A double-blind randomized trial demonstrates the role of zonal priming&direct topical application of epigallocatechin-3-gallate in modulation of cutaneous scarring in human skin.
J Invest Dermatol. 2019 Feb 26. Epub 2019 Feb 26. PMID: 30822414
BACKGROUND: Epigallocatechin-3-gallate (EGCG), a polyphenol, influences cutaneous wound healing due to its anti-angiogenic, anti-inflammatory and anti-oxidant properties. We previously demonstrated the role of EGCG in scarring in ex vivo human scar models. Here, we evaluate direct application of topical EGCG compared with zonal-priming, a unique concept in immediate treatment of zone-of-injury at the time of wounding prior to scar formation.
TRIAL DESIGN: A double-blind randomised-controlled trial.
METHODS: We assessed EGCG application compared to placebo over 1-6 weeks, in scars created in 62 human volunteers using quantitative non-invasive devices, immunohistochemical analysis, mRNA sequencing and QRT-PCR of tissue-biopsies.
RESULTS: EGCG reduced mast cells at weeks 1-3 evidenced by gene and protein analyses (p≤0.01). M2 macrophages were increased with EGCG compared to placebo. EGCG application by zonal-priming significantly downregulated VEGFA and CD31 at week 1 and 2-4 weeks after direct application (p≤0.01). Direct EGCG application also reduced scar thickness at weeks 1-3 (p=0.001), and increased scar elasticity at week 4 (p=0.01). Increased hydration was evident both non-invasively and by increased hyaluronic acid (p<0.01) at week 3.
CONCLUSIONS: We demonstrate the beneficial role of both zonal priming and direct EGCG application in scar therapy with positive effect on scar thickness, erythema, hydration and elasticity.