If you have ever cut up a fresh pineapple and noticed how smooth your hands felt afterward, you have experienced the basic action of bromelain. Pineapple (Ananas comosus) is a well-known tropical plant that has been used for centuries for both its medicinal purposes and its food value. Bromelain is a complex chemical found in the aqueous extract of the pineapple and is composed largely of proteolytic enzymes.1 As an individual product, bromelain has been available commercially since 1957. Other components of this substance include glycoproteins, complex carbohydrates, protease inhibitors, and peroxidases.1
Bromelain’s first commercially recognized use was as a meat tenderizer because of its ability to degrade animal proteins. Since then, it has been studied for its potential as an anti-inflammatory, an immune modulator, and even as an anticancer therapy. Bromelain-containing pharmaceutical products are available in other countries both by prescription and over the counter, depending on the intended use. Multiple clinical trials are ongoing in the United States.
The most studied and proven action of bromelain is as a proteolytic enzyme. Clinical trials of bromelain-containing products for the nonsurgical debridement of burn eschar have been very favorable. This procedure, long known for being horribly painful, is nonetheless essential for proper healing of severe burns. Because deep and full-thickness burns routinely require performing this painful procedure multiple times during the healing process, skin grafting is also commonly needed for adequate wound coverage. Skin grafting then not only compounds the cosmetic damage but also adds more pain and discomfort.
Products containing bromelain are being studied for their potential role in this process, with some very promising results. One leading bromelain compound has been found to reduce healthy skin tissue by up to 50%, while also reducing the number of surgical procedures required by more than 75%.2 Overall recovery rates average 85%, with 70% of these patients able to avoid skin grafting completely.2 In one prospective noncomparative trial using a bromelain-derived debriding agent in 130 patients with 332 second- and third-degree burns, wound debridement was accomplished in more than 75% of cases with 1 to 3 applications.2
This article originally appeared on Clinical Advisor