Traditional medicines for skin conditions
Examining the history of North American Indigenous treatments for common skin conditions (1,600 words, 8 minutes)
The medical community needs to acknowledge the historical contributions of Indigenous peoples to dermatology and medicine and the role that traditional medical plants have in developing modern therapeutics. Many of these plants have a long history of use for skin conditions, and research is warranted to understand how they work.
These were some key messages from a presentation by Dr. Marni Wiseman and her colleague Jonah Perlmutter at the 2022 Indigenous Skin Spectrum Summit.
Dr. Wiseman is an associate professor and section head of dermatology at the University of Manitoba and is in private practice at SkinWise Dermatology in Winnipeg. Perlmutter is a student in the biochemistry faculty at the University of Winnipeg and has research interests that include Indigenous traditional medicines, hair loss disorders, and autoimmune skin disease.
They presented some findings from their paper “Treatment of Atopic Dermatitis, Dermatophytes, and Syphilis by Indigenous Peoples Prior to 1850”, published in the Journal of Cutaneous Medicine and Surgery (March-April 2022; 26(2):198-200). Rachel Cogan, a science student at the University of Winnipeg, was a co-author.
They explored historical documents and spoke with Indigenous elders to identify specific traditional plant-based medicines for skin conditions. Speaking with elders also helped clarify terminology, Perlmutter said, including references to skin conditions such as “oji kwes,” or how a historical reference to a treatment having “good success” might compare to modern efficacy measures.
“When we are looking at atopic dermatitis, we do know that symptoms suggestive of atopic dermatitis were recognized by Indigenous peoples and were reported through oral history long before colonization,” Dr. Wiseman said. “The impact of atopic dermatitis was believed to be felt on activities such as tool crafting and bow hunting. Hence, there was a motivation to find therapy for the symptoms of atopic dermatitis.”
The observation of two trends spurred this research, Perlmutter said. The first is a trend toward the investigation of naturally-sourced therapeutics. The second is the successful implementation of Indigenous healing practices in conjunction with Western medicine in northern Indigenous communities.
“We found a series of natural treatments with some active compounds that had efficacy in treating conditions that we believe are possibly and probably atopic dermatitis, the skin lesions of syphilis, and fungal skin infections,” said Dr. Wiseman.
Some of the skin conditions, associated treatments and their possible active components identified in the paper include:
Atopic dermatitis
Sassafras tree/safrole
Syphilis
Guaiac tree/resin, volatile oils, guaiacum, rubber, vanillin, saponin
Sassafras tree/volatile oils
Eastern white cedar (known as annedda)/ascorbic acid
Oji kwes (a term used interchangeably for sexually transmitted infections and fungal skin infections)
Lichens/unknown
Willow bark (known as wighsacan)/salicylic acid
Skin swelling
Common milkweed/resins, odorous fatty matter, traces of volatile oil
“We have to research and help to identify specific mechanisms of action to understand better how these active compounds work and why they are bringing benefit to people,” said Dr. Wiseman.
Bottom line: The Indigenous peoples of North America have a long history of treating common skin conditions with natural plant-based remedies. There is value to dermatology in studying these traditions to identify beneficial treatments that may improve outcomes for today’s patients.
From the literature on Indigenous plant-based medicine
On the first book of medicinal plants written in the American continent: the libellus medicinalibus indorum herbis from Mexico, 1552: a review
This article reviews the history, authors and botany of the “Libellus de Medicinalibus Indorum Herbis” (Little Book of Indian Medicinal Plants), first written in the Nahuatl language and published in a Latin translation in 1552.
In the article, the authors discuss the chemistry and pharmacology of five plants presented in the book and the persistence, disappearance and transformation of the ethnopharmacological knowledge of Mesoamerican Indigenous peoples.
Trypanocidal activity of traditional antiparasitic medicinal plants from the Amazon
This study evaluated four plants traditionally used in the Amazon against parasitic infections. The plants were collected in the Amazon region of Columbia. Water extracts against the parasite that causes Chagas disease, Trypanosoma cruzi were tested. These extracts were also tested for toxicity against cultured human cells.
Two of the extracts—from Ambelania duckei and Curarea toxicofera—showed concentration-dependent inhibition of T. cruzi comparable to benznidazole. None of the extracts tested were cytotoxic to the human cells.
The authors conclude that several plants used by Indigenous peoples to treat protozoan infections could be assessed against T. cruzi.
Medicinal plants used by the Indigenous Ati tribe in Tobias Fornier, Antique, Philippines
For this study, the authors conducted semi-structured interviews with the tribal chieftain, a council of elders, herb doctors, and other members of the Indigenous Ati tribe in the Philippines who have Indigenous knowledge of using medicinal plants in traditional medicine.
The authors learned that the Ati used 108 plant species distributed in 97 genera and 44 families to treat 67 diseases in 12 categories. The family Fabaceae had 15 species, then Lamiaceae with 12 species, and Asteraceae, Euphorbiaceae, and Poaceae with five species each. The most frequently used parts of plants were the leaves. Medicinal plants were most commonly prepared by decoction and usually taken orally.
One of the most culturally important medicinal plants was Euphorbia hirta L, used for treating visual problems, dengue, typhoid fever and headache.
Antimicrobial wound healing properties of Indigenous medicinal plants of Lesotho: The pharmacist's role in minor wound care
The authors aimed to validate the antimicrobial activity of medicinal plants used among the Basotho people of Lesotho for minor wound infections.
The anti-infective activities of these plants are thought to be due to the presence of active phytochemicals, especially phenolic compounds, anthraquinones, glycosides, and alkaloids.
The authors also discuss the pharmacist’s role in providing patients with medical information on the active compounds in these medicinal plants and the safe use of these plants on their own and in combination with conventional medications.
VIDEO: NCCIH (National Collaborating Centre for Indigenous Health) Webinar: Traditional Indigenous Medicine Presentation with Dr. Nicole Redvers
At the intersection of skin and society
The 10th biennial Pacific Region Indigenous Doctors Congress (PRIDoC), organized by the Indigenous Physicians Association of Canada (IPAC), is scheduled for July 10 to 15, 2022, in Turtle Island, BC.
This conference will take place on the unceded, traditional territories of the Coast Salish, which comprises the Musqueam, Squamish and Tsleil-Waututh Nations.
“PRIDoC is an Indigenous conference created and led by Indigenous physicians for Indigenous physicians, as opposed to a conference that may have a few sessions on Indigenous health in the conference program,” said Melanie Osmack, IPAC’s Acting Director, in an interview with The Chronicle of Skin & Allergy. “People who have attended previous conferences describe PRIDoC as a life-changing experience.”
“It is a very holistic event,” said Osmack of the five-day conference. “It is a place for clinical learning, but it’s also a place for culture, medicine, wellness and connecting.”
Also organizing PRIDoC 2022 is Dr. Michael Dumont, Medical Director for Lu’ma Medical Centre, an Indigenous primary care clinic located in unceded Musqueam, Squamish and Tsleil-Waututh territory (East Vancouver).
Dr. Dumont is involved in fundraising for the event and has planned a cultural event and circle on Indigenizing primary care.
“This conference will provide not only an opportunity to share ideas, knowledge, wisdom and medicine but also to lift each other up and support each other as we share the special burden of being healthcare providers and healers in this challenging time,” said Dr. Dumont.
PRIDoC 2022 is hosted in partnership with ‘Ahahui’ o nā Kauka, Te Ohu Rata o Aotearoa (TeORA), The Association of American Indian Physicians (AAIP), The Australian Indigenous Doctors’ Association (AIDA), and The Medical Association for Indigenous People of Taiwan (MAIPT).
Both clinical and non-clinical content will be presented at PRIDoC 2022. The program spans topics such as the impact of climate change on the health of Indigenous peoples, social determinants of health, medical education, chronic disease, LGBTQIA2S+ health, traditional medicine and the impact of the global Covid-19 pandemic on traditional/ceremonial practices and Indigenous Covid-19 experiences and responses.
This article was prepared with files from contributor Louise Gagnon.
This week
July is Good Care Month in the UK, recognizing the contributions of social care workers
July 11 is World Population Day
July 16 is National DRESS (drug rash with eosinophilia and systemic symptoms) Syndrome Day in the US
Something to think about in the week ahead…
Chuck Tanner (July 4, 1928—Feb. 11, 2011): American professional baseball player and manager.
Next week
Taking a broad look at the landscape of Indigenous health in Canada, Dr. Rachel Netahe Asiniwasis discussed some of the findings of a scoping review of the literature she conducted with her colleagues in a presentation at the 2022 Indigenous Skin Spectrum Summit.
Coming soon
Skin Spectrum Weekly and The Chronicle of Skin & Allergy are organizing the 2022 Summer of Dialogue colloquium. This 90-minute webinar will be held virtually on Aug. 18, 2022. In recognizing persistent gaps in dermatologic training, as it pertains to skin of colour, the focus of the colloquium will be on recent progress in advancing the inclusion of diverse skin tones in research and medical education. Watch this space for registration details.
If you like Skin Spectrum Weekly, why not check out our other publications and podcasts?
Established in 1995, The Chronicle of Skin & Allergy is a scientific newspaper providing news and information on practical therapeutics and clinical progress in dermatologic medicine. The latest issue features:
A report on choosing a biologic therapy for the treatment of AD, with Dr. Aaron Drucker of Toronto
How new IL inhibitors can improve response in patients with psoriasis, featuring interviews with Dr. Jaggi Rao (Edmonton), Dr. Ben Barankin (Toronto), Dr. Catherine Zip (Calgary), Dr. Kerri Purdy (Halifax) and Dr. Kyle Cullingham (Saskatoon).
Plus regular features, including the popular column Vender on PsO by Hamilton dermatologist Dr. Ron Vender.
To apply for a complimentary* subscription or to receive a sample copy, please email health@chronicle.org with your contact information.
Women in Dermatology updates new findings concerning dermatologic issues that affect women and the female dermatologists who care for them. Read the current issue here.
Enjoy podcasts? In the first episode of season two of the Vender on Psoriasis Podcast, Canadian dermatologist Dr. Ronald B. Vender talks about self-help for psoriasis patients, generalized pustular psoriasis and the link between early response and long-term response in psoriasis treatment.