A news magazine in 2001 revealed over 2900 adverse events requiring medical care which were attributed to herbs the previous year. In addition, 104 deaths were attributed primarily to ephedra, St. John’s Wort, gingko, and ginseng (10). In 2003 the FDA removed
Ephedra and Ma Huang (Ephedra sinica) from the market due to 155 deaths directly attributed to it (11).
The most common adverse cutaneous reactions to herbal products include allergic and/or irritant contact dermatitis. Cross-sensitivity to the most sensitizing botanicals is not uncommon. For example, 12 of 106 dermatitis patients had positive patch test to tea tree oil (TTO) and all these had positive reactions to one or more of 12 other natural compounds including lavender (Lavandula angustifolia) (12). Severe cutaneous reactions including angioedema/urticaria, exfoliative erythroderma, linear IgA bullous dermatosis, lupus erythematosus, malignancies, pemphigus, Steven’s Johnson syndrome, Sweet’s syndrome, ulcerative stomatitis, and vasculitis have all been reported. Ten additional herbs have induced fatal reactions including aristolochia, arnica, cayenne, comfrey, henna, kava kava, mistletoe, rue, senna, and yohimbine. Other severe reactions include anaphylaxis, coma, rhabdomyolysis, and shock (3,13). Herbs known to pose dermatologic surgery dangers include St. John’s Wort, gingko, ginseng, garlic, echinacea, kava kava, and valerian (14). See mucocutaneous and severe complications in Table 2.
Even simple plants contain multiple reactive and interactive compounds, but natural medicine advocates and media frequently do not warn the public of the importance of interactions between different herbs and with over-the-counter and prescription drugs. Moreover, 70% of patients fail to disclose their use of herbal products preoperatively. Interactions with medical consequences probably are under-reported (14). There are many herb/food, herb/drug, and herb/herb interactions as in combinations of caution in Table 3 (3).
The medicinal botanicals of proven and potential dermatologic significance are listed by therapeutic uses in Table 4 (3). Multple herbs are effective for several different indications. Herbal medicines may be divided into several groups. Clinically validated ones have published human-controlled clinical trials. These herbs are among the most commonly used by the public and alternative medicine practitioners and would be expected to be the most commonly used in cosmeceuticals. Green and black tea, soy, pomegranate, and date have published human clinical trials for signs of photoaging as the only active. Avocado and black cohosh are included with two other actives in different topical formulations treating photoaging. Other herbs with published human studies treating dermatologic conditions with topical formulations include almond, allantoin and comfrey, aloe, anise, bitter orange, black nightshade, black seed, camptotheca, cayenne, curcumin, date palm, echinacea, german chamomile, horse chestnut, lemon balm, neem, oat, onion, oregon grape, pomegranate, St. John’s wort, tea tree, oolong tea, and western medicinal herbal mixtures. Borage, evening primrose, gotu kola, grape seed, ginko biloba, horse chestnut, black tea, and Chinese herbal mixtures have been documented to treat dermatologic conditions when administered orally.
The second group consists of herbs used in current cosmeceuticals with a scientific rationale supported only by animal, in vivo or in vitro studies, and/or proven efficacy in human systemic disease but without clinical data with topical application. These include apple, arnica, cactus pear, eucommia, ginseng, hibiscus, jojoba, licorice, milk thistle, myrtle, olive oil, papaya, prickly pear, rosemary, sandalwood, sarsaparilla, saw palmetto, spearmint, peppermint, wheat germ, and white birch.
The third group consists of herbs approved for therapy of a cutaneous condition by the German Commission E which are currently or potentially will be incorporated into cosmeceuticals. These include agrimony, bittersweet nightshade, butcher’s broom, cajuput, chaste tree, English plantain, fenugreek, flax, heartsease, horsetail, jambolan, lavender, marigold, oak, oat, pansy flower, Peruvian balsam, pineapple, poplar, sage, sesame seed, shepherd’s purse, sweet clover, walnut, and white nettle. (text continued on page 328)
Chaste Tree (Vitex agnus-castus)
St. John’s Wort (Hypericum perforatum)
Caraway (Carum carvi), Cayenne (Capsicum annuum), Echinacea (Echinacea angustifolia), Flax linseed (Linum usitatissimum), German Chamomile (Matricaria recutita), Garlic (Allium sativum), Horse Chestnut (Aesculus hippocastanum), Mistletoe (Phoradendron species), Willow Bark (Salix alba)
Cowhage (Mucuna pruniens)
Alkanet (Alkanna tinctoria), Aloe (Aloe barbadensis; Aloe capensis: Aloe vera), Alpine Ragwort (Senecio nemorensis), Areca Nut (Areca catechu), Basil (Ocimum basilicum), Bergamot (Citrus aurantium), Cascara Sagrada (Rhamnuspurshiana), Coca (Erythroxylum coca), Colt’s Foot (Tussilago farfara), Comfrey (Symphytum officinale), Cypress Spurge (Euphorbia cyparissias), Dusty Miller (Senecio aureus), Forget-me-not (Myosotis arvensis), Golden Ragwort (Senecio aureus), Groundsel (Senecio vulgaris), Hemp Agrimony (Eupatorium cannabinum), Jalap (Ipomoea purga), Madder (Rubia tinctorum), Morning Glory (Ipomoea hederacea), Petasites (Petasites hybridus), Ragwort (Senecio jacobaea), Red Clover (Trifolium pratense), Rue (Ruta species), Sassafras (Sassafras albidum), Senna (Cassia species)
Contact Blistering American Fiverwort (Hepatica nobailis), Arnica (Arnica montana), Bergamot (Citrus aurantium), Bitter Orange
(Citrus aurantium), Black Mustard (Brassica nigra), Bulbous Buttercup (Ranunculus bulbosus), Buttercup (Ranunculus acris), Cashew (Anacardium occidentale), Cayenne (Capsicum annuum), Clematis (Clematis recta), Cypress Spurge (Euphorbia cyparissias), Garlic (Allium sativum), Gingko (Ginko biloba), Globe Flower (Trollius europaeus), Henna (Lawsonia inermis), Juniper (Juniperus species), Marsh Marigold (Caltha palustris), Mezereon (Daphne mezereum), Pasque Flower (Pulsatilla pratensis), Poison Ivy, Oak, Sumac (Rhus toxicodendron) Poisonous Buttercup (Ranunculus sceleratus), Rue (Ruta species), Savin Tops (Juniperus sabina), Senna (Cassia species), Tea Tree (Melaleuca alternifolia [IgA linear dermatosis]), Traveller’s Joy (Clematis vitalba), White Bryony (Bryonia alba), Wood Anemone (Anemone nemorosa)
Conjunctivitis Black Mustard (Brassica nigra), Cypress Spurge (Euphorbia cyparissias), German Chamomile (Matricaria recutita),
Goa Powder (Andira araroba), Psyllium (Plantago ovata), Psyllium Seed (Plantago afra)
Cutaneous, Nonspecific American Hellebore (Veratrum viride), American Fiverwort (Hepatica nobilis), Arnica (Arnica montana), Artichoke
(Cynara scolymus), Asarum (Asarum europaeum), Birch (Betula species), Black Bryony (Tamus communis), Blessed Thistle (Cincus benedictus), Boneset (Eupatorium perfoliatum), Bulbous Buttercup (Ranunculus bulbosus), Burdock (Arctium lappa), Buttercup (Ranunculus acris), Camphor Tree (Cinnamomum camphora),
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White Bryony (Bryonia alba)
Bishop’s Weed (Ammi visnaga), Black Cohosh (Cimicifuga racemosa), Germander (Teucrium chamaedrys)
Henna (Lawsonia inermis)
Bloodroot (Sanguinaria canadensis)
Henna (Lawsonia inermis), Peppermint (Mentha piperita)
Bloodroot (Sanguinaria canadensis)
Yohimbine (Pausinystalia yohimbe)
Black Cohosh (Cimicifuga racemosa), Dong Quai (Angelica sinensis), Ginseng (Panax species)
American Liverwort (Hepatica nobilis), Arum (Arum maculatum), Bitter Apple (Citrullus colocynthis), Bulbous Buttercup (Ranunculus bulbosus), Buttercup (Ranunculus acris), Clematis (Clematis recta), Elecampane (Inula helenium), Gingko (Ginko biloba), Globe Flower (Trollius europaeus), Green Hellebore (Helleborous viridis), Hedge-Hyssop (Gratiola officinalis), Horse Chestnut (Aesculus hippocastanum), Horseradish (Armoracia rusticana), Marsh Marigold (Caltha palistris), Mezereon (Daphne mezereum), Orris (Iris species), Peppermint (.Mentha piperita), Poisonous Buttercup (Ranunculus sceleratus), Poke (Phytolacca americana), Spurge (.Euphorbia resinifera), Traveller’s Joy (Clematis vitalba), White Bryony (Bryonia alba)
Echinacea (Echinacea angustifolia), St. John’s Wort (Hypericum perforatum), Mountain Laurel (Kalmia latifolia) Garlic (Allium sativum)
Angelica (Angelica archangelica), Bergamot (Citrus aurantium), Bishop’s Weed (Ammi visnaga), Bitter Orange (■Citrus aurantium), Burning Bush (Dictamnus albus), Celery (Apium graveolens), Contrayerva (Dorstenia contrayerva), Dill (Anethum graveolens), Dong Quai (Angelica sinensis), Haronga (Haronga madagascariensis), Henna (Lawsonia inermis), Hogweed (Heracleum spondylium), Kava Kava (Piper methysticum), Lovage (Levisticum officinale), Masterwort (Peucedanum ostruthium), Parsley (Petroselinum crispum), Parsnip (Pastinaca sativa), Pimpinella (Pimpinella major), Rue (Ruta graveolens), St. John’s Wort (Hypericum perforatum), Tolu Balsam (Myroxylon balsamum), Wafer Ash (Ptelea trifoliate), Yarrow (Achillea millefolium)
Arnica (Arnica montana), Black Cohosh (Cimicifuga racemosa), Chaste Tree (Vitex agnus-castus), Cowhage (.Mucuna pruriens), Cypress Spurge (Euphorbia cyparissias), Dan-Shen (Salvia miltiorrhiza), Ergot (Claviceps purpurea), Feverfew (Tanacetumparthenium), Gingko (Ginko biloba), Ginseng (Panax species), Henna (Lawsonia inermis), Horse Chestnut (Aesculus hippocastanum), Kava Kava (Piper metaysticum), Mistletoe (Phoradendron species), Night Blooming Cereus (Selenicereus grandiflorus), Poppyseed (Papaver somniferum), Quinine (Cinchona pubescens), Sandalwood (Santalum album), Senna (Cassia species), Stavesacre (Delphinium staphisagria), St. John’s Wort (Hypericum perforatum), Tea Tree (Melaleuca alternifolia)
Henna (Lawsonia inermis)
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Antiarrhythmics (aloe-induced hypokalemia may affect cardiac rhythm), digitalis glycosides (increases effect), corticosteroids, thiazide diuretics, and licorice (increased potassium loss)
Anticoagulant, antiplatelet, heparin, salicylates, thrombolytic drugs, and warfarin (increased effect)
Same as above
Amantadine, dopamine D1 antagonists, levodopa, pergolide mesylate, pramipexole, and ropinirole (enhance dopaminergic adverse effects). Dopamine D2 antagonists (decreased effectiveness)
Anticoagulant, antiplatelet, heparin, thrombolytic drugs (increase effect)
Corticosteroids, immunosuppressants (interferes with effectiveness)
Anticonvulsants including phenothiazines (may lower seizure threshold and decrease effectiveness) anticoagulant, antiplatelet, heparin, and thrombolytic drugs (decrease effectiveness)
Hypoglycemic drugs (may have an additive hypoglycemic effect)
Absorption of other drugs may be delayed when taken simultaneously
Alcohol, benzodiazepines (may increase sedative effect), anticoagulants, and warfarin (increase effect)
MAO inhibitors (potentiate effect), anticonvulsants (precipitate seizures), insulin (alters need), anticoagulant, antiplatelet, heparin, thrombolytic, and NSAID drugs (increase effect), nicardipine (reduce hypotensive effect), nifedipine, and papaverine (increase effect), SSRI (precipitate hypomania), thiazide diuretics (increase blood pressure)
Hypoglycemic drugs (increases effect), loop diuretics (increases diuretic resistance), MAO inhibitors (combination increases chance for headache, tremors, mania), insulin (reduces effect), estrogen (increases effect), albendazole (alters effectiveness), anticoagulants (decreases INR), nifedipine (increase effect), opiates (decrease effect) Alkaline drugs (decrease absorption)
Anticoagulant drugs (additive effect)
Aloe, buckthorn, antiarrhythmics, digitalis glycoside, laxatives (increase hypokalemia, increase toxicity), glucocorticoids (potentiates), loop, and thiazide diuretics (additive hypokalemia), anticoagulant, antiplatelet, heparin, thrombolytic drugs, (increase effect), antihypentensives (decrease effect), antidiabetic insulin (reduce effect), MAO inhibitors (increase toxicity), potassium (decrease), testosterone (reduce), oral contraceptive (increase toxicity)
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Bittersweet Nightshade (Solarium dulcamara), Duckweed (Lemna minor), Eucalyptus (Eucalyptus globulus), German Chamomile (Matricaria recutita), Heartsease (Viola tricolor), Tea Tree (Melaleuca alternifolia)
Arnica (Arnica montana), Black Bryony (Tamus communis), Boxwood (Buxus sempervirens), Cashew (Anacardium occidental), Horsetail (Equisetum arvense), Maidenhair (Adiantum capillus-veneris), Nasturtium (Tropaeolum majus), Oriental Arborvitae (Thuja orientalis), Stavesacre (Delphinium staphisagria)
Birch (Betula species), Burr Marigold (Bidens tripartita)
Common Stonecrop (Sedum acre), Water Dock (Rumex aquaticus)
Behen (Moringa oleifera), Bistort (Persicaria bistorta), Black Cohosh (Cimicifuga racemosa), Calotropis (Calotropis procera), Cane-Reed (Costus speciosa), Cotton (Gossypium hirsutum), Echinacea (Echinacea angustifolia), Great Bumet (Sanguisorba officinalis), Matico (Piper elongatum), Picrorhiza (Picrorhiza kurroa), Plantain (Musa paradisiaca), Purple Gromwell (Lithospermum erytrorhizon), Quassia (Picrasma excelsa), Rauwolha (Rauwolfia serpentine), Red Sandalwood (Pterocarpus santalinus), Scarlet Pimpernel (Anagallis arvensis), Tea Tree (Melaleuca alternifolia), Turmeric (Curcuma domestica/longa), Wormseed Oil (Chenopodium ambrosioides)
Chinese thoroughwax (Bupleurum Chinese)
Agrimony (Agrimonia eupatoria), Brooklime (Veronica beccabunga), Cane Reed (Costus speciosa), Catechu (Acacia catechu), Elephant Ears (Bergenia crassifolia), Eucalyptus (Eucalyptus globules), European Mistletoe (Viscum album), Groundsel (Senecio vulgaris), Henbane (Hyoscyamus niger), Horsetail (Equisetum arvense), Lesser Celandine (Ranunculus ficaria), Matico (Piper elongatum), New Jersey Tea (Ceanothus americanus), Periwinkle (Vinca minor), Purple Loosestrife (Lythrum salicaria), Sage (Salvia officinalis), Scotch Broom (Cytisus scoparius), Shepherd’s Purse (Capsella bursa – pastoris)
Basil (Ocimum basilium), Beth Root (Trillium erectum), Bittersweet Nightshade (Solanum nigrum), Black Bryony (Tamus communis), Black Currant (Ribes nigrum), Black Nightshade (Solanum nigrum), Cajuput (Melaleuca leucadendra), Calotropis (Calotropis procera), Comfrey (Symphytum officinale), Cane-Reed (Costus speciosa) German Ipecac (Cynanchum vincetoxicum), Horse Chestnut (Aesculus hippocastanum), Onion (Allium сера), Rue (Ruta graveolens), Smartweed (Persicaria hydropiper), Solomon’s Seal (Polygonatum multiflorum), Spikenard (Aralia racemosa), Tansy (Tanacetum vulgare), Tolu Balsam (Myroxylon balsamum), Turmeric (Curcuma domestica/longa), Vervain (Verbena officinalis), Wild Daisy (Beilis perennis), White Fir (Abies alba)
Hibiscus (Hibiscus sabdarijfa), Tea Tree (Melaleuca alternifolia)
Cornflower (Centaurea cyanus)
Green and White Tea Catechins (Camellia sinensis), Congorosa (Maytenus ilicifolia), Spurge (Euphorbia resinifera)
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Astragalus (Astragalus species), Behen (Moringa oleifera), Black Cohosh (Cimicifuga racemosa), Cat’s Claw (Urticaria tomentosa), Coriander (Coriandrum sativum), Duckweed (Lemna minor), Echinacea (Echinacea angustifolia), Eucalyptus (Eucalyptus globules), Pasque Flower (Pulsatilla pratensis)
Aloe (Aloe barbadensis; Aloe capensis; Aloe vera), Beet (Beta vulgaris), Henna (Lawsonia inermis), Onion (Allium сера), Mountain Laurel (Kalmia latifolia), Poke (Phytolacca americana), Turmeric (Curcuma domestica/longa)
Anemarrhena (Anemarrhena asphodeloides), American Pawpaw (Asimina triloba), Black Nightshade (Solanum nigrum), Burning Bush (Dictamnus albus), Cashew (Anacardium occidental), Coconut Palm (Cocos nucifera), Corydalis (Corydalis cava), Duckweed (Lemna minor), Elecampane (Inula helenium), English Ivy (Hedera helix), Eucalyptus (Eucalyptus globules), Goa Powder (Andira araroba), Ground Ivy (Glechoma hederacea), Heartsease (Viola tricolor), Jack-in-the-Pulpit (Arisaema atrorubens), Kamala (Mallotus philippinensis), Linden (Tilia species), Oak Gall (Qeurcus infectoria), Oats (Avena sativa), Pasque Flower (Pulsatilla pratensis), Pitcher Plant (Sarracenia purpurea), Psyllium (Plantago ovata), Purple Gromwell (Lithospermum erytrorhizon), Tea Tree (Melaleuca alternifolia), Teazle (Dipsacus silvestris), Thuja (Thuja occidentalis), Turmeric (Curcuma domestica/longa), Virola (Virola theiodora), Wild Indigo (Baptisia tinctoria) Agrimony (Agrimonia eupatoria), Arnica (Arnica montana), Bear’s Garlic (Allium ursinum), Behen (Moringa oleifera), Bittersweet Nightshade (Solanum dulcamara), Black Nightshade (Solanum nigrum), Bladderwort (Utricularia vulgaris), Boxwood (Buxus sempervirens), Broad Bean (Vicia faba), Burning Bush (Dictamnus albus), Cashew (Anacardium occidentale), Castor Oil Plant (Ricinus communis), Chaulmoogra (Hydnocarpus species), Chickweed (Stellaria media), Chicory (Cichorium intybus), Club Moss (Lycopodium clavatum), Common Stonecrop (Sedum acre), Congorosa (Maytenus ilicifolia), Cornflower (Centaurea cyanus), Dandelion (Taraxacum officinale), English Ivy (Dedera helix), English Plantain (Plantago lanceolata), European Elder (Sambucus nigra), European Water Hemlock (Cicuta virosa), Evening Primrose (Oenothera biennis), Fenugreek (Trigonella foenum-graecum), Field Scabious (Knautia arvensis), Flax (Linum usitatissimum), Fumitory (Fumaria officinalis), German Chamomile (Matricaria recutita), Haronga (Haronga madagascariensis), Heartsease (Viola tricolor), Henna (Lawsonia inermis), Herb Robert (Geranium robertianum), Hibiscus (Hibiscus sabdarijfa), Horse Chesnut (Aesculus hippocastanum), Houseleek (Sempervivum tectorum), Indian Nettle (Acalypha irtdica), Jambolan (Syzygium cumini), Japanese Mint (Mentha arvensis piperascens), Labrador Tea (Ledum latifolium), Lady’s Mantle (Alchemilla vulgaris), Lycium bark (Lycium chinense), Marigold (Calendula officinalis), Marshmallow (Althaea officinalis), Mezereon (Daphne mezereum), Moneywart (Lysimachia nummularia), Monkshood (Aconitum napellus), Mullein (Verbascum densiflorum), Oak (Quercus robar), Oak Gall (Quercus infectoria), Oats (Avena sativa), Olive (Olea europaea), Pasque Flower (Pulsatilla pratensis), Peanut
(.Arachis hypogaea), Periwinkle (Vinca minor), Purple Gromwell (Lithospermum erytrorhizon), Purple Loosestrife (Lythrum salicaria), Quinine (Circhona pubescens), Red Clover (Trifolium pratense), Rosemary (Rosmarinus officinalis), Rue (Ruta graveolens), Saw Palmetto (Serenoa repens), Scotch Pine (Oinus species), Soapwart (Saponaria officinalis), Spurge (.Euphorbia resinifera), St. John’s Wort (Hypericum perforatum), Tolu Balsam (Myroxylon balsamum), Turmeric (Curcuma domestica/longa), Walnut (Juglans regia), White Lily (Lilium candidum), White Nettle (Lamium album), Witch Hazel (.Hamamelis virginiana), Wormseed Oil (Chenopodium ambrosioides)
Henbane (Hyoscyamus niger), Onion (Allium сера)
Betel Nut (Piper betle), Black Nightshade (Solanum nigrum), Calotropis (Calotropis procera), Cashew (Anacardium
occidentale), Chaulmoogra (Hydnocarpus species), Coriander (Coriandrum sativum), Cumin (Cuminum cyminum), Giant Milkweed (Calotropis gigantea), Gotu Kolu (Centella asiatica), Henna (Lawsonia inermis), Hwema Bark (Corynanthe pachyceras), Jasmine (Jasminum officinale), Kamala (Mallotus philippinensis), Lemongrass (Cymbopogon citrates), Lily- of-the-Valley (Convallaria majalis), Luffa (Luffa aegyptica), Neem (Antelaea azadirachta), Northern Prickly Ash (.Zanthoxylum americanum), Storax (Liquidambar orientalis), Turmeric (Curcuma domestica/longa)
Adrue (Cyperus articulatus), Bugleweed (Lycopus virginicus), Chaste Tree (Vitex agnus-castus), Dandelion (Taraxacum officinale), Pipsissewa (Chimaphalia umbellata)
Speedwell (Veronica officinalis)
Black Currant (Ribes nigrum), Bladderwrack (Fucus vesiculosus), Comfrey (Symphytum officinale), Echinacea (Echinacea angustifolia), Houseleek (Sempervivum tectorum), Indian Nettle (Acalyphia indica), Marshmallow (Althaea officinalis), Onion (Allium сера), Poplar (Populus species), Quince (Cydonia oblongata), Reed Herb (Phragmites communis), Rue (Ruta graveolens), Tobacco (Nicotiana tabacum), White Fir (Abies alba), Wild Indigo (Baptisia tinctoria), Wild Thyme (Thymus serpyllum), Wormwood (Artemisia absinthium)
Butcher’s Broom (Ruscus aculeatus), Buckwheat (Fagopyrum esculentum), Cabbage (Brassica oleracea), Cashew
(.Anacardium occidentale), Chaulmoogra (Hydnocarpus species), Club Moss (Lycopodium clavatum), Evening Primrose (■Oenothera biennis), Fumitory (Fumaria officinalis), Golden Shower Tree (Cassia fistula), Gotu Kola (Centella asiatica), Heartsease (Viola tricolor), Houseleek (Sempervivum tectorum), Jasmine (Jasminum officinale), Knotweed (Polygonum aviculare), Plantain (Musa paradisiaca), Poison Ivy (Rhus toxicodendron), Sarsaparilla (Smilax species), Scarlet Pimpernel (Anagallis arvensis), Scotch Pines (Pinus species), Speedwell (Veronica officinalis), Storax (Liquidambar orientalis), Sweet Gale (Myrica gale), Thyme (Thymus vulgaris), Turmeric (Curcuma domestica longa) Vervain (Verbena officinalis), Wheat (Triticum aestivum), Wild Thyme (Thymus serpyllum)
Wild Carrot (Daucus carota)
Field Scabious (Knautia arvensis), Mullein (Verbascum densiflorum)
(Continued)
Agrimony (Agrimonia eupatoria), Black Nightshade (Solarium nigrum), Burdock (Arctium lappa), Cashew (Anacardium occidentale), Chaulmoogra (Hydnocarpus species), Goa Powder (Andira araroba), Hogweed (Heracleum sphondylium), Mountain Grape (Mahonia aquifolium), Mountain Laurel (Kalmia latifolia), Olive (Olea europea), Pasque Flower (Pulsatilla pratensis), Red Clover (Trifolium pratense), Sarsaparilla (Smilax species), Sunflower (Helianthus annuus)
Sea Buckthorn (Hippophae rhamnoides)
Angelica (Andelica archangelica), Black Catnip (Phyllanthus amarus), Black Pepper (Piper nigrum), Bog Bean (Menyanthes trifoliata), Burning Bush (Dictamnus albus), Carambola (Averrhoa carambola), Celandine (Chelidonium majus), Chaulmoogra (Hydnocarpus species), Field Scabious (Knautia arvensis), Fish Berry (Anamirta cocculus), Gotu Kola (Centella asiatica), Grape (Vitis vinifera), Ground Ivy (Glechoma hederacea), Henna (Lawsonia inermis), Lycium Berries (Lycium barbarum), Morning Glory (Ipomoea hederacea), Oleander (Nerium oleander), Picrorhiza (Picrorhiza kurroa), Plantain (Musa paradisiaca), Plumbago (Plumbago zeylanica), Poisonous Buttercup (Ranunculus sceleratus), Pyrethrum (Chrysanthemum cinerariifolium), Quassia (Picrasma exselsa), Safflower (Carthamus tinctorius), Smartweed (Perisicaria hydropiper), Stavesacre (Delphinium staphisagria)
Bistort (Persicaria bistorta), Coriander (Coriandrum sativum), English Ivy (Hedera helix), Ground Ivy (Glechoma hederacea), Oregano (Origanum vulgare), Stavesacre (Delphinium staphisagria)
Stavesacre (Delphinium staphisagria)
Borage Oil (Borago officinalis), Evening Primrose Oil (Oenthera biennis)
Almond (Prunus dulcis), Avocado (Persea americana), Jojoba (Simmondsia chinesis), Peanut (Arachis hypogaea), Sorb Apple (Sorbus domestica)
Calotropis (Calotropis procera), Cane Reed (Costus speciosa), Cashew (Anacardium occidentale), Contrayerva (Dorstenia contrayerva), Cotton (Gossypium hirsutum), Echinacea (Echinacea angustifolia), German Ipecac (Cynanchum vincetoxicum), Muskmallow (Abelmoschus moschatus), Rauwolfia (Rauwolfia serpentine), Red Sandalwood (Pterocarpus santalinus), Scotch Broom (Cytisus scoparius)
Acacia (Acacia arabica), Agrimony (Agrimonia eupatoria), Amaranth (Amaranthus hypochondriacus), American Pawpaw (Asimina triloba), Anise (Pimpinella anisum), Arnica (Arnica montana), Basil (Ocimum basilicum), Bilberry (Vaccinium myrtillus), Black Currant (Ribes nigrum), Black Pepper (Piper nigrum), Blackberry (Rubas fruticosus), Bladderwort (Utricularia vulgaris), Bugle (Ajuga reptans), Catechu (Acacia catechu), Cayenne (Capsicum annuum), Cinquefoil (Potentilla erecta), Cleavers (Galium aparine), Clove (Syzygium aromaticum), Coffee (Coffea arabica), Colt’s Foot (Tussilago farfara), Comfrey (Symphytun officinale), Echinacea Purpurea (Echinacea purpurea), English Chamomile (Chamaemelum nobile), English Plantain (Plantago lanceolata), Eucalyptus (Eucalyptus globulus),
European Five-Finger Grass (Potentilla reptans), European Golden Rod (Solidago virgaurea), Gambir (Uncaria species), German Chamomile (Matricaria recutita), Herb Robert (Geranium robertianum), Hollyhock (Alcea rosea), High Mallow (.Malva sylvestris), Houseleek (Sempervivum tectorum), Iceland Moss (Cetraria islandica), Jack-in-the-Pulpit (Arisaema atrorubens), Jambolan (Syzygium cumini), Japanese Mint (Mentha arvensis piperascens), Knotweed (Polygonum aviculare), Eady’s Mantle (Alchemilla vulgaris), Larch (Larix decidua), Lesser Galangal (Alpina officinarum), Marigold (■Calendula officinalis), Marshmallow (Althaea officinalis), Myrrh (Commiphora molmol), Oak (Quercus robar), Oak Gall (Quercus infectoria), Onion (Allium сера), Peppermint (Mentha piperita), Pimpinella (Pimpinella major), Potentilla (.Potentilla anserina), Rhatany (Krameria triandra), Rose (Rosa centifolia), Rue (Ruta graveolens), Sage (Salvia officinalis), Scotch Pine (Pinus species), Self-Heal (Prunella vulgaris), Sloe (Prunus spinosa), Speedwell (Veronica officinalis), Spruce (.Picea species), Strawberry (Fragaria vesca), Sweet Violet (Viola odorata), Tamarind (Tamarindus indica), Tea Tree (.Melaleuca alternifolia), Thyme (Thymus vulgaris), Tomato (Lycopersicon esculeutum), Tropical Almond (Terminalis chebula), Turmeric (Curcuma domestica/longa), Usnea (Usnea species), White Nettle (Lamium album), Wild Indigo (Baptisia tinctoria), Willow Herb (Epilobium angustifolium)
Eyebright (Euphrasia officinalis)
Pallidum Brazilian Pepper Tree (Schinus terebinthifolius), Calotropis (Calotropis procera), Dill (Anethum graveolens), Giant Milkweed
(Calotropis gigantea), Gotu Kola (Centella asiatica), Guaiac (Guaiacum officinale), Indian-Hemp (Apocynum cannabinum), Kava Kava (Piper methysticum), New Jersey Tea (Ceanothus americanus), Poke (Phytolacca americana), Sassafras (Sassafras albidum), Stillingia (Stillingia sylvatica)
/ Decubitus, Leg, American Adder’s Tongue (Erythronium americanum), Ash (Fraxinus excelsior), Bilberry (Vaccinium myrtillus), Bittersweet
Nightshade (Solanum dulcamara), Black Nightshade (Solanum nigrum), Burdock (Arctium lappa), Calotropis (Calotropis procera), Cashew (Anacardium occidental), Castor Oil Plant (Ricinus communis), Catechu (Acacia catechu), Cleavers (Galium aparine), Clematis (Clematis recta), Congorosa (Maytenus ilicifolia), Digitalis (Digitalis purpurea), Echinacea (Echinacea angustifolia), English Adder’s Tongue (Ophioglossum vulgatum), English Ivy (Hedera helix), Field Scabious (Knautia arvensis), Frostwort (Helianthemum canadense), Ground Ivy (Glechoma hederacea), Henna (Lawsonia inermis), Indian Nettle (Acaltpha indica), Lady’s Mantle (Alchemilla vulgaris), Linden (Tilia species), Marigold (Calendula officinalis), Martagon (Lilium martagon), Myrrh (Commiphora molmol), Ox-Eye Daisy (Chrysanthemum leucanthemum), Periwinkle (Vinca minor), Petasites (Petasites hybridus), Quinine (Cinchona pubescens), Southern Bayberry (Myrica cerifera), Scurvy Grass (Cochlearia officinalis), Storax (Liquidambar orientalis), Tea Tree (Melaleuca alternifolia), Tolu Balsam (Myroxylon balsamum), Turmeric (Curcuma domestica/longa), Wild Indigo (Baptisia tinctoria), Yellow Lupin (Lupinus leteus)
(Continued)
Ammoniac Gum (Dorema ammoniacum), Beth Root (Trillium erectum), Buckwheat (Fagopyrum esculentum), Butcher’s Broom (Ruscus aculeatus), Clematis (Clematis recta), Club Moss (Lycopodium clavatum), Echinacea (Echinacea angustifolia), Figwort (Scrophularia nodosa), Garlic (Allium sativum), Gotu Kola (Centella asiatica), Grape (Vitis vinifera), Great Burnet (Sanguisorba officinalis), Horse Chestnut (Aesculus hippocastanum), Lemon Verbena (Aloysia triphylla), Marigold (Calendula officinalis), Pimpinella (Pimpinella major), Purple Loosestrife (Lythrum salicaria), Rue (Ruta graveolens), Smartweed (Persicaria hydropiper), Sweet Clover (Melilotus officinalis), Sweet Woodruff (Galium odoratum), Witch Hazel (Hamamelis virginiana), Yarrow (Achillea millefolium)
Behen (Moringa oleifera), Bittersweet Nightshade (Solanum dulcamara), Broad Bean (Vicia faba), Calotropis (Calotropis procera), Cashew (Anacardium occidental), Celandine (Chelidonium majus), Common Stonecrop (Sedum acre), Cypress Spurge (Euphoria cyparissias), Garlic (Allium sativum), Giant Milkweed (Calotropis gigantean), Houseleek (Sempervivum tectorum), Indian-Hemp (Apocynum cannabinum), Mayapple (Podophyllum peltatum), Oats (Averta sativa), Onion (Allium сера), Savin Tops (Juniperus sabina), Scarlet Pimpernel (Anagallis arvensis), Spurge (Euphorbia resinifera), Sundew (Drosera ramentacea)
Agrimony (Agrimonia eupatoria), Alkanet (Alkanna tinctoria), American White Pond Lily (Nymphaea odorata), Ammoniac Gum (Dorema ammoniacum), Ash (Fraxinus excelsior), Basil (Ocimum basilicum), Behen (Moringa oleifera), Beth Root (Trillium erectum), Birthwort (Aristolochia clematitis), Bistort (Persicaria bistorta), Black Catnip (Phyllanthus amarus), Black Currant (Ribes nigrum), Black Nightshade (Solanum nigrum), Bladderwort (Utricularia vulgaris), Blessed Thistle (Cnicus benedictus), Brazillian Pepper Tree (Schinus terebinthifolius), Broad Bean (Vicia faba), Bugle (Ajuga reptans), Burning Bush (Dictamnus albus), Cajuput (Melaleuca leucadendra), Carline Thistle (Carlina acaulis), Cascara Sagrada (Rhamnuspurshiana), Cat’s Claw (Unicaria tomentosa), Catechu
(Acacia catechu), Chickweed (Stellaria media), Cinnamon (Cinnamomum verum), Cinquefoil (Potenilla erecta), Clematis (Clematis recta), Club Moss (Lycopodium clavatum), Coconut Palm (Cocos nucifera), Coffee (Cojfea arabica), Cola (Cola acuminata), Common Kidney Vetch (Anthyllis vulneraria), Common Stonecrop (Sedum acre), Congorosa (Maytenus ilicifolia), Corydalis (Corydalis cava), Costus (Saussurea costus), Date Palm (Phoenix dactylifera), Digitalis (Digitalis purpurea), Dogwood (Cornus florida), Echinacea (Echinacea angustifolia and purpurea), Elm Bark (Ulmus minor), English Ivy (Hedera helix), English Plantain (Plantago lanceolata), English Lavendar (Lavandula angustifolia), Eucalyptus (Eucalyptus globulus), European Goldenrod (Solidago virgaurea), Fenugreek (Trigonella foenum-graecum), Feverfew (Tanacetum parthenium), Galbanum (Ferula gummosa), German Chamomile (Matricaria recutita), Goldenseal (Hydrastis canadensis), Gotu Kola (Centella asiatica), Goutweed (Aegopodium podagraria), Great Burnet (Sanguisorba officinalis), Ground Ivy (Glechoma hederacea), Heather (Calluna vulgaris), Henna (Lawsonia inermis), High Mallow (Malva sylvestris), Horehound (Marrubium vulgare), Horsetail (Equisetum arvense), Hound’s Tongue (Cynoglossum officinale), Houseleek (Sempervivum tectorum),
Iceland Moss (Cetraria islandica), Indian Nettle (Acalypha indica), Jambolan (Syzygium cumini), Jujube (Zyzyphus jujube), Lady’s Bedstraw (Galium verum), Lesser Celandine (Ranunculus ficaria), Licorice (Glycyrrhiza glabra), Loosestrife (Lysimachia vulgaris), Lungwort (Pulmonaria officinalis), Male Fern (Dryopteris fili-max), Marigold (Calendula officinalis), Marsh Marigold (Caltha palustris), Marshmallow (Althaea officinalis), Moneywort (Lysimachia nummularia), Monkshood (Aconitum napellus), Mouse Ear (Pilosella offikinarum), Mullein (Verbascum densiflorum), Myrrh (Commiphora molmol), Nasturtium (Tropaelum majus), Oak Gall (Quercus infectoria), Onion (Allium сера), Ox-Eye Daisy (Chrysanthemum leucanthemum), Petasites (Pentasites hybridus), Peruvian Balsam (Myroxylon balsamum), Pimpinella (Pimpinella major), Pineapple (Ananas comosus), Poplar (Populus species), Poley (Teucrium polium), Quinine (Cinchona pubescens), Rauwolfia (Rawolfia serpentina), Rose (Rosa centifolia), Rosemary (Rosemary officinalis), Safflower (Carthamus tinctorius), Scarlet Pimpernel (Anagallis arvensis), Sea Buckthorn (Hippophae rhamnoides), Shepherd’s Purse (Capsella bursa-pastoris), Slippery Elm (Ulmus rubra), Smartweed (Persicaria hydropiper), Speedwell (Veronica officinalis), Spikenard (Aralia racemosa), Squill (Urginea maritima), St. John’s Wort (Hypericum perforatum), Storax (Liquidambar orientalis), Sunflower (Helianthus annuus), Tansy (Tanacetum vulgare), Teazle (Dipsacus silvestris), Thyme (Thymus vulgaris), Tolu Balsam (Myroxylon balsamum), Traveller’s Joy (Clematis vitalba), Tropical Almond (Terminalia chebula), Turmeric (Curcuma domestica/longa), Vervain
(Verbena officinalis), Virola (Virola theiodora), Water Dock (Rumex aquaticus), Water Germander (Teucrium scordium), White Fir (Abies alba), White Lily (Lilium candidum), White Nettle (Lamium album), White Willow (Salix nigra), Wild Daisy (Beilisperennis), Wild Indigo (Baptisia tinctoria), Willow Herb (Epilobium angustifolium), Witch Hazel (Hamamelis virginiana), Wood Sage (Teucrium scorodonia), Woodsorrel (Oxalis acetosella), Wormwood (Artemisia absinthium), Woundwort (Stachys palustris), Yarrow (Achillea millefolium), Yellow Toadflax (Linaria vulgaris), Zedoary (Curcuma zedoaria)
Xerosis Marigold (Calendula officinalis), Mountain Grape (Mahonia aquifolium)
‘ These herbs are approved by the German Commission E. for this indication.