THE EFFECT OF ST. JOHN'S WORT OİL APPLİCATİON ON PERIORBITAL EDEMA AND ECCHYMOSİS AFTER RHİNOPLASTY

February 26, 2026 updated by: Şirin URUÇ DEMİR, Inonu University

Rhinoplasty is one of the most frequently performed procedures in aesthetic and reconstructive surgery, with steadily increasing demand worldwide. Periorbital ecchymosis and edema are common early postoperative complications, primarily resulting from soft tissue hemorrhage during osteotomy. Although these findings are considered part of the natural postoperative course, they may negatively affect patient comfort and satisfaction, particularly in young individuals with high aesthetic expectations. St. John's Wort (Hypericum perforatum) has been reported to possess anti-inflammatory, anti-edematous, and antispasmodic properties. This study aims to evaluate the effect of topical St. John's Wort oil on postoperative periorbital edema and ecchymosis in patients undergoing rhinoplasty.

Methods

This randomized controlled experimental study will be conducted in a university hospital setting. The study population will consist of patients scheduled for rhinoplasty, and the sample will include those who provide informed consent. Participants will be randomly assigned to either the experimental group (n = 55) or the control group (n = 55). In addition to routine postoperative care, the experimental group will receive topical St. John's Wort oil application, while the control group will receive routine care alone. Data will be collected using a Personal Information Form, the Upper and Lower Eyelid Ecchymosis Assessment Scale, and the Eyelid Edema Assessment Scale. Assessments will be performed on postoperative Day 0, Day 1 (24 hours), Day 3 (72 hours), and Day 7 (168 hours). Statistical analyses will be conducted using SPSS version 25. Data distribution will be assessed for normality, and appropriate parametric or non-parametric tests will be applied. Statistical significance will be set at p < 0.05.

Results

It is anticipated that patients receiving topical St. John's Wort oil will demonstrate significantly lower periorbital edema and ecchymosis scores compared to the control group during the early postoperative period.

Conclusion

Given the role of soft tissue hemorrhage in the development of postoperative ecchymosis and edema, and considering the documented pharmacological properties of St. John's Wort, topical application may represent a safe and effective adjunctive intervention for reducing periorbital complications following rhinoplasty. Further clinical evidence may support its integration into routine postoperative care protocols.

Aim of the Study

The aim of this study is to investigate the effect of St. John's Wort oil (Hypericum perforatum) on postoperative periorbital edema and ecchymosis in patients undergoing rhinoplasty.

Hypotheses

H0a (Null Hypothesis):

St. John's Wort oil (Hypericum perforatum) has no effect on postoperative periorbital edema following rhinoplasty.

H1a (Alternative Hypothesis):

St. John's Wort oil (Hypericum perforatum) has a significant effect on postoperative periorbital edema following rhinoplasty.

H0b (Null Hypothesis):

St. John's Wort oil (Hypericum perforatum) has no effect on postoperative periorbital ecchymosis following rhinoplasty.

H1b (Alternative Hypothesis):

St. John's Wort oil (Hypericum perforatum) has a significant effect on postoperative periorbital ecchymosis following rhinoplasty.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

110

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Malatya
      • Malatya, Malatya, Turkey (Türkiye), 44100
        • İnonü Universty

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Undergoing aesthetic or functional rhinoplasty. Aged 18 years or older. Not receiving anticoagulant therapy. No known hematological disorders. No fibrinolytic disorders. No allergy to St. John's Wort oil (Hypericum perforatum) or any of its components.

Undergoing surgery with the same surgical technique. No communication difficulties. No psychiatric diagnoses. First-time rhinoplasty patients.

Exclusion Criteria:

  • Undergoing rhinoplasty due to trauma. Diagnosed with diabetes mellitus. Diagnosed with hypertension. Current smokers. Having a psychiatric diagnosis. Allergic to St. John's Wort oil (Hypericum perforatum) or any of its components.

Using anticoagulant therapy. Having hematological disorders. Having fibrinolytic disorders. Using medications metabolized by CYP3A4, CYP2C9, or CYP2C19. Using medications containing oral contraceptives, antidepressants, or theophylline.

Scheduled for organ transplantation within the next two months.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Experimental group

Patients undergoing rhinoplasty will provide verbal and written consent, and the experimental group will undergo a preoperative patch test for St. John's Wort oil (Hypericum perforatum) allergy. Postoperatively, patients will receive routine cold application followed by bilateral topical St. John's Wort oil. On the day of surgery, three applications will be administered at 4-hour intervals, continuing three times daily for seven days at home.

Periorbital edema and ecchymosis will be assessed at 1 and 24 hours postoperatively through direct observation, and on Days 3 and 7 via digital photographs. Both the researcher and clinical nurse will independently score each eye using standardized criteria. Data will be analyzed to evaluate the effect of St. John's Wort oil on postoperative periorbital complications.
Other: Topical St. John's Wort oil application
Considering the beneficial effects of St. John's Wort oil, the study aims to accelerate patients' return to normal daily activities after surgery by more rapidly reducing aesthetic concerns and postoperative complications.
No Intervention: Control group
During the preoperative period, patients will be introduced to the study, provided with detailed information, and both verbal and written informed consent will be obtained. After introducing the data collection tools, the researcher will complete the Personal Information Data Form. Postoperatively (considered Day 0), periorbital edema and ecchymosis scores will be recorded at four time points: 1 hour, 24 hours (Day 1), 72 hours (Day 3), and 168 hours (Day 7) using the Upper and Lower Eyelid Ecchymosis Assessment Scale and the Eyelid Edema Assessment Scale.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Periorbital edema and ecchymosis score
Time Frame: Within the first week after surgery
Periorbital edema and ecchymosis score: A standardized clinical scale used to quantify the severity of swelling (edema) and bruising (ecchymosis) around the upper and lower eyelids following surgery.
Within the first week after surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Inonu University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 27, 2026

Primary Completion (Estimated)

June 27, 2026

Study Completion (Estimated)

July 27, 2026

Study Registration Dates

First Submitted

February 26, 2026

First Submitted That Met QC Criteria

February 26, 2026

First Posted (Actual)

March 4, 2026

Study Record Updates

Last Update Posted (Actual)

March 4, 2026

Last Update Submitted That Met QC Criteria

February 26, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2024/6259

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Effect of postoperative topical St. John's Wort oil (Hypericum perforatum) on periorbital edema and ecchymosis following rhinoplasty

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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