The use of Arnica in Plastic Surgery

The use of Arnica in Plastic Surgery

Arnica montana, is a European flowering plant in the sunflower family which is noted for its large yellow flower head. The main constituents of are essential oils, fatty acids, thymol, pseudoguaianolide sesquiterpene lactones and flavanone glycosides.

Arnica montana has a history of medicinal use dating back to the 1500s and patients have been using Arnica to help reduce post-surgical swelling and bruising. It is postulated that Arnica’s actions may be due to two chemicals called helenalin and dihyrdohelenalin.

In plastic surgery where bruising and swelling can be more apparent the widespread use of arnica has often been recommended even though the evidence has been somewhat contradictory.

A recent randomized, placebo-controlled trial study from Holland has evaluated arnica and its effect on patients undergoing blepharoplasty surgery. The authors evaluated patients who had undergone bilateral upper blepharoplasty patients into two study arms: One received arnica ointment 10% and the other a placebo ointment. The periorbital area of the treated side received either arnica or placebo ointment, whereas the opposite periorbital area received no ointment and served as an internal control. The overall periorbital appearance was assessed by a medical and nonmedical panel using light photography at 3 days, 7 days and 6 weeks. Swelling, pain, ecchymosis (bruising), erythema and patient satisfaction with recovery/outcome were also assessed.

The study found no significant differences between arnica and placebo justifying the conclusion:-

“Our study demonstrates that the use of topical arnica after upper blepharoplasty does not reduce postoperative ecchymosis, erythema, swelling, or pain of the eyelids, nor does it increase patient satisfaction with postoperative recovery or outcome.”

As the authors suggest this study should provide guidance to patients and clinicians about the role of arnica in postoperative recovery.

Mr Ross believes that patients should be empowered to make their own decisions regarding the use of Arnica Montana and does not routinely recommend its use within his plastic surgery practice.


Reference

Van exsel DC, Pool SM, Van uchelen JH, Edens MA, Van der lei B, Melenhorst WB. Arnica Ointment 10% Does Not Improve Upper Blepharoplasty Outcome: A Randomized, Placebo-Controlled Trial. Plast Reconstr Surg. 2016;138(1):66-73.