The efficacy of topical Marham-e-Akbar in chronic atopic dermatitis – an open-label interventional study

Objectives
Chronic atopic dermatitis (AD) is an inflammatory skin condition marked by intense pruritus, dry skin, and severe impact on the life quality of the patients. Conventionally, it is managed by using emollients, calcineurin inhibitors, and topical corticosteroids. In Unani medicine, eminent scholars advocated many drug formulations including topical Marham-e-Akbar for effective healing of AD but scientific evidence is scarce. Hence, this study was designed.

Methods
This was a single-arm clinical trial conducted on 30 participants aged 18–65 years suffering from chronic AD after obtaining written informed consent. The trial intervention was Marham-e-Akbar consisting of Murdār Sang (Plumbi oxidum); Sindūr (red lead); olive oil (Olea europaea oil); Kath (Acacia catechu extract); Safeda Kāshgari (Zinc oxide); Sirka (vinegar); and Phitkirī (alum) to be applied twice daily for 42 days. The objective parameters were SCORAD and DLQI, while the subjective parameters included itching, scaling, and erythema assessed on a customized VAS scale and 4-point Likert scale.

Results
The pre-post analysis inferred statistically significant attenuation in subjective parameters (itching, scaling, and erythema) and objective scales (SCORAD) and (DLQI) with p<0.001.

Conclusions
The study findings deduced that Marham-e-Akbar is effective in the amelioration of chronic atopic dermatitis and quality of life of the patients as well.