Topical Glycyrrhiza Glabra gel/guar gum mixture accelerates healing and scar reduction in second-degree burns: A randomized triple-blind controlled trial

Burn injuries remain a major clinical challenge, particularly in resource-limited settings where safe, effective, and affordable topical therapies are essential. Glycyrrhiza glabra (licorice root) has long been recognized for its anti-inflammatory, antioxidant, and antimicrobial properties, yet its efficacy in human burn wound management remains underexplored. The current study aims to evaluate the therapeutic effects of a 5% G. glabra gel formulated in a guar gum base on wound healing and scar outcomes in patients with second-degree burns. 48 adult patients with superficial or deep second-degree burns (<10% TBSA) were randomly assigned to receive either a topical G.glabra gel (n=24) or standard silver sulfadiazine (SSD) cream (n=24). The primary outcome was time to complete wound healing. Secondary outcomes included changes in Vancouver Scar Scale (VSS) scores and subcomponents (vascularity, height, pliability, pigmentation, pain, and pruritus) assessed on Days 1, 7, 14, and 21. The total phenolic content of the extract was measured spectrophotometrically. The G.glabra group showed significantly faster wound closure (mean 11.75 ± 3.80 vs. 16.33 ± 3.76 days, p<0.001) and greater reductions in total VSS score by Day 21 (p<0.001). All VSS components showed full resolution in the treatment group, compared to partial recovery in controls. Total phenolic content of the extract was 55.96 mg GAE/g, supporting its bioactive potential. Topical application of G.glabra gel significantly accelerated burn wound healing and scar resolution compared to standard treatment. These findings support the integration of phytotherapeutic agents in modern burn care and warrant further large-scale trials.