Common herbal remedies, adverse reactions, and dermatologic effects.

Herbal remedies (phytomedicines) possess significant biological activity and pharmacologic efficacy. Consequently, they may manifest potential adverse effects and drug interactions. The expansion in sales of herbal remedies has brought products to the marketplace that do not always conform to the standards of safety and efficacy that physicians and patients have come to expect. Relatively few physicians inquire about herbal medicine use, and up to 70% of patients do not reveal their use of herbal medicines to their physicians and pharmacists. All physicians should question patients regarding their use of herbal remedies and document their responses in the medical record. Patients should be aware that potentially limited standardization and quality control, and somewhat circumscribed regulation, may result in variability in content, efficacy, and potential contamination of herbal remedies. Physicians in general, and specifically dermatologists, should be aware of potential adverse reactions related to the use of certain herbal remedies. Specific cautions exist with regard to dermatologic side effects such as contact dermatitis, blisters, urticaria, angioedema, ulceration, photosensitization, and changes in skin pigmentation.