ARTÍCULO

Ethnopharmacological survey of medicinal plants used to treat skin diseases among herbal shops in Jahrom, Iran

FARZANEH KHAJOEI NASAB¹, MASOUMEH ZARE², AHMADREZA MEHRABIAN¹ & ALI AKBAR GHOTBI-RAVANDI¹

¹ Department of Plant Sciences and Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, IR-1983969411 Tehran, Iran
² R&D Department, Tinjin Mei Xin trading international Co., CN-300041 Tianjin, China

ORCID iD. F. KHAJOEI NASAB: https://orcid.org/0000-0002-2325-9555,
M. ZARE: https://orcid.org/0000-0003-3820-6445, A. MEHRABIAN: https://orcid.org/0000-0001-6633-3092,
A. A. GHOTBI-RAVANDI: https://orcid.org/0000-0002-9937-7232

Author for correspondence: A. A. Ghotbi-Ravandi (a_ghotbi@sbu.ac.ir)

Editor: T. Garnatje

ABSTRACT
Ethnopharmacological survey of medicinal plants used to treat skin diseases among herbal shops in Jahrom, Iran.— Among the most common illnesses affecting people’s lives are skin disorders, for which a variety of therapeutic approaches has been suggested. Traditional herbal remedies can be counted among the best therapies for such diseases. Herbal shops, or “attaris” (in Persian), play a major role in the traditional therapy of each region. This study investigated the medicinal plants commonly prescribed and traded in herbal shops of Jahrom, Iran, to cure skin diseases. Ethnomedicinal data were collected using the snowball method for 38 plant species belonging to 34 families. A semi-structured questionnaire was used to collect information from herbal shops. Asteraceae, with five species, was the most dominant medicinal family of the prescribed plants, and the fruits, seeds, and leaves of plants are the parts most used. Herbal mask (36%) was the most common mode of herbal drug preparation. The medicinal herbs prescribed by herbal healers are often used for the treatment of acne (36%) as well as for strengthening, clarifying, and giving freshness to the skin (26%). These medicinal plants may be candidates for the development of novel herbal skincare products. The findings of this research revealed that the herbal healers of Jahrom have an outstanding knowledge of traditional treatments for skin diseases.
KEY WORDS: acne; Asteraceae; skin disease; traditional herbal medicine.

RESUMEN
Encuesta etnofarmacológica sobre plantas utilizadas en enfermedades de la piel en herboristerías de Jahrom, Irán.— Entre las enfermedades más comunes que afectan a la vida de las personas se encuentran los trastornos de la piel, para los que se han sugerido diversos enfoques terapéuticos. Los remedios tradicionales a base de plantas pueden contarse entre las mejores terapias para estas enfermedades. Las herboristerías, o “attaris” (en persa), juegan un papel importante en la terapia tradicional de cada región. En este estudio se inventariaron las plantas medicinales comúnmente recetadas y comercializadas en las herboristerías de Jahrom, Irán, para curar enfermedades de la piel. Los datos etnomedicinales se recolectaron mediante el método de bola de nieve para 38 especies de plantas pertenecientes a 34 familias. Se utilizó un cuestionario semiestructurado para recolectar información de las herboristerías. Las Asteraceae, con cinco especies, fueron la familia botánica más citada, y los frutos, semillas y hojas de las plantas fueron las partes más utilizadas. La mascarilla a base de plantas (36%) fue la forma más común de preparación. Las plantas medicinales prescritas por los curanderos se utilizan a menudo para el tratamiento del acné (36%), así como para fortalecer, aclarar y dar frescura a la piel (26%). Estas especies pueden ser candidatas para el desarrollo de nuevos productos a base de plantas para el cuidado de la piel. Los resultados de esta investigación revelaron que los curanderos de Jahrom tienen un elevado conocimiento de los tratamientos tradicionales para las enfermedades de la piel.
PALABRAS CLAVE: acné; Asteraceae; enfermedades de la piel; medicina tradicional a base de plantas.

CONTENTS

INTRODUCTIONTop

Skin is a part of the integumentary system of the body and has a total surface area of about two square meters. Being the largest organ of the body, it serves several critical functions such as creating a protective barrier, regulating body temperature, and providing sensation among others (Gebelein, 1997Gebelein, C. G. 1997. Chemistry and our world. Wm. C. Brown Publishers, Dubuque.). During an individual’s life from infancy to old age, various disorders and diseases may affect the skin. Several factors, including genetics, poor diet, stress, and inner emotions as well as exposure to UV radiation and airborne pollutants, may contribute to the development of skin diseases. It has been estimated that skin diseases account for approximately 34% of all diseases encountered worldwide (Śpiewak, 2000Śpiewak, R. 2000. Occupational skin diseases among farmers. In: Zagorski, J. (Ed.), Occupational and para-occupational diseases in agriculture. Institute of Agriculture Medicine, Lublin: 142–152 (in Polish).; Abbasi et al., 2010Abbasi, A., Khan, M. A., Ahmad, M., Zafar, M., Jahan, S. & Sultana, S. 2010. Ethnopharmacological application of medicinal plants to cure skin diseases and in folk cosmetics among the tribal communities of North-West Frontier Province, Pakistan. Journal of Ethnopharmacology 128: 322–335. https://doi.org/10.1016/j.jep.2010.01.052). Currently, skin diseases impose major burdens on both developed and developing countries (WHO, 2005WHO [World Health Organization] 2005. Epidemiology and management of common skin diseases in children in developing countries. WHO, Geneva. Retrieved April 7, 2005, from https://apps.who.int/iris/handle/10665/69229; Afsar, 2010Afsar, F. S. 2010. Skin infections in developing countries. Current Opinion in Pediatrics 4: 459–466. https://doi.org/10.1097/MOP.0b013e32833bc468).

The search for natural remedies for use in skincare has received a great deal of interest from the scientific community in recent years. According to the World Health Organization (WHO), 80% of the world’s population is primarily dependent on indigenous medicine (Robinson & Zhang, 2011Robinson, M. M. & Zhang, X. 2011. The World medicines situation 2011. Traditional medicines: global situation, issues and challenges. World Health Organization, Geneva. ). About 33% of all traditional therapies are prescribed for the treatment of dermatological disorders (Annan & Houghton, 2008Annan, K. & Houghton, P. J. 2008. Antibacterial, antioxidant and fibroblast growth stimulation of aqueous extracts of Ficus asperifolia Miq. and Gossypium arboreum L., wound healing plants of Ghana. Journal of Ethnopharmacology 119: 141–144. https://doi.org/10.1016/j.jep.2008.06.017). Traditional medicinal resources, especially plants, play a major role in the treatment of a variety of dermatological conditions (Saikia et al., 2006Saikia, A. P., Ryakala, V. K., Sharma, P., Goswami, P. & Bora, U. 2006. Ethnobotany of medicinal plants used by Assamese people for various skin ailments and cosmetics. Journal of Ethnopharmacology 106: 149–157. https://doi.org/10.1016/j.jep.2005.11.033). Many modern drugs and medicines have originated from ethnic herbal medicine. In recent years, a variety of herbal medicines for the treatment of skin diseases has been marketed globally. Boiron UAS, Cortizone 10®, and Kamillosan® are examples of therapeutic plant products. Other creams, gels, lotions, and ointments are produced from herbal ingredients, including Aloe vera (L.) Burm. f. leaf juice, Boswellia serrata Roxb. gum, Zingiber officinale Roscoe root extract, Calendula officinalis L. flower extract, and Matricaria L. spp. flower extract. Two creams made with a calendula base are Calendula Burn, applied for minor and moderate burns, and Calendula (Calendula L. spp.) and Borage (Borago officinalis L.), used to treat eczema. “Cortizone 10®” and “Kamillosan Salbe®” medical ointments are made with Matricaria chamomilla L. (Chamomile) extract and are commonly found in markets throughout the world.

Each ethnic culture has a traditional knowledge of plants found in the surrounding environment that are specially used to treat a variety of diseases. Indigenous people of any region, including rural residents, herbal healers, and vendors of medicinal plants, play an important role in collecting ethnobotanical data on medicinal plants. Traditional herbal shops, commonly known as “attaris” in Persian, are deeply involved in the trade and culture of each area and are thus important to ethnopharmacological studies (Mati & De Boer, 2011Mati, E. & De Boer, H. 2011. Ethnobotany and trade of medicinal plants in the Qaysari Market, Kurdish Autonomous Region, Iraq. Journal of Ethnopharmacology 133: 490–510. https://doi.org/10.1016/j.jep.2010.10.023). Investigating herbal shops and medicinal plant stores can bring to light valuable information about the use of medicinal plants and their natural products for the treatment of various diseases. Ethnobotanical surveys on herbal shops have already been conducted in some parts of the world, including Iraq, West Africa, and Bolivia (Macía et al., 2005Macía, M. J., García, E. & Vidaurre, P. J. 2005. An ethnobotanical survey of medicinal plants commercialized in the markets of La Paz and El Alto, Bolivia. Journal of Ethnopharmacology 97: 337–350. https://doi.org/10.1016/j.jep.2004.11.022; Mati & De Boer, 2011Mati, E. & De Boer, H. 2011. Ethnobotany and trade of medicinal plants in the Qaysari Market, Kurdish Autonomous Region, Iraq. Journal of Ethnopharmacology 133: 490–510. https://doi.org/10.1016/j.jep.2010.10.023; Quiroz et al., 2014Quiroz, D., Towns, A., Legba, S. I., Swier, J., Brière, S., Sosef, M. & van Andel, T. 2014. Quantifying the domestic market in herbal medicine in Benin, West Africa. Journal of Ethnopharmacology 151: 1100–1108. https://doi.org/10.1016/j.jep.2013.12.019).

Iran’s unique plant diversity makes it one of the world’s top ten centers of plant speciation (Noroozi et al., 2019Noroozi, J., Naqinezhad, A., Talebi, A., Doostmohammadi, M., Plutzar, C., Rumpf, S. B., Asgarpour, Z. & Schneeweiss, G. M. 2019. Hotspots of vascular plant endemism in a global biodiversity hotspot in Southwest Asia suffer from significant conservation gaps. Biological Conservation 237: 299–307. https://doi.org/10.1016/j.biocon.2019.07.005). The exceptional plant diversity found in Iran has given rise to differing plant-based traditional remedies across the country. Indigenous people from different parts of Iran use a variety of plant species for the traditional treatment of diseases (Ghorbani, 2005Ghorbani, A. 2005. Studies on pharmaceutical ethnobotany in the region of Turkmen Sahra, North of Iran (Part 1): general results. Journal of Ethnopharmacology 102: 58–68. https://doi.org/10.1016/j.jep.2005.05.035; Khajoei Nasab & Khosravi, 2014Khajoei Nasab, F. & Khosravi, A. R. 2014. Ethnobotanical study of medicinal plants of Sirjan in Kerman Province, Iran. Journal of Ethnopharmacology 154:190–197. https://doi.org/10.1016/j.jep.2014.04.003). Although different ethnobotanical surveys have documented medicinal plants from several regions of Iran, no systematic investigation has been conducted on the ethnopharmacological application of medicinal plants used to treat skin diseases in the southeast of Iran. Despite the existence of numerous herbal shops in every region of the country, only a few ethnobotanical studies have been conducted in Iran with a particular emphasis on herbal shops (Amiri & Joharchi, 2013Amiri, M. S. & Joharchi, M. R. 2013. Ethnobotanical investigation of traditional medicinal plants commercialized in the markets of Mashhad, Iran. Avicenna Journal of Phytomedicine 3: 254–271.). The current research is the first to study the traditional treatment of skin diseases using plants available in herbal shops in southeastern Iran. The region is rich in plant diversity and has an abundance of medicinal plants; thus, indigenous people of this region have developed a substantial ethno-medical tradition. The aim of the present study was to investigate the plants and plant-based products prescribed and supplied by local herbal healers in Jahrom for the treatment of different skin conditions. Herein we report the ethnobotany of medicinal plants claimed to be effective in treating skin diseases.

MATERIALS AND METHODSTop

Study area

Jahrom is located 170 kilometers southeast of Shiraz, the capital of Fars Province, Iran. It is the largest city in the southern half of the province. The study area is located at 28° 30′ 00″ N and 53° 33′ 38″ E (Fig. 1). With a population of 14,130 inhabitants, Jahrom covers 5498 km² and is at an average altitude of 1050 m above sea level. A hot and arid climate with an average temperature around 19.5°C is dominant in this city. January (average temperature = 2°C) and July (average temperature = 40.5°C) are the coldest and hottest months of the year, respectively (Ghanbarian et al., 2011Ghanbarian, G. A., Jafari, E. & Hatami, A. 2011. Presentation of flora, life forms and chorology of plant species in the Jahrom area (Fars Province, Iran). European Journal of Biology 70(2): 1–11.). Average annual rainfall measures about 200–500 mm. Calcareous, clay, and gypsum are the main soil types, and Jahrom’s vegetation is classified as woodland, scrubland, and subtropical annual grassland in 1,393,693 ha. Date palms, citrus, and many tropical and sub-tropical plants are grown in Jahrom, and the city’s economy is based mainly on agriculture and horticulture.

Figure 1. (A), map of Iran showing Fars Province; (B), Jahrom district. [View full size] [Descargar tamaño completo]

Collecting ethnopharmacological data

An ethnopharmacological survey of herbal shops in Jahrom city was conducted using the snowball method (Espinosa et al., 2014Espinosa, M. M., Bieski, I. & Martins, D. T. O. 2014. Probability sampling design in ethnobotanical surveys of medicinal plants. Revista Brasileira de Farmacognosia 22: 1362–1367. https://doi.org/10.1590/S0102-695X2012005000091). A total of 21 herbal shops are located in the city, of which 16 agreed to cooperate in the current study. The aims of the present study were described to the participating herbal healers, and consent to participate was obtained from each of them according to the code of ethics of the International Society of Ethnobiology (ISE) (Hardison & Bannister, 2011Hardison, P. & Bannister, K. 2011. Ethics in ethnobiology: History, international law and policy, and contemporary issues. In: Anderson, E. N., Pearsall, D., Hunn, E. & Turner, N. (Eds.), Ethnobiology. Wiley-Blackwell, Washington: 27–49. https://doi.org/10.1002/9781118015872.ch3). Semi-structured questionnaires were applied to systematically collect data on the treatment of skin diseases using herbal medicines (Appendix 1). Interviews were conducted in Persian with the herbal healers in their shops and included questions regarding their knowledge of various skin diseases, demographic characteristics (name, age, sex, years of experience, education), and data on medicinal plants (local names of plants, parts of plants used, methods of preparation and application of drugs). Plant specimens were identified using Flora of Iran (Assadi, 1988–2015Assadi, M. (Ed.) 1988–2015. Flora of Iran 1–77. Research Institute of Forests and Rangelands, Tehran.) and Flora Iranica (Rechinger, 1965–2016Rechinger, K. H. (Ed.) 1965–2016. Flora Iranica 1–164. Akademischer Druch-u, Verlagsanstat, Graz.), and vouchers were deposited in the herbarium of Shahid Beheshti University (HSBU).

RESULTS AND DISCUSSIONTop

Demographic information of herbal healers

Approximately 87% of participants in this study were men; only two participants (about 13%) were women. The age of herbal healers ranged between 24–55 years with an average of 38 years. The highest level of education was a high school diploma (56%). None of the participants had an academic education in a field related to herbal medicine. Most of their knowledge had been obtained only through experience or from the legacy of past generations (68%). Only 32% of participants used traditional medicine books in addition to personal experience.

Ethnomedicinal data

A total of 38 species belonging to 34 genera and 23 families of medicinal plants were obtained in this study (Fig. 2; Table 1). Asteraceae (5), Fabaceae (3), and Malvaceae (3) were the most frequently used plant families, respectively (Fig. 3). Asteraceae with 23,600 species is one of the largest families of flowering plants, and most of the medicinal plants reported in many ethnopharmacological studies worldwide belong to this family (Ghorbani, 2005Ghorbani, A. 2005. Studies on pharmaceutical ethnobotany in the region of Turkmen Sahra, North of Iran (Part 1): general results. Journal of Ethnopharmacology 102: 58–68. https://doi.org/10.1016/j.jep.2005.05.035; Leitão et al., 2013Leitão, F., Leitão, S. G., Almeida, M. Z., Cantos, J., Coelho, T. & da Silva, P. E. 2013. Medicinal plants from open-air markets in the State of Rio de Janeiro, Brazil as a potential source of new antimycobacterial agents. Journal of Ethnopharmacology 149: 513–521. https://doi.org/10.1016/j.jep.2013.07.009). More than 50% of all species are annual herbs (Fig. 4), and 79% of them are native to Iran. The most used parts of plants for treating skin diseases were the fruits, seeds, and leaves (Fig. 5). Herbal mask (36%) was the most common mode of herbal drug preparation (Fig. 6). The use of an herbal mask is a simple and safe method with low complications. Because of the dust and toxic particles suspended in the air of Iran resulting from industrial pollution, exhaust fumes from automobiles, advancing deserts, and forest fires, using an herbal mask can help significantly reduce dermal complications resulting from air-borne pollutants. Medicinal herbs prescribed by herbal healers are often used for the treatment of acne (36%) as well as strengthening, clarifying, and adding freshness to the skin (26%) (Fig. 7). Acne is the 8th most common disease around the world affecting many people in their lifetimes (Tan & Bhate, 2015Tan, J. K. L. & Bhate, K. 2015. A global perspective on the epidemiology of acne. The British Journal of Dermatology 172: 3–12. https://doi.org/10.1111/bjd.13462). Poor diet, hormonal changes, genetic factors, and inadequate cleansing of the skin are factors in acne. Considering the profusion of acne cases among the world’s population, the utilization of herbal medicine is a cheap but effective method to treat this condition, especially in developing countries.

Figure 2. Some medicinal plants prescribed in skin disease by attars of Jahrom. [View full size] [Descargar tamaño completo]

Figure 3. Medicinal plant families used for skin diseases in Jahrom region, Fars province. [View full size] [Descargar tamaño completo]

Figure 4. Percentage of biological forms of plants use for skin diseases in Jahrom region, Fars province. [View full size] [Descargar tamaño completo]

Figure 5. Plant part use of plants use for skin diseases in Jahrom region, Fars province. [View full size] [Descargar tamaño completo]

Figure 6. Number of plant species in each medicinal manner of use for skin diseases in Jahrom region, Fars province. [View full size] [Descargar tamaño completo]

Figure 7. Number of species in each medicinal use category of plants use for skin diseases in Jahrom region, Fars province. [View full size] [Descargar tamaño completo]

Phytochemicals of collected plants effective on the skin

Phytochemicals are chemical compounds found naturally in plants. Each plant species contains a variety of chemical compounds which, in most cases, are unique to the species. These compounds are produced and stored in different parts of the plant and can be used as pharmaceutical raw materials. Antioxidant, anticancer, and antimicrobial activities, stimulating the immune system, and affecting hormone metabolism are among some of the known properties of secondary plant compounds, which make phytochemicals suitable for preventing or treating a diverse range of diseases. Alkaloids, terpenoids, fatty acids, phenolic compounds are among the most important phytochemicals existing in medicinal plants. Interestingly, many phytochemicals which are known to contribute to the treatment of dermatological diseases and skincare were found in the plants collected in the current study (Table 1).

Electronic databases including Google Scholar, PubMed, and Web of Science were searched for the scientific names of all species and the keywords “chemical profiling” and “pharmacological properties”. An extensive number of studies published in various journals was collected, including research reports, review articles, book chapters, and books. The literature was divided into different sections based on the title and abstract, and all non-relevant and duplicate articles were removed. Finally, some of the newest articles with a comprehensive amount of information were selected.

Comparing the results of the present study with those of previous works on phytochemicals revealed that herbal medicines prescribed by herbal healers in the Jahrom region comprise the most efficient and suitable natural compounds for the treatment of skin diseases. For example, tannins, which have astringent properties and cause the coagulation of albumin, are found in Lawsonia inermis L. (henna) and Ziziphus spina-christi (L.) Willd., both of which are rich in tannins and are suitable herbal remedies for the treatment of acne (Maleki et al., 2007Maleki, F., Delgoshaee, F., Khakzad, M. R., Wejdanparast, M. & Zakerian, B. 2007. The efficacy of alcoholic extracts of camomile, henna, cedar, Aloe vera on experimental contact dermatitis (C.D.) in mice. Journal of Ardabil University of Medical Sciences 7: 302–307. ). The skin softening properties of saponins, mucilage, and salicylic acid which are abundant in the Viola L. species make this species a great candidate for remedies to soften and refresh skin (Bedi & Shenefelt, 2002Bedi, M. K. & Shenefelt, P. D. 2002. Herbal therapy in dermatology. Archives of Dermatological Research 138: 232–242. https://doi.org/10.1001/archderm.138.2.232). Amino acids, with their great water holding capacity, can promote freshness in skin and represent an effective treatment for dry skin (e.g. in Aloe vera; Maleki et al., 2007Maleki, F., Delgoshaee, F., Khakzad, M. R., Wejdanparast, M. & Zakerian, B. 2007. The efficacy of alcoholic extracts of camomile, henna, cedar, Aloe vera on experimental contact dermatitis (C.D.) in mice. Journal of Ardabil University of Medical Sciences 7: 302–307. ). Fumaric acid found in Fumaria L. is effective in curing skin disorders (Khalighi Sigaroodi et al., 2005Khalighi Sigaroodi, F., Yazdani, D., Taghi Zadeh, M. & Rezazadeh, S. 2005. Quantitative determination of an effective component of Fumaria parviflora Lam. Journal of Medicinal Plants 4: 71–62.). Wheat germ (the flour of embryos of wheat grains) is rich in vitamins A and E as well as antioxidants and can be considered a potent softening and moisturizing agent for skincare (Bakhtiyari & Radan, 2013Bakhtiyari, Z. & Radan, M. R. 2013. Pharmacological effects of medicinal plants on skin. Journal of Dermatology and Cosmetics 4: 98–106.). Moreover, vitamin A is a rejuvenating and anti-aging agent which stimulates the formation of new cells and helps reduce wrinkling (Gediya et al., 2011Gediya, S. K., Mistry, R. B., Patel, U. K., Blessy, M. & Jain, H. N. 2011. Herbal plants: used as a cosmetics. Journal of Natural Product and Plant Resources 1: 24–32.). In Matricaria chamomilla (chamomile), linoleic and oleic fatty acids and chamazulene improve the process of wound healing and water retention in the horny layer of the skin (Maleki et al., 2007Maleki, F., Delgoshaee, F., Khakzad, M. R., Wejdanparast, M. & Zakerian, B. 2007. The efficacy of alcoholic extracts of camomile, henna, cedar, Aloe vera on experimental contact dermatitis (C.D.) in mice. Journal of Ardabil University of Medical Sciences 7: 302–307. ).

Medicinal plants for skin treatment in other parts of Iran and the world

Some of the plant species presented in the current study, such as Trigonella foenum-graecum L., Lawsonia inermis, Olea europaea Wall. & G. Don, Nigella sativa L., Urtica dioica L., and Aloe vera, are also used in other parts of Iran and the world to treat skin disease (Malik et al., 2019Malik, K., Ahmad, M., Zafar, M., Ullah, R., Majid Mahmood, H., Parveen, B., Rashid, N., Sultana, S., Shah, S. N. & Lubna. 2019. An ethnobotanical study of medicinal plants used to treat skin diseases in northern Pakistan. BMC Complementary and Alternative Medicine 19: 210–248. https://doi.org/10.1186/s12906-019-2605-6; Nambejja et al., 2019Nambejja, C., Tugume, P., Nyakoojo, C. & Kamatenesi-Mugisha, M. 2019. Medicinal plant species used in the treatment of skin diseases in Katabi Sub-County, Wakiso District, Uganda. Ethnobotany Research & Applications 20: 1–17.; Sinkar & Samarth, 2019Sinkar, S. R. & Samarth, V. D. 2019. Medicinal plants used for the treatment of various skin disorders by a rural community in Warud region of Maharashtra. The Pharma Innovation Journal 8: 791–794.; Tsioutsiou et al., 2019Tsioutsiou, E. E., Giordani, P., Hanlidou, E., Biagi, M., De Feo, V. & Cornara, L. 2019. Ethnobotanical study of medicinal plants used in Central Macedonia, Greece. Hindawi Evidence-Based Complementary and Alternative Medicine 1: 1–22. https://doi.org/10.1155/2019/4513792). Similar to the indigenous people of Jahrom, the locals of Central Macedonia and Greece use Matricaria chamomilla, for wound healing (Ghafari et al., 2017Ghafari, S., Fahimi, Sh. & Sahranavard, Sh. 2017. Plants used to treat hyperpigmentation in Iranian traditional medicine: a review. Research Journal of Pharmacognosy (RJP) 4: 71–85.; Tsioutsiou et al., 2019Tsioutsiou, E. E., Giordani, P., Hanlidou, E., Biagi, M., De Feo, V. & Cornara, L. 2019. Ethnobotanical study of medicinal plants used in Central Macedonia, Greece. Hindawi Evidence-Based Complementary and Alternative Medicine 1: 1–22. https://doi.org/10.1155/2019/4513792). Silybum marianum (L.) Gaertn., Alcea rosea L., Malva sylvestris L., Rosa ×damascena Herrm., Urtica dioica, Cucumis sativus L., Ficus carica L., and Trigonella foenum-graecum are used globally for the treatment of hyperpigmentation (Ghafari et al., 2017Ghafari, S., Fahimi, Sh. & Sahranavard, Sh. 2017. Plants used to treat hyperpigmentation in Iranian traditional medicine: a review. Research Journal of Pharmacognosy (RJP) 4: 71–85.). Trigonella foenum-graecum is used in Jahrom and northern Pakistan to treat wounds (Malik et al., 2019Malik, K., Ahmad, M., Zafar, M., Ullah, R., Majid Mahmood, H., Parveen, B., Rashid, N., Sultana, S., Shah, S. N. & Lubna. 2019. An ethnobotanical study of medicinal plants used to treat skin diseases in northern Pakistan. BMC Complementary and Alternative Medicine 19: 210–248. https://doi.org/10.1186/s12906-019-2605-6). Cucumis sativus in Katabi, Uganda (Nambejja et al., 2019Nambejja, C., Tugume, P., Nyakoojo, C. & Kamatenesi-Mugisha, M. 2019. Medicinal plant species used in the treatment of skin diseases in Katabi Sub-County, Wakiso District, Uganda. Ethnobotany Research & Applications 20: 1–17.) and Calendula officinalis, in the Warud region of Maharashtra, India (Sinkar & Samarth, 2019Sinkar, S. R. & Samarth, V. D. 2019. Medicinal plants used for the treatment of various skin disorders by a rural community in Warud region of Maharashtra. The Pharma Innovation Journal 8: 791–794.) are used to treat different skin diseases. Cichorium intybus L. is used traditionally by the indigenous people of Urmia, Iran, for head itching (Baharvand-Ahmadi et al., 2015Baharvand-Ahmadi, B., Bahmani, M., Naghdi, N., Saki, K. & Rafieian-kopaei, M. 2015. Medicinal plants used to treat infectious and non-infectious diseases of skin and skin appendages in city of Urmia, northwest Iran. Der Pharmacia Lettre 7: 189–196.). The indigenous people of Jahrom and Chagharzai Valley (in Pakistan) use C. officinalis to treat skin diseases (Sheri et al., 2011Sheri, Z., Khan, Z. D. & Hussain, F. 2011. Ethnobotanical studies of some plants of Chagharzai Valley, district Buuner. Pakistan Journal of Botany 43:1445–1452.). Punica granatum L. and C. sativus have the same therapeutic use for the treatment of skin disorders in Jahrom and the northwest Frontier Province of Pakistan (Abbasi et al., 2010Abbasi, A., Khan, M. A., Ahmad, M., Zafar, M., Jahan, S. & Sultana, S. 2010. Ethnopharmacological application of medicinal plants to cure skin diseases and in folk cosmetics among the tribal communities of North-West Frontier Province, Pakistan. Journal of Ethnopharmacology 128: 322–335. https://doi.org/10.1016/j.jep.2010.01.052). Senna alexandrina Mill. is used to treat pimples in Jahrom and northwest Punjab, Pakistan (Gul et al., 2012Gul, F., Shinwari, Z. K. & Afzal, I. 2012. Screening of indigenous knowledge of herbal remedies for skin diseases among local communities of North west Punjab, Pakistan. Pakistan Journal of Botany 44: 1609–1616.). Descurainia sophia (L.) Webb ex Prantl and L. inermis (henna) are used as traditional herbal medicines in Jahrom and in the Saravan region of Iran (Sadeghi et al., 2014Sadeghi, Z., Kouhestani, K., Abdollahi, V. & Mahmood, A. 2014. Ethnopharmacological studies of indigenous medicinal plants of Saravan region, Baluchistan, Iran. Journal of Ethnopharmacology 153: 111–118. https://doi.org/10.1016/j.jep.2014.01.007). Malva sylvestris is a common medicinal plant for the treatment of skin diseases in Sirjan, Saravan, and Jahrom (Khajoei Nasab & Khosravi, 2014Khajoei Nasab, F. & Khosravi, A. R. 2014. Ethnobotanical study of medicinal plants of Sirjan in Kerman Province, Iran. Journal of Ethnopharmacology 154:190–197. https://doi.org/10.1016/j.jep.2014.04.003; Sadeghi et al., 2014Sadeghi, Z., Kouhestani, K., Abdollahi, V. & Mahmood, A. 2014. Ethnopharmacological studies of indigenous medicinal plants of Saravan region, Baluchistan, Iran. Journal of Ethnopharmacology 153: 111–118. https://doi.org/10.1016/j.jep.2014.01.007). Fumaria parviflora Lam. has the same therapeutic use on the skin in the Hormozgan province of Iran as it does in Jahrom (Safa et al., 2013Safa, O., Soltanipoor, M., Rastegar, S., Kazemi, M., Nourbakhsh Dehkordi, K. & Ghannadi, A. 2013. An ethnobotanical survey on Hormozgan province, Iran. Avicenna Journal of Phytomedicine 3: 64–81.).

CONCLUSIONSTop

Documentation of traditional medical practices is of a great importance for the preservation the knowledge and possible new drug discoveries. The purpose of the present study was to assess and document the knowledge of herbal healers in the traditional treatment of skin diseases and ensure the accuracy of traditional herbal remedies recommended by these therapists. This study was the first documentation of herbal medicines prescribed for skincare in southeastern Iran. The results demonstrated that the use of traditional medicinal plants for skincare is still prevalent in this region. Diverse plant-based remedies are prescribed by local herbal shops and healers for the treatment of a variety of skin-related conditions. By reviewing previously published literature on the phytochemical composition of plants included in the present research, it can be concluded that the herbal medicines are being prescribed accurately for the treatment of skin diseases. Further exploration of the phytochemicals of these medicinal plants may lead to the discovery of novel skincare products.

ACKNOWLEDGMENTSTop

The authors thank all attars and traditional therapists who participated in the survey.

REFERENCESTop

APPENDIX 1. Semi-structured questionnaire used in the interviews, in English and the original Persian versions Top

(In English) [View full size] [Descargar tamaño completo]

(In Persian) [View full size] [Descargar tamaño completo]