Products for humans
Skin and nail treatment and wound treatment
Repolar Pharmaceuticals Oy is a Finnish family business that researches, develops, manufactures and markets treatment products for people and animals based on Norway spruce (Picea abies) resin and its active substances. Our product development team comprises many doctors of medical science and professionals in the fields of chemistry, technology and pharmaceuticals.
The resin is collected by hand in northern Lapland using a method that respects nature. The resin is cleaned and processed without heating it. That way, it is possible to preserve all the biologically active substances in the resin, and ensure that the end-products do not have carcinogenic (cancer-causing) properties.
Many laboratory tests all around the world have been carried out on the resin processed by Repolar. Through in vitro tests on spruce resin, it has been possible to demonstrate not only its antimicrobial effects but also its soothing and epithelialising properties.
All products developed and manufactured by Repolar are based on comprehensive scientific studies and practical testing. The company’s quality management system is ISO 13485:2016-certified. The batches of completed products are always tested before being released for distribution.
Abilar® 10% Resin Salve and Abicin® 30% Resin Lacquer contain cold-cleaned raw Norway spruce resin in the proportion indicated by their names.
AbiCare Creme, Resolain Scalp Tonic and all Ani-series animal products are based on a non-sticky resin solution developed using new Repolar technology.
Repolar Pharmaceuticals Oy values and supports Finnish labour and the Finnish economy. All our products carry the Key Flag symbol indicating 100% Finnish content.
General treatment of nail fungus
Nail fungus (athlete’s foot, onychomycosis, tinea unguium) is a difficult-to-treat disease of the layer of keratin on the skin under the nail, and 8-11% of the Finnish adult population suffer from it. Nail fungus is usually found in the toenails, and less commonly in the fingernails. Untreated nail fungus causes thickening, brittleness, peeling off and yellowness of the nail. The harm caused by nail fungus is not merely cosmetic, as it can act as a gateway to the infection of the body by bacteria that cause erysipelas and cellulitis. More than 90% of the fungal infections of human skin and nails are caused by dermatophytes (filamentous fungi). Different diagnoses of nail fungus include nail psoriasis and changes in the nail due to ageing and impaired arterial circulation in the lower limbs.
Nail fungal infections are common
Nail fungus is a common complaint. Nail fungus occurs in 8-11% of the Finnish adult population. The risk of nail fungal infection increases with age. The most common nail fungus patients are middle-aged or elderly men. Nail fungus is rare in children.
Dermatophytes are almost always the cause of nail fungal infection
In Western countries, most (over 90%) of the causes of nail fungus are the dermatophytes Trichophyton-, Microsporum– and Epidermophyton. The most common types are Trichophyton rubrum, Trichophyton mentagrophytes and Trichophyton tonsurans. The transmission of nail fungus usually occurs at moist public spaces such as swimming pools. Poor foot hygiene predisposes people to contracting the disease. Other possible causes are mould and yeast, of which Candida albicans yeast is the most common.
Classification of nail fungal infections
Nail fungus is classified into five categories based on its location and pathogen. All nail fungal infections can ultimately result in complete degeneration or dystrophy of the nail.
- A fungal infection beginning at the tip or side of the nail, which gradually spreads to its base.
- A superficial fungal infection of the nail, which partially or completely covers the surface of the nail. Superficial nail fungus is most commonly caused by the Trichophyton mentagrophytes dermatophyte. Superficial nail fungus is rarer than fungal infection originating at the tip or side of the nail.
- A nail fungal infection originating at the base of the nail is the rarest type. It is often caused by a circulatory disorder in the lower limbs, diabetes or impairment of the body’s immune system, for example as a result of an immunosuppressive medication or disease. Nail fungus originating from the base of the nail thickens the nail, makes it brittle and finally destroys it altogether.
- Internal fungal infection of the nail is a relatively rare type of nail fungus. In the early stage, it does not necessarily cause the nail to thicken, become brittle, peel off or typically to accumulate a pale mass of keratin under the nail. A long-term internal infection of the nail often leads to dystrophy or degeneration of the nail.
- Nail fungus caused by Candida albicans yeast is usually a chronic infection of the cuticle or a chronic yeast infection between the toes. Constant humidity or keeping the nails in rubber gloves or rubber boots for a long time increases the risk of yeast infection.
Although a diagnosis of nail fungus is often clear based on clinical findings, before starting treatment it is recommended that it be verified through a test of fungal culture or an examination using a microscope. A sample of the fungus is taken from the area between the healthy and infected part of the nail. Getting a technically successful sample might sometimes be difficult, and wrong negative diagnoses are relatively common. There should be a sufficiently long break between the last medical treatment of the nail fungus and the taking of the sample. After local treatment, there should be a break of at least six weeks and, after fungal medication taken orally, a break of at least six months.
Nail fungus cannot be cured without treatment and, even with the most effective orally administered anti-fungal medication, it is estimated that only about 50% of toenail fungal infections treated are completely cured.
Fungal infections of the fingernails are almost always cured. The duration of treatment varies from three months to two years. The best treatment response is obtained if treatment is started immediately after the nail fungal infection and diagnosis.
In elderly patients, growing a new big toenail might take up to two years. The duration of treatment does not, however, correspond directly to the speed of growth of the nail. It is vitally important to receive a sufficient content of active substance under the nail to be treated, whose anti-fungal efficacy lasts for months. The final treatment result will therefore not be evident until months after the end of the treatment.
Urea solution treatment of thickened, dystrophic and fungally infected nails improves the treatment result. Treatment alternatives for nail fungus are local treatment and/or anti-fungal medication administered orally. The general understanding is that local treatment is effective in fungal infections at the tip of the nail when only a little time has passed since the infection was contracted. Treatment of completely dystrophic nails by local treatment is not sensible.
Irritation of the scalp and skin, and dandruff
Scalp problems are very common. Symptoms also often occur without more serious disorders like atopic eczema or psoriasis. Itchy rash, redness and dandruff may also be caused by seborrheic dermatitis, or sometimes they may just be symptoms caused by dry skin. Often the problem is caused by a combination of different factors such as excessive growth of yeast, stress, genes, diet, certain diseases or medication. Often the symptoms worsen in cold and dry weather.
Skin is being constantly renewed and, under normal circumstances, dead skin cells that fall off are small and invisible. Dandruff that comes off as large flakes is usually the result of imbalance in normal microbial growth on the scalp. This imbalance is not an infection but rather an inflammation caused by irritation, which results in itching, redness and dandruff.
Excessive growth of Malassezia yeast that commonly lives on the skin is one of the key causes of dandruff. Reducing dandruff can often be done by selection of the right shampoo, avoiding the excessive use of care products, and a change in diet or medication. Additional assistance can be obtained from products that help to control the microbial growth of yeast and bacteria. Such products help create a physiological balance in the skin, and preserve a healthy scalp.
Scalp irritation may also be a result of an atopic rash, a certain type of psoriasis or infection of the hair follicles. These cases may require examination and treatment by a dermatologist.
General information about wound treatment
The healing of tissue damage is a prerequisite of life. Viewed on a cellular and molecular level, the simple-looking healing of a flesh wound is actually a very complex, precisely regulated chain of events. The healing of a wound is divided into three stages: 1. infection, 2. fibroplasia, and 3. maturation. A scar made of connective tissue is created as an end result of healing. This scar fills the tissue defect caused by the wound and provides the healed wound with sufficient tensile strength at the initial stage. After the wound has healed, the maturation of scar tissue lasts about one year.
Based on their mechanism of creation, circumstances of creation and injury energy, wounds may be classified into acute, chronic, superficial, deep, dirty and clean. Usually, acute wounds are created by accident as a result of trauma or, for example, by damage caused to the skin deliberately due to a surgical procedure. A superficial wound extends no further than through the layers of skin, whilst a deep wound may penetrate the skin, the tissue under the skin, the muscular sheaths and the muscles to reach the bones or the cavities of the body, and may cause serious damage to internal organs. Typical dirty wounds are bites, wounds caused by a knife or broken glass and wounds and bruises caused by falling over or some other trauma. A wound is always contaminated if, at the time of the accident, such substances as saliva, sand, soil, etc. enter it. A surgical operation wound is a model example of a clean wound.
The typical symptoms of an acute wound are pain and bleeding. First aid entails stemming the flow of blood and keeping the wound clean. This will prevent possible microbial contamination of the wound and reduce the risk of infection. Depending on the nature of the injury mechanism, an acute wound can either be stitched surgically or left open. The validity of vaccinations should be checked if it is a question of a bite or if the wound is very dirty. After first-aid, it is essential to create an optimal environment for the wound to heal. A dirty wound must at least be washed or, if necessary, cleaned mechanically (by debridement, a surgical revision) and protected with clean dressings or bandages. In an ideal case, an acute wound closes and heals quickly (so-called per primam). This occurs if the edges of the wound can be brought together, there is sufficient blood circulation to the wound and it is not infected. Depending on the injury mechanism, a wound can heal or be healed according to so-called per secundam, whereby granulation tissue that forms in a wound cavity deliberately left open fills the wound cavity, brings together the edges of the wound and gradually reduces its surface area. Typical per secundam healing wounds are ragged dirty wounds and bites in which the risk of infection is great. If the healing of an acute wound slows down or stops entirely, the wound can become chronic.
A chronic wound is one whose healing becomes prolonged for one reason or another. A chronic wound might remain open for years. The tendency of a chronic wound to heal or the speed at which it does so is difficult to forecast, and a wound that has already once healed might reopen. The most common chronic wounds are varicose ulcers in the veins and arteries, pressure sores and diabetic foot ulcers. A chronic wound is often the result of some chronic disease suffered by the patient. Because of this, the cornerstone of the treatment of a chronic wound is treatment targeted at the aetiology or cause of the wound. The key prerequisite for a wound to heal is treatment of the disease causing it or the factor maintaining it. In addition to treatment of the cause, another important prerequisite for a wound to heal is appropriate and carefully performed local treatment. The purpose of local treatment is to create for the wound optimal healing circumstances and conditions. The correctly performed local treatment of a wound accelerates its sealing up, and prevents it from becoming infected.
With the exception of wounds created in an operating theatre, all wounds are contaminated, that is to say bacteria have entered them. However, not until the number of bacteria exceeds 105/per gram of tissue does the healing of the wound become disrupted. The classic symptoms of wound infection are redness, swelling, warmth, pain and pus. The most common cause of wound infection is the Staphylococcus aureus bacterium. The rarer Gram-positive bacteria can also cause wound infections in patients with multiple diseases and those in hospital or institutional care. Bacteria and fungi that do not cause infections in healthy people can cause so-called opportunist infections in patients whose immune system is impaired, for example as a result of immunosuppressive medication or diseases that weaken the immune system. In serious wound infections or special cases, the local treatment of a wound is done in conjunction with antibiotic treatment administered either orally or, if necessary, intravenously. Prior to the commencement of antibiotic treatment, comprehensive samples for bacterial culture must be taken from the infected wound. Wound infection keeps chronic wounds going.
Dead or necrotic tissue in a wound or around it slows down its healing and increases the risk of infection. Because of this, necrotic tissue should be removed surgically from a healing wound (debridement). In very mild cases, the necrotic tissue or cells in a wound can be treated with local treatment products.
Effective local treatment of a wound plays a very important role alongside treatment related to its cause. The importance of local treatment is particularly heightened in patients who, because of their general condition, life expectancy, risks associated with surgery or sometimes even because of a lack of resources, are, for example, unable to undergo surgical treatment. In practice, this means patients with multiple disorders, a poor prognosis and often in institutional care, for whom it is no longer sensible or even humane to consider large-scale surgical wound revisions, the most difficult plastic surgical revisions or vascular surgical reconstructions. Nevertheless, the acute and chronic wounds of such patients must be treated appropriately, with as little pain as possible and well. In such cases, the foundation of wound treatment is good local treatment with available local treatment products. A good local treatment product creates an optimal environment and the prerequisites for wound healing, is safe and effective, and there is sufficient experience of its use in different wounds and patient groups.
Publications and case reports
- Sipponen A. Coniferous resin salve, ancient and effective treatment for chronic wounds – laboratory and clinical studies. Department of Orthopedics and Traumatology, Helsinki, University Hospital, Faculty of Medicine, University of Helsinki, Helsinki, Finland 2013.
- Sipponen P, Sipponen A, Lohi J, Soini M, Tapanainen R, Jokinen JJ. Natural coniferous resin lacquer in treatment of toenail onychomycosis: an observational study. Mycoses 2013;56:289-96.
- Auvinen T, Tiihonen R, Soini M, Wangel M, Sipponen A, Jokinen JJ. Efficacy of topical resin lacquer, amorolfine and oral terbinafine for treating toenail onychomycosis: a prospective, randomized, controlled, investigator-blinded, parallel-group clinical trial. Br J Dermatol 2015;173:940-8.
- Rautio M, Sipponen A, Lohi J, Lounatmaa K, Koukila-Kähkölä P, Laitinen K. In vitro fungistatic effects of natural coniferous resin from Norway spruce (Picea abies). Eur J Clin Microbiol Infect Dis 2012;31:1783-9.
- Jokinen JJ, Sipponen A. Refined spruce resin to treat chronic wounds: rebirth of an old folkloristic therapy. Adv Wound Care 2016;5:198-207.
- Peripheral Rearterialization for Critical Limb Ischaemia and Antiseptic Resin or Honey Salve in Postoperative Ulcer Care Results in Healing Rate Of Leg Ulcers in Three Quarters of Cases. A Prospective Clinical Follow-up of 35 Patients with Preoperative Chronic Ulcer and 5 Patients with Post-Surgery Wound (Surgical Site Infection)