Herbal remedy may aid bruising after face-lift

NEW YORK (Reuters Health) - The herbal remedy arnica seems to help lessen the bruising that often comes with plastic surgery, according to a small study published Monday.

The study, of 29 face-lift patients, tested the effects of an oral preparation of arnica, an herb derived from the Arnica montana plant (also known as wolf's bane) that has long been used as a homeopathic remedy for bruising, swelling and muscle soreness.

Homeopathy is based on the theory that "like cures like." The idea is to use minute, heavily diluted doses of substances that, in larger amounts, would cause the symptoms being treated.

Arnica is toxic if taken in a strong enough dose, but proponents say that in homeopathic doses, the plant has a range of uses -- one of the most popular being as a banisher of bruises.

Bruises form when tiny blood vessels are damaged by an impact and begin to bleed under the skin. Some lab research has suggested that arnica has anti-inflammatory substances that may act on these blood vessels and minimize bruising.

Arnica is often sold in health food stores as a topical ointment, but can also be taken in pill form.

In fact, many surgeons have started giving oral arnica to their patients as a way to minimize post-operative bruising, Dr. Corey S. Maas, the senior author of the new study, told Reuters Health.

The research evidence on arnica, however, has been mixed. Some studies have found the herb to be no better than a placebo in helping bruises to heal.

For their study, Maas and his colleagues assessed an arnica product, sold as SinEcch, that is marketed specifically for reducing bruising and swelling following plastic surgery. Alpine Pharmaceuticals, the maker of SinEcch, partially funded the study.

The 29 face-lift patients were randomly assigned to take 12 doses of either arnica pills or placebo pills, starting on the morning of their surgery. During their recovery, photographs were taken to chart the changes in facial bruising. The patients also rated their own impressions of their healing.

Overall, there were no clear differences between the groups in terms of how well they thought their bruises were healing. In both groups, it took about 11 days, on average, for patients to "feel comfortable going out to dinner."

But by objective measures --a "trained eye" looking at patients' photographs -- the arnica group did come out on top, according to Maas, a plastic surgeon who directs the Maas Clinic in San Francisco.

Specifically, arnica patients' bruises tended to be smaller, particularly on the first day after surgery and one week later. They also showed a different pattern in bruise healing - steadily improving after the first post-operative day, whereas placebo patients tended to get worse before improving.

Maas said larger studies are needed to measure the true effectiveness of arnica in speeding plastic surgery patients' recovery. A larger study, he noted, might have uncovered differences in patients' impressions of their healing.

As for people who use arnica cream for everyday bruises, the current findings may have little relevance. For one, Maas said, it's not clear that common topical arnica preparations penetrate the skin enough to have much impact on bruises.

SOURCE: Archives of Facial Plastic Surgery, January/February 2006.