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Curcumin gel ‘effective in treating burns and scalds’: Where’s the evidence?

Rating

2 Star

Topical curcumin gel effective in treating burns and scalds

Our Review Summary

A case series review published in BioDiscovery follows the recovery of three patients after they are treated with topical curcumin gel. Curcumin is the active substance found in the common spice turmeric, which has been extensively studied in the past half century for its role in treating various conditions. For example, some promising effects have been observed in patients with pro-inflammatory diseases, such as cancer, cardiovascular disease and arthritis.

The news release for this journal article does a good job explaining what curcumin is and how this ingredient is recently the focus of many scientific studies. However, it’s not clear from the news release how effective topical curcumin gel really is in treating burns and scalds. For example, the release states curcumin gel “reduces the severity of injury, lessens pain and inflammation and improves health with less than expected scarring” but doesn’t put the claim in numerical context. Furthermore, there is no discussion in the news release on the study limitations, the main one being that the research article is a case series report with no control group. Therefore, it is impossible to attribute the patients’ outcomes to the gel alone.

There is no mention of costs, harms and conflicts of interest, even though the author of this review is the founder of Omnicure Inc, a company manufacturing and marketing topical curcumin gel. We also question the novelty of this treatment approach, since the same three patient cases detailed in the journal article were published in a book in 2011.

 

Why This Matters

News of an alternative treatment for burns is likely to capture interest since this is a common injury, and scarring is an unfortunate outcome, particularly on the face. Treatment with curcumin is considered to be alternative medicine, but complementary treatments should still be backed up by evidence to prove their safety and effectiveness. Some unconventional cancer therapies, for example, have proven to be ineffective, while some alternative treatments can have potentially dangerous adverse effects and interactions with standard treatments.

In the case with curcumin, a recent article in the Journal of Medicinal Chemistry reviewed more than 120 clinical trials of this active ingredient against several diseases. They found that no double-blinded, placebo controlled clinical trial of curcumin has been successful and concluded that “curcumin is an unstable, reactive, nonbioavailable compound and, therefore, a highly improbable lead.”

Curcumin will continue to be investigated in clinical trials and when its results are reported, it’s up to news release writers and journalists to scrutinize evidence and assess its quality before making  recommendations, even with complementary treatments.

Criteria

Does the news release adequately discuss the costs of the intervention?

Not Satisfactory

Since there is no discussion of costs in the news release, we give it a Not Satisfactory rating here.

A Google search reveals that curcumin gel is available for purchase, mostly in natural food stores and through alternative medicine websites. A 2-oz tub of “Curcumin Gel For Face And Body” from Omnicure sells for about $89. Topical curcumin is also available as a cream, in which a 4-oz. bottle goes for $44.95.

Other companies also market and manufacture topical curcumin gel, but the researcher in this study owns Omnicure shares (see our conflict of interests section).

Does the news release adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The news release doesn’t give any numbers to support the author’s statements about benefits. There is only one paragraph devoted to benefits in the news release, which states the “use of curcumin after burns and scalds were found to reduce the severity of the injury, lessen pain and inflammation, and improve healing with less than expected scarring, or even no scarring, of the affected skin.” Without any numbers, we don’t know the extent of the reduction from this vague, comparative wording. And how were these parameters measured?

The original journal article also doesn’t provide any benefits data. Instead, it shows before and after pictures of three patients and then describes their recovery ranging from one day to six months after treatment.

We still expect the news release to provide the quantitative scope of the potential benefits by asking the researcher to supply these numbers. Since no data are given, we give the news release a Not Satisfactory rating.

Does the news release adequately explain/quantify the harms of the intervention?

Not Satisfactory

Curcumin, the active ingredient of tumeric, is considered to be an alternative therapy. Neither turmeric nor curcumin has been extensively studied in clinical trials, but animal studies have shown that chronic use could lead to stomach ulcers. In addition, the American Herbal Products Association classifies turmeric as a menstrual stimulant. Turmeric should be avoided in patients with bleeding disorders and bile duct obstruction.

Experts believe tumeric is generally safe, although the quality of the available clinical studies is questionable.

An additional potential harm is failure to be treated with appropriate care. We would not want parents of kids with severe burns to forgo appropriate, evidence-based medical care in favor of an alternative over-the-counter product with no scientific evidence to support its use. The last sentence of the news release states that the doctor uses curcumin gel in addition to standard medical treatment. That important bit of information should have been highlighted more prominently in the release so that people skimming the release wouldn’t assume they could attempt to self-treat burns or scalds with curcumin alone.

Since harms weren’t mentioned in the news release we give it a Not Satisfactory rating here.

Does the news release seem to grasp the quality of the evidence?

Not Satisfactory

There are no caveats in the news release about the research type and quality. The published review was a case series, in which three patients were treated with topical curcumin gel.

Case series are usually low on the hierarchy of evidence-based research, since they are anecdotal reports and employ no control group to compare outcomes. As a result, they have little statistical validity.

In this study, all three patients presented with second degree burns, but they were of various ages and followed up for different times. We also don’t know how these patients were treated for their burns apart from curcumin gel application. The news release suggests that they were given standard treatment for their burns, since “Dr. Heng uses curcumin gel for burns, scalds and other skin conditions as complementary treatment.” What standard care were these patients given? And were they all the same? How could these patients’ results be attributed to curcumin gel alone? Might the patients have improved with time without the gel?

Since the news release does not critically evaluate the evidence, we give it a Not Satisfactory rating here.

Does the news release commit disease-mongering?

Satisfactory

There is no disease mongering in the news release. The release provides some context on the medicinal uses of  curcumin throughout history.

Does the news release identify funding sources & disclose conflicts of interest?

Not Satisfactory

The journal article (but not the news release) states that Dr. Heng has shares in Omnicure Inc., a company that manufactures and markets topical curcumin gel. We also found that Dr. Heng is the founder and practicing research physician of this US-based company. Its main product line Psoria-Gold has been used as an anti-inflammatory gel in various spas, health stores and medical clinics in the US and Canada, according to its website. Did the company also help fund the research? That isn’t made transparent in either the news release or the journal article.

Since the news release does not disclose funding sources and conflicts of interest, we give it a Not Satisfactory rating.

Does the news release compare the new approach with existing alternatives?

Not Satisfactory

Although the news release does mention the use of curcumin tablets, we wish it could have gone into depth about some conventional therapies used to minimize scarring after a burn.

There are various ways to treat burns, such as specialty wound dressings and antibiotics to prevent infection and to speed up healing. Careful monitoring for infection is critical. To minimize scarring, some doctors recommend wearing pressure garments, which are tight-fitting clothes to be worn over burned areas. These are worn 23 hours per day (taken off only for bathing) for up to 2 years after the burn. If the burn area is very large, patients may undergo physical therapy. Deep burns could require plastic surgery or skin grafts.

Since none of the more traditional burn treatments are discussed, we give the news release a Not Satisfactory rating here.

Does the news release establish the availability of the treatment/test/product/procedure?

Satisfactory

The news release discusses the uses of curcumin for gastronomical and cosmetic purposes — many of which go back centuries. It adds that medicinal aspects of curcumin have been studied intensely for various human ailments in recent years.

It’s also clear from the news release that patients have the option of taking curcumin tablets orally for “other conditions.” A quick Google search shows that curcumin tablets are available for purchase at health food stores.

For these reasons, we give the news release a Satisfactory rating.

Does the news release establish the true novelty of the approach?

Not Satisfactory

It’s unclear from the news release how exactly this research is novel. Since 2009, researchers have been developing curcumin gel for topical application and studying its effects. Topical curcumin has also been studied in animal models, such as a treatment for burns in rats and for radiation burns in mini-pigs.

In addition, the author of the study Dr. Madalene Heng published a book in August 30, 2011, entitled BURNS & SCARS: Improvement with Curcumin Gel. This book contains numerous before and after photographs — some of which were re-published in the recent BioDiscovery article. In fact, all three patients highlighted in the Feb 24 research paper were drawn from her book.

For these reasons, we give the news release a Not Satisfactory rating.

Does the news release include unjustifiable, sensational language, including in the quotes of researchers?

Satisfactory

The news release does not include unjustifiable, sensational language.

Total Score: 3 of 10 Satisfactory

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