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Ammonium bituminosulfonate or ammonium bituminosulphonate (synonyms of ichthammol, CAS# brand name: Ichthyol) is a product of natural origin obtained in the first step by dry
distillation
Distillation, or classical distillation, is the process of separating the components or substances from a liquid mixture by using selective boiling and condensation, usually inside an apparatus known as a still. Dry distillation is the heat ...
of
sulfur-rich
oil shale
Oil shale is an organic-rich fine-grained sedimentary rock containing kerogen (a solid mixture of organic chemical compounds) from which liquid hydrocarbons can be produced. In addition to kerogen, general composition of oil shales constitut ...
(bituminous schists). By sulfonation of the resulting oil (or purified fractions thereof), and subsequent neutralization with ammonia, Ichthammol results as a viscous, water-soluble substance with a characteristic bitumen-like odor.
It is used in
medicine
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pr ...
(sometimes in combination with
zinc oxide
Zinc oxide is an inorganic compound with the formula . It is a white powder that is insoluble in water. ZnO is used as an additive in numerous materials and products including cosmetics, food supplements, rubbers, plastics, ceramics, glass, cement ...
) as a treatment for different
skin diseases
A skin condition, also known as cutaneous condition, is any medical condition that affects the integumentary system—the organ system that encloses the body and includes skin, nails, and related muscle and glands. The major function of thi ...
, including
eczema
Dermatitis is inflammation of the skin, typically characterized by itchiness, redness and a rash. In cases of short duration, there may be small blisters, while in long-term cases the skin may become thickened. The area of skin involved can ...
and
psoriasis
Psoriasis is a long-lasting, noncontagious autoimmune disease characterized by raised areas of abnormal skin. These areas are red, pink, or purple, dry, itchy, and scaly. Psoriasis varies in severity from small, localized patches to complete ...
(see below).
Ointments containing 10% or 20% Ichthammol are most common. They are sometimes called "black ointments" or "drawing salves". Ichthammol's dermatological action was promoted by German physician
Paul Gerson Unna
Paul Gerson Unna, (September 8, 1850, Hamburg – January 29, 1929, Hamburg) was a German physician specialized in dermatology and one of the pioneers in dermatopathology. Biography
Paul Unna was the son of Moritz Adolph Unna, a physician from H ...
.
Composition
From elemental analysis, the composition of Ichthammol was calculated to be C
28H
36S
5O
6(NH
4)
2. However, as a product of natural origin, it is a mixture of many different compounds.
Chemically, it is a
sulfonated shale oil
Shale oil is an unconventional oil produced from oil shale rock fragments by pyrolysis, hydrogenation, or thermal dissolution. These processes convert the organic matter within the rock (kerogen) into synthetic oil and gas. The resulting oil c ...
that is incompatible with acids, alkali carbonates or hydrates and alkaloidal salts. It is a thick reddish brown liquid, possessing a bituminous odor and taste. It is soluble in water and miscible with
glycerin
Glycerol (), also called glycerine in British English and glycerin in American English, is a simple triol compound. It is a colorless, odorless, viscous liquid that is sweet-tasting and non-toxic. The glycerol backbone is found in lipids known ...
, but is nearly insoluble in strong alcohol or concentrated ether. It contains a large percentage of organically combined
sulfur.
Differentiation from Chinese Materials
Materials made in China (Pinyin transcription: yushizhi and yushizhi ruangao) and offered outside China as Ichthammol or Ammonium Bituminosulfonate do not meet the requirements for this substance in the United States Pharmacopoeia (USP) or European Pharmacopoeia (Ph.Eur). Also, there is no conformity with the definition as connected to CAS# 8029-68-3. The Chinese material is derived from vegetable oils (e.g., soybean oil) instead of bituminous schists as required (Chinese definition according to ChP 10: "Ichthammol is a mixture obtained by sulfuration of vegetable oils (soybean oil, tung oil, corn oil, etc.), sulfonation, and neutralization with ammonia"). As a result, its chemical basis is totally different from the one of Ichthammol USP/Ph.Eur./CAS# 8029-68-3. The characteristic bitumen-like odor (originating from the bituminous source material) is missing with Chinese material.
Usage
Human
Bituminosulfonates are classified as local therapeutic agents with very good tolerability. Pharmacologically, ichthammol has
anti-inflammatory
Anti-inflammatory is the property of a substance or treatment that reduces inflammation or swelling. Anti-inflammatory drugs, also called anti-inflammatories, make up about half of analgesics. These drugs remedy pain by reducing inflammation as o ...
,
bactericidal, and
fungicidal properties. It is used to treat a variety of skin disorders as e.g.
eczema
Dermatitis is inflammation of the skin, typically characterized by itchiness, redness and a rash. In cases of short duration, there may be small blisters, while in long-term cases the skin may become thickened. The area of skin involved can ...
,
psoriasis
Psoriasis is a long-lasting, noncontagious autoimmune disease characterized by raised areas of abnormal skin. These areas are red, pink, or purple, dry, itchy, and scaly. Psoriasis varies in severity from small, localized patches to complete ...
,
Acne rosacea and
acne
Acne, also known as ''acne vulgaris'', is a long-term skin condition that occurs when dead skin cells and oil from the skin clog hair follicles. Typical features of the condition include blackheads or whiteheads, pimples, oily skin, and ...
,
and it decreases microorganisms in the area surrounding a skin condition. It is commonly used in 10% or 20% concentrate
ointment, applied topically. Ichthammol ointments, commonly known as ''black ointment'' or ''drawing salve'', should not be confused with
black salve
Black salve, also known by the brand name Cansema, is a pseudoscientific alternative cancer treatment. The product is commonly classified as an escharotic—a topical paste which destroys skin tissue and leaves behind a scar called an eschar. E ...
, a
escharotic
An eschar (; Greek: ''ἐσχάρᾱ'', ''eskhara''; Latin: ''eschara'') is a slough or piece of dead tissue that is cast off from the surface of the skin, particularly after a burn injury, but also seen in gangrene, ulcer, fungal infections, n ...
(corrosive) paste intended to destroy skin tissue. In contrast, ichthammol does not have any corrosive properties on the skin.
In
otology
Otology is a branch of medicine which studies normal and pathological anatomy and physiology of the ear (hearing and vestibular sensory systems and related structures and functions) as well as their diseases, diagnosis and treatment. Otologi ...
, a mixture of glycerol and ichthammol (G & I) is used for the topical
treatment of
ear infection
Otitis is a general term for inflammation or infection, inner ear infection, middle ear infection of the ear, in both humans and other animals. When infection is present, it may be viral or bacterial. When inflammation is present due to fluid buil ...
s. It is effective against
Gram-positive
In bacteriology, gram-positive bacteria are bacteria that give a positive result in the Gram stain test, which is traditionally used to quickly classify bacteria into two broad categories according to their type of cell wall.
Gram-positive bact ...
bacteria. The anti-inflammatory action is explained by its influence on the formation, secretion, and effect of
inflammation
Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molec ...
mediators.
Ichthammol is available in pharmacies for compounding medications. Different sources of information exist for exemplary formulations (creams, shake lotions, suppositories, etc.).
According to the "list of preferred Specials" by the British Association of Dermatologists (BAD) Ichthammol can be used in dermatology prescribing to treat acutely inflamed atopic eczema, among others. A corresponding recommendation exists for bituminosulfonates in Germany. According to “guideline atopic eczema” bituminosulfonates can be considered for treatment of atopic eczema based on general clinic experience. In the European Dermatology Forum (EDF) guidelines for treatment of atopic eczema Ichthammol is recommended as a useful addition to the basic treatment regimen, especially in mild disease or if TCS treatment is not possible from a patient’s perspective, e.g. corticophobia (steroid phobia).
Veterinary
The
European Medicines Agency published a summary report on ichthyol-substances (synonym: bituminosulfonates) during the course of the European Maximum Residue Limits (MRL) procedure
in veterinary medicine. The
Committee for Medicinal Products for Veterinary Use
The Committee for Medicinal Products for Veterinary Use (CVMP) is the European Medicines Agency's committee responsible for elaborating the agency's opinions on all issues regarding veterinary medicines. Text was copied from this source which is © ...
(CVMP) decided that due to good tolerance and safety, there is no need to establish an MRL for ichthyol-substances. As a result, ichthyol-substances can be applied topically in all
mammalian
Mammals () are a group of vertebrate animals constituting the class Mammalia (), characterized by the presence of mammary glands which in females produce milk for feeding (nursing) their young, a neocortex (a region of the brain), fur o ...
food-producing species without restriction.
See also
*
Coal tar
Coal tar is a thick dark liquid which is a by-product of the production of coke and coal gas from coal. It is a type of creosote. It has both medical and industrial uses. Medicinally it is a topical medication applied to skin to treat psorias ...
*
Pine tar
References
External sources
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{{Ammonium salts
Ammonium compounds
Organosulfur compounds