In the 2008 edition of "Harrison's Principles of Internal Medicine," University of Alabama Medical School Professor Richard J. Whitely endorses topical application of aluminum acetate solution as a safe, natural treatment for herpes zoster and its characteristic skin rash, shingles. Discovered in the 19th century by ophthalmologist Karl August Burow, aluminum acetate solution forms when the naturally occurring salts of two metals, aluminum and calcium, are combined with water. Historically, aluminum acetate solutions have been used to treat ear infections and skin conditions due to poison ivy, poison sumac, insect bites, athlete's foot and allergic reactions, as well as herpes zoster.
History
In the March 6, 2009 edition of "The Federal Register," the U.S. Food and Drug Administration announced that it was adding aluminum salts to the list of food and drug components that are "generally recognized as safe and effective," or GRASE. This means that manufacturers may market aluminum acetate salts or aluminum acetate solutions as "skin protectants" without submitting a new drug application. Patients can purchase aluminum salts in powder, pencil and liquid forms at conventional drug stores or from naturopaths and internet specialty stores.
Mechanism of Action
According to University of North Carolina dermatologist Craig N. Burkhart, M.D. in the 2008 edition of "Fitzpatrick's Dermatology in General Medicine," aluminum acetate solution works as an astringent. Topical application causes contraction of the tissues, arrest of secretions and inhibition of bleeding. In the case of shingles, aluminum acetate decreases the infiltration of inflammatory mediators within skin. This quells irritation, itching and pain. In addition, says Burkhart, the solution is germicidal, so it decreases the risk of secondary bacterial infections.
Safety
The FDA designates aluminum salts as safe for topical use. Patients should not swallow them, or apply them to internal surfaces, such as the ear canal or nasal passages. Patients who are sensitive to aluminum should not use aluminum salts because this may lead to an allergic reaction. Patients who experience stinging, burning or itching upon application should rinse the treated area with cool water and discontinue use.
Effectiveness
Whitely specifically recommends cool compresses soaked in aluminum acetate solution to "soothe and cleanse" skin affected by shingles. However, randomized clinical trials have not been performed and the FDA does not allow manufacturers of aluminum salts to claim therapeutic benefit in herpes zoster or any other condition.
Dosing & Application
According to Burkhart, aluminum acetate solutions may be applied as a wet dressing, cool compress, soak or bath. In each case, patients should read and follow the manufacturer's directions first to determine the appropriate dilution. Bayer Consumer Care Products, manufacturer of the product Domeboro, recommends limiting use to 15 to 30 minutes per treatment, up to three times per day.
Disclaimer
Aluminum acetate does not replace prescription antiviral drugs as a treatment for herpes zoster. Patients who are not candidates for antiviral drugs may experience relief from shingles rash with aluminum acetate. Patients who are candidates for antiviral drugs may experience additional benefits from concurrent use of aluminum acetate. As with any treatment, patients who use aluminum acetate solutions should always inform their doctors about their use.
References
- "Harrison's Principles of Internal Medicine, 23rd Edition;" A.S. Fauci et al.; 2008
- "Fitzpatrick's Dermatology in General Medicine, 7th Edition;" K. Wolff et al.; 2008
- "Federal Register;" Astringent Drug Products That Produce Aluminum Acetate; Food and Drug Administration; Mar. 6 2009
- Bayer Consumer Care Products: Domeboro Frequently Asked Questions
