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Sept ember 2005 issue

Informal Study of Bee Venom creamby Andrew Kochan, M.D.

BackgroundBee venom creams have been developed in the hopes of getting the benefits of bee venom stings withoutthe stings. The creams are used by rubbing on the skin as a treatment for arthritis, tendonitis, and othermaladies for which bee venom is reportedly useful. It might be expected that since the object of a beevenom cream is to deliver the active ingredient (bee venom) through the skin to the underlyingstructures, the reaction in the skin would be similar to that of a bee sting. It might be expected that thestronger the skin reaction and the closer it mimics a bee sting with respect to redness, stinging, andswelling, the better the clinical response would be.

How can we evaluate the effectiveness of these creams? Ideally, a trial would be done on a group ofpeople that studied the effect on a particular arthritic joint of a cream or creams containing bee venom,compared with a placebo cream, which does not contain any active ingredient. None of the subjects or

the investigators would know which cream was being used, and different creams would be used atdifferent times. The degree of pain relief would be assessed. I decided to take a preliminary step inevaluating bee venom creams, by studying the skin reaction to six of the products currently available.

M aterial and M ethodsAt the recent CMAC in Burlington I proposed a trial of the skin reaction to six different bee venomcreams to the students and faculty present and asked for volunteers; 19 volunteers were found. A one-half-inch circle of each test substance was applied using a Q-tip, in order from #1 to #6, starting justproximal to the wrist joint. They were spaced one inch apart up the forearm towards the elbow. Thesubjects were not told which cream was which. Five minutes after application, the subjects were asked toevaluate and write down the degree of reaction of each cream, on a scale of 0 to 4, as well as anycomments about their sensory response, such as stinging, burning, or itching. (0 =no noticeable reaction;4 =bright red skin reaction with stinging or burning sensation and possibly swelling or wheal formation; 1,

2, and 3 =a reaction somewhere in between.) The scores for each cream were added and an averagescore obtained.

Results

Product Average score

#1 Nectar Balm from New Zealand 0.26#2 Apireven from Romania 2.42#3 Forapin E from Germany 2.53#4 Dancing BeeAcres 0.21#5 Venex from Michael Simics 3.34#6 Emu Oil 0.16

DiscussionThe clear winner was Venex, formulated recently by Michael Simics. In addition to producing thestrongest redness, it was associated with the greatest amount of stinging or burning, and many subjectsnoticed a raised wheal and redness even beyond the direct area of application. None of the other creamsdemonstrated spread of tissue erythema (redness) beyond the borders of the original application. Manysubjects reported that the skin reaction to #2, #3 and #5 lasted for hours.

It must again be emphasized that the degree of skin reaction does not necessarily correlate with theclinical result that would be obtained by applying a cream to the area of a joint and rubbing it in. Thiswould have to be tested on a group of people with arthritic joints. Thus, I am planning a clinical trial in the

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near future to follow up on these results. If readers have comments about their experience with any ofthe products tested or have another product they would like me to look at and test, please write to meat the AAS (aasoffice@apitherapy.org).

I would like to thank everyone who volunteered to help with the study and made possible the rapidcollection of this interesting data.