For centuries, the leaves of Plantago major have been used in most regions of the world in traditional medical treatment of wounds and various diseases, including cutaneous conditions (J. Ethnopharmacol. 2000;71:1-21). P. major, also known as broadleaf plantain or greater plantain, is a member of the Plantaginaceae family, which is now widely dispersed throughout the world, though native to much of Europe as well as northern and central Asia. The Norwegian and Swedish name for the plant, groblad, means “healing leaves” (J. Ethnopharmacol. 2000;71:1-21). It was brought to the Americas by Europeans during the colonial period. Native Americans referred to it as the “white man’s footprint,” which inspired the genus name Plantago from the Latin planta (foot) (J. Ethnopharmacol. 2000;71:1-21).
Among the biologically active constituents of P. major are polysaccharides, lipids, caffeic acid derivatives, flavonoids (apigenin, luteolin, scutellarin, baicalein, nepetin, hispidulin, plantagoside), iridoid glycosides (aucubin, catalpol), terpenoids, and alkaloids (J. Ethnopharmacol. 2000;71:1-21; Medical Herbalism: The Science and Practice of Herbal Medicine, 2003, Healing Arts Press). In an ethnopharmacologic and folk medicine survey study of 1,225 residents of the Atlantic coast of Colombia completed in 2011, Gómez-Estrada et al. found that P. major was one of the plants traditionally used to treat inflammation; it also was used to treat kidney pain and eye injuries (J. Ethnobiol. Ethnomed. 2011;7:27). P. major also is traditionally used as a mucilage and bulk laxative (Principles and Practice of Phytotherapy: Modern Herbal Medicine, 2013, Churchill Livingstone).
Wikimedia Commons
Plantago major
Extracts of the plant have been associated with myriad biologic activities, including wound healing, anti-inflammatory, antimicrobial, analgesic, antioxidant, immunomodulating, and antiulcerogenic action, which Samuelsen suggested may account for the use of the botanical in traditional medicine (J. Ethnopharmacol. 2000;71:1-21; Medical Herbalism: The Science and Practice of Herbal Medicine, 2003, Healing Arts Press). In fact, the range of biologic properties attributed to P. major also includes astringent, anesthetic, antihelminthic, analeptic, antihistaminic, antirheumatic, antiviral, antitumor, antiulcer, diuretic, hypotensive, and expectorant activity (Exp. Biol. Med. [Maywood] 2012;237:1379-86). Though not the most popular botanical for this indication, P. major is among the plants used in the treatment of cutaneous leishmanial ulcers in Bahia, Brazil, where Leishmania brazilenesis is endemic (Rev. Soc. Bras. Med. Trop. 1996;29:229-32). Other dermatologic uses in traditional medicine include eczema, cuts, hemorrhoids, ulcerations, and wounds (Medical Herbalism: The Science and Practice of Herbal Medicine, 2003, Healing Arts Press).
Wound healing
The use of P. major for wound healing dates back to the first century, as described by the Greek physician Dioscorides in “De Materia Medica” (J. Ethnopharmacol. 2000;71:1-21).
In 2011, Krasnov et al. developed an experimental model for characterizing proteins and showed that a newly discovered group of tissue-specific biogregulating proteins found previously in animal tissues was also present in P. major and responsible for the wound-healing activity associated with the plant (Prikl Biokhim. Mikrobiol. 2011;47:146-53).
The next year, Thomé et al. investigated and compared the wound-healing effects of P. major and Siparuna guianensis with a commercial product used in Brazil. Mice with cervical dorsal area wounds were treated with the botanical ingredients and the commercial product. Decreases in the wound area occurred earliest in mice treated with P. major, with complete closure (by day 15) seen only in this group. The investigators concluded that their findings support the traditional application of P. major, which shows potential as a viable wound-healing agent (Exp. Biol. Med. [Maywood] 2012;237:1379-86).
Conclusion
The numerous biologic properties of P. major are well established. In addition, use of the plant in traditional medicine for some cutaneous indications warrants consideration for modern therapeutic usage. Much more research is necessary, however, to elucidate the potential incorporation of this botanical into standard topical preparations for any of various skin conditions.
Dr. Baumann is chief executive officer of the Baumann Cosmetic & Research Institute in the Design District in Miami. She founded the Cosmetic Dermatology Center at the University of Miami in 1997. Dr. Baumann wrote the textbook “Cosmetic Dermatology: Principles and Practice” (New York: McGraw-Hill, 2002), and a book for consumers, “The Skin Type Solution” (New York: Bantam Dell, 2006). She has contributed to the Cosmeceutical Critique column in Dermatology News since January 2001. Her latest book, “Cosmeceuticals and Cosmetic Ingredients,” was published in November 2014. Dr. Baumann has received funding for clinical grants from Allergan, Aveeno, Avon Products, Evolus, Galderma, GlaxoSmithKline, Kythera Biopharmaceuticals, Mary Kay, Medicis Pharmaceuticals, Neutrogena, Philosophy, Topix Pharmaceuticals, and Unilever.