Current therapeutic goals of wound treatment focus on the reduction of scar formation and severity. However, scar formation itself varies not only between individuals based on factors such as ethnicity, but also within an individual based on the location of the wound. Therefore, the ability to customize treatments for individual patients represents an important therapeutic opportunity.
The objective of a case series by Banov et al. was to evaluate the utility of fatty acids found in pracaxi oil for wound and scar therapy. Initially, 21 patients with various surgical, traumatic, or burn wounds and scars were enrolled. A topical anhydrous silicone base containing pracaxi oil was applied alone, or was compounded to include one or more additional medications tailored to the specific needs of each patient, such as 1% pentoxifylline, 1% caffeine, 1% tranilast, or 2% mupirocin. Patients were advised to apply the compounded topical medication to new or existing scar or wound areas by lightly massaging the compound into and around the scar or wound. The recommended application frequency was two to four times daily based on the attributes of the scar or wound. The mean duration of application of the compounded topical anhydrous base containing pracaxi oil was 11 days and ranged from 48 hours to 3 weeks based on the size and severity of the wound or scar.
Wound/scar photographs taken before and after application of the compounded pracaxi oil topical formulation (with/without additional ingredients) were reviewed and adjudicated by a blinded dermatology reviewer. In all seven cases that were available for analysis, patients reported improvement in scar and wound size, severity, color, or pain after application of the compounded medication. Patients rated their satisfaction with treatment highly, with a mean score of 10 on a rating scale of 1-10. Retrospective review of wound/scar photographs demonstrated clinically relevant improvements in wound attributes as assessed by a dermatologist. Six of the seven wounds examined were considered "much improved" from baseline.
Pracaxi oil contains high amounts of oleic, linoleic, and behenic fatty acids, which are frequently utilized in the cosmetic industry and have been shown to enhance wound closure and improve healing in several wound models. Fatty acids are integral to the formation and maintenance of cell membranes within the stratum corneum, the layer of the skin that provides a barrier to the environment and regulates permeability. In addition, fatty acids have lubricant, emollient, and anti-inflammatory properties, which help to restore the natural oils of the skin and protect the skin from environmental damage.
Pracaxi oil can aid in the delivery of topical bactericidal and collagen-modifying drugs during wound healing and scar formation. During this study, tranilast and pentoxifylline, inhibitors of collagen synthesis and wound contraction, respectively, were added to the compounded medicine for one patient. As collagen is the major protein deposited during scar formation, inhibition of its synthesis leads to decreased scar formation. Caffeine was also added to the compounded preparation to increase the flow of blood to the area and to aid in healing. In another patient, the bactericidal agent mupirocin was compounded with the topical anhydrous silicone base containing pracaxi oil to prevent infection. The ability to add these types of active ingredients to this base may allow for the treatment of more severe and more complex lesions, such as burns and diabetic ulcers.
Examples of wounds that responded to treatment in this case series included traumatic injury to the elbow, radiation burns to the head, severe facial burns on an infant, and diaper rash.
In conclusion, application of a compounded anhydrous silicone base containing pracaxi oil alone or in combination with other active substances led to considerable improvements in wound healing and scar attributes and is a potentially useful option in the treatment of burns or surgical, or traumatic wounds and scars.
Dermatol Ther (Heidelb). 2014 Dec;4(2):259-69.
