title: Is There a Role for Arnica and Bromelain in Prevention of Post-Procedure Ecchymosis or Edema? A Systematic Review of the Literature.
abstract: BACKGROUND
  The management of postprocedure skin care is of significant interest to dermatologists and other physicians. Ecchymosis and edema are common temporary postprocedure unwanted effects. Two botanically-derived products, arnica and bromelain, are used internationally by physicians to limit ecchymosis and edema that occur secondary to cosmetic, laser, and surgical skin procedures.
  
  
  OBJECTIVE
  The authors review the published literature and provide evidence-based recommendations on arnica and bromelain for prevention and treatment of postprocedure ecchymosis and edema.
  
  
  METHODS
  A search of the computerized bibliographic databases Medline, EMBASE, Scopus, and CINAHL was performed on March 23, 2015. The key terms used were "arnica," and "bromelain."
  
  
  RESULTS
  This review contains clinical trials that evaluated prevention and/or treatment of postprocedure ecchymosis or edema with oral arnica (11), topical arnica (2), and oral bromelain (7). No studies on topical bromelain were found. Clinical trials on arnica and bromelain have demonstrated mixed results. Some randomized controlled trials reported improvement postprocedure with arnica (4/13) and bromelain (5/7).
  
  
  CONCLUSIONS
  Based upon published studies, there is insufficient data to support use of arnica and bromelain post procedure, and the authors recommend additional research to determine the efficacy and safety of arnica and bromelain to prevent and/or treat ecchymosis and edema in patients.
authors.affiliation: *Dermatology Service, Sacramento VA Medical Center, Mather, California; †Department of Dermatology, University of California Davis, Sacramento, California; ‡Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York; §Department of Dermatology, The Icahn School of Medicine of Mount Sinai, New York, New York; ‖Private Practice Waldorf Dermatology and Laser Associates PC, Nanuet, New York.
authors.forename: Derek
authors.initials: D
authors.lastname: Ho
authors.forename: Jared
authors.initials: J
authors.lastname: Jagdeo
authors.forename: Heidi A
authors.initials: HA
authors.lastname: Waldorf
mesh_terms: D018650:Arnica; D001963:Bromelains / Q000627:therapeutic use*; D062109:Dermatologic Surgical Procedures; D004438:Ecchymosis / Q000517:prevention & control*; D004487:Edema / Q000517:prevention & control*; D006705:Homeopathy; D006801:Humans; D010936:Plant Extracts / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*
chemical_list: D010936:Plant Extracts; D001963:Bromelains