Mechanistic Evidence Supporting Topical Natural Remedies from Traditional Persian Medicine for Common Signs of Atopic Dermatitis

Atopic dermatitis is a common global inflammatory skin condition. While standard treatments involve emollients, corticosteroids, and immunomodulators, patient adherence is low, largely due to concerns over side effects and steroid-phobia. Consequently, many patients use complementary herbal medicine. This study reviews topical natural treatments from traditional Persian medicine (TPM) to evaluate their relevance to atopic dermatitis symptoms and their potential for use in integrative therapy. Medicinal plants were selected based on repeated mentions in thirteen major TPM textbooks, and their reported anti‑inflammatory, antipruritic, and skin‑hydrating effects were examined using recent experimental and clinical literature retrieved from major electronic databases (Scopus, PubMed, Cochrane Library, ScienceDirect, and Google Scholar). Nineteen individual medicinal substances were identified in TPM sources for treating symptoms compatible with atopic dermatitis. Modern data indicate that frankincense (Boswellia serrata Roxb.) and honey possess all three desired properties—anti‑inflammatory, antipruritic, and skin‑hydrating—whereas most other agents show at least one of these actions, predominantly via down‑regulation of inflammatory mediators and, in some cases, modulation of itch signalling and improvement of skin barrier or hydration parameters. This review suggests that natural substances recommended in TPM may help mitigate atopic dermatitis symptoms through these complementary mechanisms. However, evidence is heterogeneous and often limited to preclinical or small clinical studies, underscoring the need for well‑designed clinical trials before any evidence‑based clinical recommendations can be made.