THE DERMATOLOGICAL REVIVAL OF ECHINACEA PURPUREA: A COMPREHENSIVE SYSTEMATIC REVIEW OF CLINICAL EFFICACY IN ATOPIC DERMATITIS AND ACNE VULGARIS WITH ADVANCES IN LIPOSOMAL DELIVERY TECHNOLOGY

Abstract

Echinacea purpurea (L.) Moench has a long history in traditional medicine for its immunomodulatory properties. Recent research has increasingly explored its dermatological applications. This systematic review synthesizes current evidence on its phytochemistry, mechanisms of action, clinical efficacy, safety profile, and advanced liposomal delivery strategies in the management of inflammatory skin disorders, particularly atopic dermatitis (AD) and acne vulgaris.A thorough search of PubMed, Scopus, Web of Science and Google Scholar. The search was done with the following keywords: Echinacea purpurea, alkylamides, (Jan 2000-Feb 2025).atopic dermatitis, acne vulgaris, cannabinoid receptor, and liposomes. Included studies were in the form of randomized controlled trials, mechanistic and clinical studies, formulation studies, and meta-analyses. Quality of the studies was evaluated with the help of CONSORT and PRISMA guidelines.

Findings: 85 studies were included out of 847 records that were identified.. Alkylamides, such as dodeca-2E,4E,8Z,10Z-tetraenoic acid isobutylamide, selectively activated CB2 receptors, suppressing IL-6 (67.3%, p<0.01), IL-8 (71.8%, p<0.01), TNF-α (58.2%, p<0.01), and COX-2 in keratinocytes.A randomized trial on 60 individuals showed that topical.E. purpurea extract (alkylamides standardized) decreased the SCORAD by 7.2 points (p<0.01), Increased ceramide EOS by 34.2% (p<0.001) and cholesterol by 28.7% (p<0.01), and improved Lipid lamellae organization..Preclinical studies showed MIC₉₀ against C. acnes at 0.5 mg/mL, with more than 94% reversal of bacteria-induced IL-6/IL-8 secretion (p<0.001). Human patch tests (n=110) confirmed no irritation or sensitization.Liposomal formulations achieved 63–75% entrapment efficiency, a half-life of 6.2 h, and enhanced cytoprotection (89.3% vs. 62.1% viability, p<0.01)^.Six major research gaps were highlighted. Echinacea purpurea functions as a multifunctional dermatological agent addressing inflammation and barrier dysfunction in AD and acne via CB2 receptor activation. Liposomal delivery enhances its therapeutic effectiveness, and a 10-year research agenda has been proposed to guide regulatory development.

PROSPERO Registration: Registered under Id 1339784.