Abstract:
The invention provides compositions comprising oleum hyoscyami together with a pharmaceutical carrier or excipient and a method for the prevention or treatment of scar tissue whereby existing scar tissue or a wound or surgical incision is treated topically with oleum hyoscyami.

Description:
DESCRIPTION 
     This invention relates to a method and composition for the treatment of scars. 
     Hypertrophic scars and keloids are an almost inevitable result of injury and surgery and hitherto there has been no available method for their prevention or removal. A number of techniques have been proposed for the elimination of scars, such as treatments with hydrocortisone, collagen, vitamins such as Vitamins E and A, and extracts from animal organs such as placenta, but no reliably effective composition or method has been discovered. 
     We have now found that the active components of oleum hyoscyami are surprisingly effective in the prevention and elimination of scars. This oil has been known from ancient times for the alleviation of tooth and ear pains; the oil has always hitherto been used as such, however, and has never been associated in any with the treatment of wounds or scars. 
     We have now found that regular application of oleum hyoscyami either to a healing wound or surgical incision or to an existing scar is remarkably effective in preventing or removing the formation of disfiguring scar tissue. 
     The active components of oleum hyoscyami are parasympathetic-blocking alkaloids such as atropine, scopolamine and hyoscyamine, as well as copper phyllocyanates. It appears that all these components exert a surprisingly beneficial action upon the scar tissue. 
     According to the present invention, therefore, we provide a method for the prevention or elimination of scars whereby a wound or surgical incision or an existing scar is treated with a parasympathetic-blocking alkaloid such as atropine, scopolamine or hyoscyamine, and/or a copper phyllocyanate. In general, the above active substances will be used in combination in the form of oleum hyoscyamine. 
     The above active substances may be applied to the affected area prophylactically or post-operatively for a period of 2-3 weeks after the injury or surgical treatment. In this way it is normally possible to avoid formation of disfiguring scars, contractures or keloids. The active material can also be applied to hypertropic keloid-forming scar tissues after surgical operations, for example skin transplants, and also in the case of burns and wounds. Even where a second corrective operation is required, the treatment according to the invention can provide advantageous pre-treatment. In general, the redness of fresh scar tissues is more rapidly returned to the normal skin colour. 
     In general, oleum hyoscyami comprises the active components in a vegetable oil such as arachis oil. According to the Pharmacopoeia Helvetia, VI, page 391,  the oil is formed by moistening leaves of hyoscyamus (100 g) and copper powder R (3 g) with 94% aqueous ethanol (100 g) and 10% aqueous ammonia (50 g) and allowed to stand for 24 hours in a covered container. The mixture is then heated on a water bath with vigorous stirring with arachis oil pre-heated to 60°-70° C. until the smell of ammonia has disappeared and the oil has clarified. After removal of the solids and pressing, the liquid is filtered. The preparation contains about 0.005% alkaloids as bases and copper phyllocyanate formed by reaction of the copper with extracted chlorophyll. 
     According to the invention, the active components of the oleum hyoscyami are preferably formulated in compositions together with pharmaceutical carriers and/or excipients. 
     The formulations should be suitable for topical application by rubbing on to the scar tissue and may thus comprise creams, emulsions, lotions, oils, gels and aerosols. 
     Creams and emulsions may comprise water-in-oil emulsions which are readily applied to the skin and lead to good absorption of the active components. The compositions may advantageously contain oil-soluble vitamins A and E as well as water-soluble vitamins, which are particularly favourable for skin treatment, such as vitamins of the B complex. Amino acid-containing complexes are also of use, for example collagen, which regulates the water-uptake of the skin. 
     Oil-in-water emulsions are also possible for the formulation of creams and lotions. 
     In general emulsions will contain appropriate surfactants which are preferably non-ionic. Suitable surfactants include glyceryl esters of long-chain fatty acids such as triglyceryl diisostearate, conveniently in a mixture with long-chain fatty acid ethanolamides such as isostearic acid diethanolamide, or glyceryl monostearate; alkoxylated long-chain alcohols such as ethoxylated or propoxylated lanolin alcohol; alkoxylated fatty acid esters, e.g. ethoxylated esters; sugar alcohol esters of long-chain fatty acids such as sorbitan sesquioleate. Oils and waxes may conveniently be present, such as white paraffin wax or bleached beeswax, microcrystalline wax, paraffin oil and synthetic waxes such as polyethylenes. A preservative will commonly be present. 
     Oily preparations may contain oils in addition to the arachis oil in the oleum hyoscyami, for example esters of long chain fatty acids such as isopropyl palmitate, isoadipate or myristate or ethylhexyl palmitate. 
     Gels according to the invention may comprise thickening agents based on silica, for example Aerosil 200 (Degussa). 
     Aerosol formulations may, for example, take the form of aerosol foams which may contain, for example, about 50% oleum hyscyami. Suitable propellants include propane/butane, isobutane, carbon dioxide and fluorinated hydrocarbons. Aerosols have the advantage of easy application, sterile packaging and convenient in carrying. 
     In all of the above formulations, the content of oleum hyoscyami will range between 10% and 60%. A preferred level is about 50%. 
     In general, the semi-solid formulations such as creams, emulsions, gels and aerosol foams are preferred to the liquid oils. 
     The hyoscyamus leaves used as starting material in the preparation of the oil are described in detail in European Pharmacopoeia, Volume 1, page 289. 
    
    
     The following examples are given by way of illustration only: 
     EXAMPLE 1 
     
         ______________________________________Non-ionic water-in-oil emulsifying agent*                    3,00%Hydroxylated lanolin     2,20%Cera alba                15,00%Methyl p-hydroxybenzoate 0,20%Oleum hyoscyami (Ph.H.VI)                    50,00%Collagen 15%, (sterile-filtered)                    5,00%Polyethylene-glycol B.P. 5,00%Perfume oil              0,70%Demineralised water, sterile-filtered                    ad. 100,00%______________________________________ 
    
     EXAMPLE 2 
     
         ______________________________________Hydroxylated lanolin     2,20%Oleum hyoscyami          50,00%Non-ionic water-in-oil emulsifying agent*                    3,00%Beeswax, bleached        15,00%p-Hydroxybenzoic acid methyl ester                    0,20%p-Hydroxybenzoic acid propyl ester                    0,02%Polyethylene-glycol B.P. 5,00%Perfume oil              0,50%Demineralised water, sterile-filtered                    ad. 100,00%______________________________________ *Mixture of triglyceryl diisostearate and isostearoyl diethanolamide. 
    
     The above components are formed into a water-in-oil emulsion by conventional techniques. 
     EXAMPLE 3 
     
         ______________________________________Hydroxylated lanolin    3,00%Oleum hyoscyami         50,00%Beeswax, bleached       10,00%Propyl ester of lanolin alcohol                   2,00%Glyceryl-monostearate   2,00%Micro-wax               5,00%Borax                   0,60%p-Hydroxybenzoic acid methyl ester                   0,20%p-Hydroxibenzoic acid propyl ester                   0,02%Propylene-glycol        5,00%Perfume oil             0,50%Demineralised water, sterile-filtered                   ad. 100,00%______________________________________ 
    
     The above components are formed into a water-in-oil emulsion by conventional techniques. 
     EXAMPLE 4 
     
         ______________________________________Microwax                24,00%Paraffin wax (hard)     20,50%Propoxylated lanolin alcohol with5 Mol. Propylene-oxide  2,00%Lanolin alcohol absorption base                   0,30%Oleum hyoscyami         50,00%Perfume oil             0,50%p-Hydroxybenzoic acid methyl ester                   0,15%p-Hydroxybenzoic acid propyl ester                   0,02%Demineralised water, sterile-filtered                   ad. 100,00%______________________________________ 
    
     The above components are formed into a water-in-oil emulsion by conventional techniques. 
     EXAMPLE 5 
     
         ______________________________________Oleum hyoscyami         50,00%Sorbitan sesquioleate   3,00%AC-Polyethylene         10,00%Hydroxylated lanolin    2,00%Cis-1-1-(3 chloroallyl)-3,5,7-triaza-1-azoniaadamantane chloride                   0,10%Sorbitol                5,00%Perfume oil             0,50%Demineralised water, sterile-filtered                   ad. 100,00%______________________________________ 
    
     The above components are formed into a water-in-oil emulsion by conventional techniques. 
     EXAMPLE 6 
     
         ______________________________________Oleum hyoscyami         16,00%Stearic acid            8,00%Cetyl alcohol           1,00%Polyoxyethylene fatty acid ester                   5,00%Propylen glycol         3,50%Cis-1-1-(3 chloroallyl)-3,5,7-triaza-1-azoniaadamantane chloride                   0,20%Perfume oil             0,20%Demineralised water, sterile-filtered                   ad. 100,00%______________________________________ 
    
     The above components are formed into a water-in-oil emulsion by conventional techniques. 
     EXAMPLE 7 
     
         ______________________________________Diethanolamine cetyl-phosphate complex                     3,00%Wool wax alcohol          5,00%Paraffin oil perl.        5,00%Glyceryl monostearate non-self emulsifying                     5,00%Oleum hyoscyami           20,00%p-Hydroxybenzoic acid methyl ester                     0,18%p-Hydroxybenzoic acid propyl ester                     0,02%Sorbitol 70%              5,00%Perfume oil               0,20%                     ad. 100,00%______________________________________ 
    
     The above components are formed into a water-in-oil emulsion by conventional techniques. 
     EXAMPLE 8 
     
         ______________________________________Beeswax                   7,00%Absorption base Amerchol 500                     3,00%Lanolin alcohol ethoxilate with 16 Mol.ethylene-oxide            2,00%Glycerylmonostearate, non-self emulsifying                     2,00%Microwax                  5,00%Oleum hyoscyami           30,00%Petroleum jelly           4,00%2-Ethylhexyl palmitate    10,00%Sorbitol                  5,00%Cis-1-1-(3 chloroallyl)-3,5,7-triaza-1-azoniaadamantane chloride 0,20%Perfume oil               0,20%Demineralised water, sterile-filtered                     ad. 100,00%______________________________________ 
    
     The components are formed into an oil-in-water emulsion using conventional techniques. 
     EXAMPLE 9 
     Oil 
     
         ______________________________________Oleum hyoscyami        50,00%Isopropyl palmitate    30,00%Isopropyl isoadipate   20,00%______________________________________ 
    
     EXAMPLE 10 
     Oil 
     
         ______________________________________Oleum hyoscyami        50,00%2-ethylhexyl palmitate 30,00%Isopropyl isoadipate   19,00%Perfume oil             0,50%______________________________________ 
    
     EXAMPLE 11 
     Gel 
     
         ______________________________________Oleum hyoscyami        50,00%Paraffin oil           20,00%Aerosil 200             8,00%Isopropyl myristate    12,00%2-ethylhexyl palmitate 10,00%______________________________________ 
    
     The components are formed into a gel by conventional techniques.