Usnea

Category

Herbs & Supplements

Synonyms

Ab-Solution plus®, ascorbic acid, atranorin, barbatic acid, binan, depsides, depsidones, diffractaic acid, dihydrousnic acid, evernic acid, glutinol, isoanhydromethyldihydrousnic acid, isodihydrousnic acid, isolichenin, isomethoxide, lichen, Lipokinetix®, longissiminone A, longissiminone B, methylusnic acid, oak moss extract, old man's beard, parmeliaceae, raffinose, sodium usnate, sodium usnic acid, tree's dandruff, tree moss, woman's long hair, Usnea amblyoclada, Usnea barbata, Usnea complanta, Usnea dasypoga, Usnea diffracta, Usnea fasciata, Usnea florida, Usnea ghattensis, Usnea hirta, Usnea longissima, Usnea rubiginea, Usnea siamensis, Usnea subfloridana, Usneaceae (family), usnic acid, usno, Zeta-N®.

Background

Usnea species are classified as fruticose lichens, which are a symbiosis of fungus and algae. Usnea grows on the bark and wood of coniferous (e.g., spruces, firs, and pines) and deciduous hardwood (e.g., oak, hickory, walnut, apple, and other fruit trees) host trees throughout the northern hemisphere in Asia, Europe, and North America.

Usnea has been used as a therapeutic agent in traditional Chinese medicine (TCM) for thousands of years. Usnea longissima is traditionally taken by mouth for lung and upper respiratory infections, and applied on the skin to treat surface infections or external ulcers. It is still used today in TCM in liquid extract and tincture form to treat tuberculosis lymphadenitis.

Usnic acid is a secondary metabolite uniquely found in all lichens. Usnea or usnic acid has been used as a human papillomavirus (HPV) treatment and as an oral hygiene agent, with limited effectiveness.

Usnic acid is also found in various oral (by mouth) dietary supplements, including Lipokinetix®, marketed as a weight loss agent. However, Lipokinetix® may not be safe and may cause liver damage. Lipokinetix®, now withdrawn from the market, contained phenylpropanolamine (PPA), caffeine, yohimbine hydrochloride, diiodothyronine and usnic acid.

Evidence

DISCLAIMER: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Human papillomavirus: Usnea and usnic acid both are reported in laboratory studies to have antiviral activity. A combination of usnic acid and zinc sulfate may help treat human papillomavirus. Additional study of usnea alone, and not in combination, is needed to a make a strong recommendation.
Grade: C

Oral hygiene: Usnea has been used historically as an oral antibacterial agent, and animal and laboratory studies support this. However, there is currently insufficient available evidence to recommend for or against the use of mouthwashes or rinses containing usnea extracts or usnic acid for oral hygiene.
Grade: C

Tradition

WARNING: DISCLAIMER: The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.
Analgesic (pain reliever), antibacterial, anticoagulant (blood thinning), antifungal, anti-inflammatory, antioxidant, antiparasitic, antipyretic (fever reducer), antiviral, cancer, deodorant, gastric ulcers, headache, lupus, oral hygiene, sunscreen, sunstroke, tetanus, tuberculosis, weight loss, wound healing.

Dosing

Adults (18 years and older):

There is no proven safe or effective dose. However, the German Commission E has approved 1 usnea lozenge (equivalent of 100 milligrams powdered usnea lichen) 3-6 times daily for mouth irritation. Usnea has also been taken by mouth as a powder (100 milligrams three times a day), tea, or tincture (3-4 milliliters three times daily). Usnea has also been applied on the affected area(s) of the skin two or three times daily.

Children (younger than 18 years):

There is no proven safe or effective dose for usnea in children, and use is not recommended.

Safety

DISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Allergies

Avoid in individuals with a known allergy or hypersensitivity to usnea, its constituents, or related lichens. Usnea and its constituents have been reported to cause allergic reactions, such as skin rash, in individuals handling usnea, or using usnic acid vaginally. Deodorant sprays containing usnic acid have been linked to allergic contact eczema.

Side Effects and Warnings

It appears that usnea is not well tolerated in humans except when applied on the skin or used as a homeopathic agent. The chemical constituent usnic acid has been reported in laboratory studies to be toxic, and dietary supplement products containing usnic acid have been reported to cause liver damage. Based on available research, only preparations of homeopathic usnea are recommended for oral (taken by mouth) use at this time.

Usnea and usnic acid may cause contact dermatitis that may lead a hypersensitivity reaction, including urticaria ("hives"), rhinitis (runny or congested nose), asthma, or photoallergic contact dermatitis.

Although not well studied in humans, usnic acid may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

Pregnancy and Breastfeeding

Usnea or usnic acid is not recommended in pregnant or breastfeeding women based on a lack of available scientific evidence.

Interactions

Interactions with Drugs

Usnea may increase bleeding time by inhibition of platelet aggregation. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Some examples of drugs that increase the risk of bleeding include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix ®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®). Dosing adjustments may be necessary.

Usnea may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be decreased in the blood, and reduce the intended effects. Patients taking any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

Interactions with Herbs and Dietary Supplements

Usnea may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Usnea may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may become too low in the blood. It may also alter the effects that other herbs or supplements potentially may have on the P450 system.

Attribution

This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Brent Bauer, MD (Mayo Clinic); Idy Chu, PharmD (Massachusetts College of Pharmacy); Molly Davis, PharmD (University of Rhode Island); Nicole Giese, MS (Natural Standard Research Collaboration); Ernest B. Hawkins, MS, BSPharm (Health Education Resources); Petra Jancar, PharmD (University of Ljubljana); Brian Szczechowski, PharmD (Massachusetts College of Pharmacy); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Wendy Weissner, BA (Natural Standard Research Collaboration).

Bibliography

DISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

Aalto-Korte K, Lauerma A, Alanko K. Occupational allergic contact dermatitis from lichens in present-day Finland. Contact Dermatitis 2005;52(1):36-38.

Arneborn P, Jansson A, Bottiger Y. [Acute hepatitis in a woman after intake of slimming pills bought via Internet]. Lakartidningen 7-11-2005;102(28-29):2071-2072.

Behera BC, Verma N, Sonone A, et al. Antioxidant and antibacterial activities of lichen Usnea ghattensis in vitro. Biotechnol Lett 2005;27(14):991-995.

Behera BC, Verma N, Sonone A, et al. Evaluation of antioxidant potential of the cultured mycobiont of a lichen Usnea ghattensis. Phytother.Res 2005;19(1):58-64.

Choudhary MI, Azizuddin Jalil S, Atta ur Rahman. Bioactive phenolic compounds from a medicinal lichen, Usnea longissima. Phytochemistry 2005;66(19):2346-2350.

De Carvalho EA, Andrade PP, Silva NH, et al. Effect of usnic acid from the lichen Cladonia substellata on Trypanosoma cruzi in vitro: an ultrastructural study. Micron. 2005;36(2):155-161.

Halici M, Odabasoglu F, Suleyman H, et al. Effects of water extract of Usnea longissima on antioxidant enzyme activity and mucosal damage caused by indomethacin in rats. Phytomedicine 2005;12(9):656-662.

Hsu LM, Huang YS, Chang FY, et al. 'Fat burner' herb, usnic Acid, induced acute hepatitis in a family. J Gastroenterol.Hepatol. 2005;20(7):1138-1139.

Kathirgamanathar S, Williams DE, Andersen RJ, et al. Beta-orcinol depsidones from the lichen Usnea sp. from Sri Lanka. Nat Prod Res 2005;19(7):695-701.

Lee KA, Kim MS. Antiplatelet and antithrombotic activities of methanol extract of Usnea longissima. Phytother Res 2005;19(12):1061-1064.

Mayer M, O'Neill MA, Murray KE, et al. Usnic acid: a non-genotoxic compound with anti-cancer properties. Anticancer Drugs 2005;16(8):805-809.

Odabasoglu F, Cakir A, Suleyman H, et al. Gastroprotective and antioxidant effects of usnic acid on indomethacin-induced gastric ulcer in rats. J Ethnopharmacol 1-3-2006;103(1):59-65.

Saenz MT, Garcia MD, Rowe JG. Antimicrobial activity and phytochemical studies of some lichens from south of Spain. Fitoterapia 2006;77(3):156-159.

Sanchez W, Maple JT, Burgart LJ, et al. Severe hepatotoxicity associated with use of a dietary supplement containing usnic acid. Mayo Clin Proc 2006;81(4):541-544.

Wang XP, Liu HJ, Zhen L, et al. [Plasmid elimination effect of usnic acid on antibiotic-resistant Staphylococcus aureus]. Zhong.Yao Cai. 2006;29(1):36-39.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.