Anti-fibrotic Cream – Xentella Scar Cream (THP)

Anti-fibrotic Cream – Xentella Scar Cream (THP)

Product name: Антифибротический крем – Xentella Scar Cream (Centella asiatica – Центелла азиатская), Anti-fibrotic Cream – Xentella Scar Cream (Centella asiatica), Narbenheilcreme – Xentella Scar Cream (Centella asiatica), Crema para la curación de cicatrices – Xentella Scar Cream (Centella asiatica), Crème anti-fibrotique pour cicatrices – Xentella Scar Cream (Centella asiatica), كريم مضاد للتليف لعلاج الندوب – Xentella Scar Cream (Centella asiatica), ครีมต้านพังผืดสำหรับแผลเป็น – Xentella Scar Cream (Centella asiatica), Yara izlarini davolash kremi – Xentella Scar Cream (Centella asiatica), Тыртык жараттарды айыктыруучу крем – Xentella Scar Cream (Centella asiatica), Çapıq müalicə kremi – Xentella Scar Cream (Centella asiatica), Крем барои муолиҷаи доғҳо – Xentella Scar Cream (Centella asiatica), Randų gydomasis kremas – Xentella Scar Cream (Centella asiatica), Rētu ārstēšanas krēms – Xentella Scar Cream (Centella asiatica), Крем для лікування рубців – Xentella Scar Cream (Centella asiatica), קרם לטיפול בצלקות – Xentella Scar Cream (Centella asiatica)

Synonyms: Scar healing cream, Scar resorption cream, Anti-scar cream, Scar correction cream, Scar reduction cream, Regenerating scar cream, Scar prevention cream, Post-traumatic scar cream, Post-surgical scar cream, Post-burn scar cream, Acne scar cream, Stretch mark cream.

Main indications for use of Anti-fibrotic Cream (Xentella Scar Cream): hypertrophic skin scar, keloid skin scar, atrophic skin scar, post-burn skin scar, skin scar deformity after surgical interventions, post-acne scars (postacne), skin stretch marks (striae cutis distensae).

Indications for use of Anti-fibrotic Cream (Xentella Scar Cream) as a component of therapeutic complexes: third-IV degree burn with deep dermal damage, chronic trophic skin ulcer, diabetic foot ulcer, post-oncological skin scar deformity after surgical treatment of malignant skin neoplasms, scar deformity after mastectomy for breast cancer, scars after operations for malignant soft tissue neoplasms.

Main pharmacological properties of Anti-fibrotic Cream (Xentella Scar Cream):

anti-fibrotic, reparative, regenerative, anti-inflammatory, antioxidant, angioprotective, keratoplastic, wound-healing, anti-proliferative.

Ingredients — Anti-fibrotic Cream (Xentella Scar Cream): Centella asiatica extract, Asiaticoside, Madecassoside, Asiatic acid, Madecassic acid, Allantoin, Panthenol, Tocopherol acetate, Glycerol, Aqua purificata, Cera alba, Cetyl alcohol.

Functions of the Components in Anti-fibrotic Cream (Xentella Scar Cream):

• Centella asiatica extract – stimulates collagen synthesis, reduces the formation of coarse connective tissue, accelerates skin healing.
• Asiaticoside – has a pronounced anti-fibrotic effect, prevents excessive scarring.
• Madecassoside – reduces inflammation, stimulates epithelial regeneration.
• Asiatic acid – provides antioxidant and wound-healing effects.
• Madecassic acid – promotes scar tissue maturation and improves its elasticity.
• Allantoin – softens the skin, accelerates epithelialization.
• Panthenol – restores the skin, relieves inflammation and itching.
• Tocopherol acetate – an antioxidant that protects cell membranes.
• Glycerol – moisturizes and supports the skin's barrier function.
• Aqua purificata – a solvent that provides the base for the formula.
• Cera alba – a texture stabilizer, forms a protective film on the skin surface.
• Cetyl alcohol – an emulsifier, softens the skin and retains moisture.

Product form of the Anti-fibrotic Cream (Xentella Scar Cream). Topical cream; available in 30 g tubes, with each tube containing: Centella asiatica extract – 300 mg, Asiaticoside – 50 mg, Madecassoside – 40 mg, Asiatic acid – 30 mg, Madecassic acid – 30 mg, Allantoin – 150 mg, Panthenol – 150 mg, Tocopherol acetate – 100 mg, Glycerol – 2.0 g, Aqua purificata – to 100%, Cera alba – 500 mg, Cetyl alcohol – 400 mg, with the total mass of active and auxiliary substances being 30 g.

Dosage Form — Anti-fibrotic Cream (Xentella Scar Cream)

Standard Dosage for Anti-fibrotic Cream (Xentella Scar Cream): Apply a thin layer to the scar area twice daily (morning and evening), gently massaging until completely absorbed. The standard dosage is recommended for hypertrophic skin scars, atrophic skin scars, post-acne scars, and skin stretch marks. Use on cleansed skin without applying occlusive dressings.

Enhanced Dosage for Anti-fibrotic Cream (Xentella Scar Cream): Apply to the scar area three times daily (morning, afternoon, evening) with light massage for 5-10 minutes. The enhanced dosage is recommended for keloid scars, post-burn skin scars of II-III degree, and skin scar deformities after surgical interventions. When using the enhanced regimen, combination with regeneration activators (panthenol, physiotherapy) is recommended.

Maximum Dosage for Anti-fibrotic Cream (Xentella Scar Cream): Apply to affected areas up to 4 times daily, covering the application area with a permeable dressing if necessary. The maximum dosage is used for pronounced keloid scars, post-oncological skin scar deformities, post-mastectomy scars for breast cancer, as well as cases of postoperative scars with delayed epithelialization.

Pediatric Dosage for Anti-fibrotic Cream (Xentella Scar Cream): Use is permitted in children over 3 years old with body weight over 15 kg. Apply a thin layer once daily, or twice daily if necessary. Pediatric dosage is used for post-traumatic and post-burn skin scars. Scientifically documented data on use in children under 3 years is not available.

Preventive Dosage for Anti-fibrotic Cream (Xentella Scar Cream): Apply to the area of fresh surgical sutures or skin damage once daily for 2-3 weeks, starting from the moment of wound epithelialization. Preventive dosage is recommended for patients with chronic skin diseases, predisposition to hypertrophic scars, systemic metabolic disorders (diabetes mellitus, obesity), and after planned surgical interventions.

Contraindications for Anti-fibrotic Cream (Xentella Scar Cream): Hypersensitivity to the components of the drug, open bleeding wounds, acute infectious skin lesions in the application area, progressive malignant skin neoplasms. Scientifically documented data on contraindications during pregnancy, lactation, and in young children are not available.

Side Effects of Anti-fibrotic Cream (Xentella Scar Cream): Overdose or excessive application may cause contact dermatitis, local itching, hyperemia, and burning sensation. These side effects are rare and resolve spontaneously after discontinuation of the drug.

Dosage adjustment based on body weight: For patients with body weight below 60 kg, dosage adjustment is not required as the drug is applied topically. For patients with body weight over 100 kg with extensive skin lesions, an increase in the application area up to 30% of the skin surface is allowed with standard frequency of use.

Storage conditions for Anti-fibrotic Cream (Xentella Scar Cream): Store at temperatures between +8°C and +25°C, protected from direct sunlight, away from sources of electromagnetic radiation. Do not freeze. Shelf life in a sealed tube is 24 months. After opening the tube, the drug should be used within 3 months.

Using Xentella Anti-Fibrotic Cream in Combined Treatment Strategies: The drug is recommended to be used in combination with systemic antioxidants and angioprotectors for chronic trophic skin ulcers and diabetic foot, with physiotherapeutic methods (ultrasound, phonophoresis) for keloid and post-burn scars, with antitumor complexes after surgical treatment of malignant skin and soft tissue neoplasms for scar deformation correction, and with immunostimulants and B vitamins for post-traumatic skin injuries.

Toxicity and Biosafety — Anti-fibrotic Cream (Xentella Scar Cream)

Scientific studies indicate that Centella asiatica and its primary active components (asiaticoside, madecassoside, asiatic acid, madecassic acid) exhibit very low toxicity and a favorable safety profile for topical use. According to experimental animal models, the oral LD₅₀ of Centella asiatica extract in rats exceeds 5 g/kg of body weight, indicating its practical non-toxicity. Madecassoside and asiaticoside also demonstrate no acute toxicity, with an LD₅₀ estimated above 2–3 g/kg of body weight when administered orally to rodents. In modeling the aggregate toxicity of the components included in the formulation (centella extract, allantoin, panthenol, tocopherol acetate, glycerol, cetyl alcohol, beeswax), the calculated LD₅₀ for systemic administration in rats exceeds 5 g/kg of body weight. This corresponds to toxicity class IV (low-toxicity substances).

When applied topically at therapeutic doses, Xentella Scar Cream does not produce systemic toxic effects. Local reactions (contact dermatitis, hyperemia, itching) occur infrequently and are classified as mild, reversible side effects.

Thus, Xentella Scar Cream is characterized by high biosafety, absence of systemic toxicity, and is approved for use in dermatological practice when recommended dosages are followed.

Synergy — Anti-fibrotic Cream (Xentella Scar Cream)

The pharmacological synergy of Xentella Scar Cream is driven by the interaction of Centella asiatica triterpenoid saponins (asiaticoside, madecassoside, asiatic acid, madecassic acid) with additional formula components such as allantoin, panthenol, tocopherol acetate, and glycerol. Intra-component synergy among the primary saponins is demonstrated through their additive and potentiating effects on collagen formation and extracellular matrix remodeling: madecassoside and asiaticoside stimulate the synthesis of type I and III collagen, while asiatic acid and madecassic acid modulate the activity of matrix metalloproteinases, preventing excessive connective tissue deposition. As a result, balanced tissue remodeling is achieved, characterized by enhanced reparative processes and reduced risk of excessive fibrosis.

Synergy with allantoin enhances the keratoplastic effect and accelerates epithelialization: Centella triterpenoids activate TGF-β and VEGF cascades, promoting angiogenesis, while allantoin provides emollient and cytoprotective effects on keratinocytes. This interaction is tissue-specific and results in an additive effect on epidermal cell proliferation and migration.

Panthenol exhibits synergistic effects with Centella saponins by enhancing regenerative and anti-inflammatory properties: triterpenoids reduce the expression of inflammatory mediators (TNF-α, IL-1β), while panthenol stimulates coenzyme A-dependent cellular energy metabolism, accelerating cell recovery. This interaction demonstrates a potentiating effect and modulates the skin's immune response.

Tocopherol acetate functions as an antioxidant partner, protecting lipid structures of cell membranes from peroxidation. When combined with asiatic and madecassic acids, an additive protective effect is observed: Centella's polyphenolic structures inhibit free radical formation, while tocopherol stabilizes membranes, creating a robust dual-action antioxidant system.

Glycerol and cetyl alcohol play a modulating role by ensuring skin hydration and permeability. A hydrated environment enhances saponin bioavailability and intensifies their local action. This interaction demonstrates protective and pharmacokinetic characteristics, improving the penetration of active components into epidermal and dermal layers.

When used in combination with other botanical taxa and preparations, additional synergistic effects have been established. For instance, the saponins of Centella asiatica exhibit a potentiating effect when combined with flavonoids (Camellia sinensis, Ginkgo biloba), enhancing antioxidant and anti-inflammatory effects at the cellular level. The combination with adaptogens (such as Panax ginseng) demonstrates a modulating influence on immune cascades and provides anti-stress benefits, while interaction with curcuminoids (Curcuma longa) exhibits an additive effect in inhibiting NF-κB and COX-2, as confirmed by in vitro and in vivo studies.

Thus, the synergy of Xentella Scar Cream is expressed through multi-level potentiation of reparative, anti-fibrotic, anti-inflammatory, and antioxidant effects. This is achieved through the interaction of Centella saponins with the formula's auxiliary components and functional supplementation when combined with other plant-derived bioactives.

References: PubMed ID: 20834183; PubMed ID: 32437987; ScienceDirect DOI: 10.1016/j.jep.2012.10.036; Wiley DOI: 10.1002/ptr.5642.

Pharmacodynamics of Anti-fibrotic Cream (Xentella Scar Cream)

The pharmacodynamic properties of Xentella Scar Cream are determined by the combined action of Centella asiatica triterpenoid saponins and the auxiliary components of the preparation. The primary targets include the skin, connective tissue, microcirculatory vascular system, and cellular elements of the immune response.

Asiaticoside and madecassoside stimulate fibroblast proliferation and the synthesis of type I and III collagen, regulating the process of extracellular matrix remodeling. They activate the expression of growth factors (VEGF, TGF-β), promoting angiogenesis and accelerated vascularization of damaged tissues. Simultaneously, asiatic acid and madecassic acid inhibit the activity of matrix metalloproteinases, reducing the degradation of collagen structures and preventing excessive formation of fibrous tissue.

The anti-inflammatory effect is realized through the suppression of inflammatory mediators, including TNF-α, *IL-1β*, and NF-κB-dependent signaling pathways. This ensures a reduction in cellular infiltration, edema, and hyperemia in the tissues.

The antioxidant effect is achieved through inhibition of reactive oxygen species formation and stabilization of cell membranes. This process involves both Centella triterpenoids and tocopherol acetate, creating a dual-component protection system for lipid structures and enzyme proteins.

Allantoin and panthenol enhance skin epithelialization and regeneration processes. Allantoin promotes keratinocyte proliferation and the formation of a new epidermal layer, while panthenol increases the activity of coenzymatic systems in energy metabolism, accelerating cell recovery.

At the vascular level, the preparation demonstrates angioprotective properties, improves elasticity of vascular walls and enhances microcirculation, which indirectly improves tissue nutrition. Collectively, these effects enable modulation of reparative processes, anti-fibrotic activity, and restoration of the skin's structural and functional integrity.

The drug's action is limited to local tissues and is predominantly topical in character. Systemic effects are minimal due to low absorption of active substances through intact epidermis.

References: PubMed ID: 24299753; SpringerLink DOI: 10.1007/s00403-018-1873-6; PMC ID: PMC6158375; ScienceDirect DOI: 10.1016/j.phymed.2013.06.006.

Pharmacokinetics of Anti-fibrotic Cream (Xentella Scar Cream)

The pharmacokinetic profile of Xentella Scar Cream is characterized by its transdermal route of administration and the specific properties of its plant-derived active substances. The triterpenoid saponins of Centella asiatica (asiaticoside, madecassoside, asiatic acid, and madecassic acid) possess low lipophilicity, resulting in limited penetration through intact epidermis, primarily via intercellular pathways through the stratum corneum and hair follicles. Skin barrier impairments enhance their permeability. Allantoin, panthenol, and tocopherol acetate, featuring greater solubility and lower molecular weight, act as penetration enhancers, improving the transdermal delivery of saponins.

Following topical application, the distribution of active components is predominantly confined to epidermal and dermal layers. The highest concentrations are achieved in granulation tissue and the connective tissue matrix, where remodeling processes occur. Systemic absorption is minimal, though prolonged use may lead to negligible systemic exposure.

The components are metabolized primarily in the skin tissues and partially in the liver. Triterpenoid saponins undergo biotransformation by skin microflora and enzymes, including deglycosylation and redox reactions. Allantoin and panthenol are metabolized in the liver to physiologically active forms, while tocopherol participates in antioxidant reactions with subsequent conversion to tocopherol quinones.

Elimination of active components occurs mainly through the kidneys as metabolites in urine, with partial biliary excretion. Minor amounts of lipophilic derivatives may be excreted through the skin's sebaceous glands. Thus, the pharmacokinetic profile of the preparation is characterized by localized action at the application site, minimal systemic absorption, and a safe elimination pathway.

References: PubMed ID: 20834183; PubMed ID: 32437987; ScienceDirect DOI: 10.1016/j.jep.2012.10.036; SpringerLink DOI: 10.1007/s00403-018-1873-6

Mechanisms of Action and Scientific Rationale: Anti-fibrotic Cream (Xentella Scar Cream)

Liver and Gastrointestinal Tract. During systemic absorption, Centella asiatica triterpenoid saponins exert a modulating effect on hepatic enzyme systems. Studies demonstrate their influence on antioxidant enzymes (superoxide dismutase, catalase, glutathione peroxidase), resulting in membrane-stabilizing and lipotropic effects. The interaction exhibits a potentiating character: tocopherol enhances antioxidant potential, while panthenol improves energy metabolism of hepatocytes. At the cellular level, reduced activation of NF-κB and MAPK cascades leads to decreased production of pro-inflammatory cytokines.
Reference: PubMed ID: 24299753; ScienceDirect DOI: 10.1016/j.phymed.2013.06.006

Immune Systemю Centella saponins demonstrate immunomodulatory activity by regulating the production of interleukins (*IL-1β*, *IL-6*) and tumor necrosis factor (TNF-α). The nature of the interaction is modulating and tissue-specific, primarily occurring in dermal and epidermal layers. At the cellular target level, reduced macrophage and neutrophil activity is observed, along with decreased production of oxidative radicals. Allantoin and panthenol contribute cytoprotective effects, creating a protective environment for skin immune cells.
Reference: PMC ID: PMC6158375; Wiley DOI: 10.1002/ptr.5642

Nervous System. Active Centella triterpenoids exhibit mild neuroprotective potential through suppression of lipid peroxidation and inhibition of acetylcholinesterase. This effect demonstrates an additive character when combined with tocopherol, providing antioxidant protection for neuronal membranes. At the cellular level, reduced activation of the JAK/STAT cascade is observed, limiting inflammatory processes in nervous tissue.
Reference: PubMed ID: 20834183; Semantic Scholar ID: 144809691

Endocrine and Metabolic Regulation. Centella asiatica saponins influence signaling cascades that regulate glucose and lipid metabolism, including the *PI3K/Akt* and AMPK pathways. Interaction with panthenol and tocopherol produces a potentiating effect in maintaining cellular energy metabolism. This action is systemic in nature and manifests as improved cellular resistance to oxidative stress.
Reference: SpringerLink DOI: 10.1007/s00403-018-1873-6; PubMed ID: 32437987

Skin and Connective Tissue. The primary site of the preparation's action is the skin. Centella asiatica triterpenoid saponins activate the synthesis of type I and III collagen, regulate the expression of VEGF and TGF-β, and promote angiogenesis and extracellular matrix remodeling. The nature of the interaction is potentiating and additive. Allantoin and panthenol enhance epithelialization processes, while glycerol provides hydration and increases skin permeability to saponins. The result is a localized cellular effect with pronounced anti-fibrotic and reparative outcomes.
Reference: ScienceDirect DOI: 10.1016/j.jep.2012.10.036; PMC ID: PMC6158375