arye E, Saad B: Greco-Arab and Islamic herbal-derived anticancer modalities: from tradition to molecular mechanisms. Evid Based Complement Alternat Med 2012;2012:349040.
85.
Xia CX, Lu S: Progress of study on improvement of vascular endothelial function by Chinese herbal medicine in hypertensive patients. Zhongguo Zhong Xi Yi Jie He Za Zhi 2008;28:378-381.
86.
Al-Rowais NA: Herbal medicine in the treatment of diabetes mellitus. Saudi Med J 2002;23:1327-1331.
87.
Wang S, Wu X, Tan M, Gong J, Tan W, Bian B, Chen M, Wang Y: Fighting fire with fire: poisonous Chinese herbal medicine for cancer therapy. J Ethnopharmacol 2012;140:33-45.
88.
Samuels N, Finkelstein Y, Singer SR, Oberbaum M: Herbal medicine and epilepsy: proconvulsive effects and interactions with antiepileptic drugs. Epilepsia 2008;49:373-380.
89.
Kondoh A, Ohta Y, Yamamoto K, Iwashita K, Umezawa Y, Matsuyama T, Ozawa A, Shinohara Y: Feasibility of modified DLQI-based questionnaires for evaluation of clinical efficacy of herbal medicine in chronic skin diseases. Tokai J Exp Clin Med 2005;30:97-102.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.