Author's Accepted Manuscript

An ethnobotanical survey of medicinal plants

used in Rwanda for voluntary depigmentation
Léocadie Kamagaju, Elias Bizuru, Védaste
Minani, Renato Morandini, Caroline Stevigny,
Ghanen Ghanem, Pierre Duez

www.elsevier.com/locate/jep

PII: S0378-8741(13)00678-8
DOI: http://dx.doi.org/10.1016/j.jep.2013.09.031
Reference: JEP8352

To appear in: Journal of Ethnopharmacology

Received date: 16 May 2013

Revised date: 9 September 2013
Accepted date: 23 September 2013

Cite this article as: Léocadie Kamagaju, Elias Bizuru, Védaste Minani, Renato
Morandini, Caroline Stevigny, Ghanen Ghanem, Pierre Duez, An ethnobota-
nical survey of medicinal plants used in Rwanda for voluntary depigmenta-
tion, Journal of Ethnopharmacology, http://dx.doi.org/10.1016/j.jep.2013.09.031

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 An ethnobotanical survey of medicinal plants used in Rwanda for
voluntary depigmentation
Léocadie KAMAGAJUa,b , Elias BIZURUc, Védaste MINANIc, Renato MORANDINId,
Caroline STEVIGNYa, Ghanen GHANEMd, Pierre DUEZa,e*
a
Laboratoire de Pharmacognosie, de Bromatologie et de Nutrition Humaine, Université Libre de Bruxelles (ULB),

Campus de la Plaine, CP205/9, Bd du Triomphe, 1050 Bruxelles, Belgique

b
Programme de Recherche en Phytomédicaments et Sciences de la Vie, Institut de Recherche Scientifique et

Technologique (IRST), B.P. 227 Butare, Rwanda

c
National University of Rwanda (NUR), Department of Biology, BP 117 Butare-Rwanda
d
Laboratoire d’Oncologie et de Chirurgie Expérimentale, Université Libre de Bruxelles (ULB), Institut Jules

Bordet-CP401, rue Héger-Bordet1, 1000 Bruxelles, Belgique

e
Service de Chimie Thérapeutique et de Pharmacognosie, Université de Mons (UMONS), Bât. Mendeleiev, Avenue

Maistriau, 7000 Mons, Belgique

Abstract
Ethnopharmacological relevance: Voluntary depigmentation, a very common practice in sub-
Saharan Africa, often performed with pharmaceutical products diverted from their
pharmacological use, may cause severe dermatological and systemic side effects. The present
work aims at investigating whether and which herbs were used in Rwanda for similar purposes
before the advent of the current depigmentation craze; this may give clues at herbal treatments
possibly advantageous compared to current products.
Material and methods: Sixty-one traditional healers, mostly representatives of their associations,
were surveyed by questionnaires for knowledge and practice of voluntary depigmentation.
Recipes or plants used, plant parts, harvest area, preparation methods, dosage and route of
administration were recorded. Most of the cited herbs were harvested with the help of traditional

Corresponding author at: Laboratoire de Pharmacognosie, de Bromatologie
et de Nutrition Humaine, Faculté de Pharmacie, Université Libre de Bruxelles,
CP 205/09, Bd du Triomphe, 1050 Bruxelles, Belgique.
Tel.: +32 26505172; fax: +32 26505430.
E-mail address:lkamagaj@ulb.ac.be(L.KAMAGAJU);pduez@ulb.ac.be(P.DUEZ).

1
healers and identified by comparison with voucher specimens; herbal vouchers of the five most
cited herbs were deposited in official herbaria.
Results: All surveyed traditional healers have knowledge of voluntary depigmentation; the
population currently practicing do not recourse to their services but obtain bleaching products
directly from the market. Traditional healers disclosed recipes prescribed or self-used (often by
women) in their youth; others cited recipes are used to treat skin diseases with properties of
"clarification", "black skin stain removal", in cases of hyperpigmentation, and/or "skin
softening". Curiously, from the 28 recipes cited by traditional healers, all are mono-herbal
preparations; most of the plants are mixed with butter for application to the skin.
Conclusion: Compared to other pathophysiological conditions, there is currently a very limited
use of herbal preparations for depigmentation. Five herbs had a citation percentage equal or
above to 50 %, Brillantaisia cicatricosa Lindau (Acanthaceae), Chenopodium ugandae (Aellen)
Aellen (Chenopodiaceae), Dolichopentas longiflora Oliv. (Rubiaceae), Protea madiensis Oliv.
(Proteaceae) and Sesamum angolense Welw. (Pedaliaceae); in vitro experiments indicated a
modulation of melanogenesis by these plant extracts, confirming the information obtained from
traditional healers.

Keywords: Skin; Botany; Cosmetics; Traditional medicine Africa; Voluntary Depigmentation;

Rwanda

1. Introduction

Throughout history and all over the world, people, especially women, have used various
products, notably of herbal origin, to take care of their bodies and maintain their skin.
Nowadays, so-called "natural cosmetics" are favored by the general public, partly due to
increased wariness towards the chemicals contained in many commercial products; this branch of
cosmetics specifically exhibited increased revenue of 20.9% from 2006 to 2011 (Vermaak et al.,
2011). Also, in recent years, the possibly beneficial dermatological properties of herbs have been
widely investigated by top cosmetic laboratories.
In most sub-Saharan African cultures especially, clear skin complexion has been for a long time
considered as one of the main criteria of beauty for an African woman (Bonniol, 1995); skin-
whitening cosmetics probably existed well before the advent of modern cosmetics (Miyanji de

2
Souza, 2008). For example, in Rwanda, some plants were traditionally used to lighten the skin,
especially by women and girls, to prepare for major ceremonies like marriage. This practice
called Voluntary Depigmentation (VD), or skin lightening, is defined as a deliberate attempt to
reduce the physiological pigmentation of his/her skin for cosmetic purposes (Levang et al., 2009;
Morand et al., 2007). VD practice appears quite common in Africa and is known under various
names according to the country, for example "xessal" in Senegal, (del Giudice and Y., 2002;
Mahe et al., 2003), "tcha-tcho" in Mali (Mahe et al., 1993), "ambi" in Gabon, "maquillage" in
Congo (Gathse et al., 2005; Petit, 2007), "kwitukuza" (that literally means "rendering his/her
skin red") in Rwanda.
The most used modern depigmenting products include topical steroids, hydroquinone and its
derivatives, kojic acid and mercury derivatives (Pitche et al., 1997). Among them hydroquinone
is the most commonly used, fist allowed in cosmetics (up to 2 %) in the European union in 1984,
by the Commission Directive 84/415/EEC (Fifth Commission Directive 84/415/EEC, 1984).
Sixteen years later however, its use was restricted to hair-dye products and artificial nail systems
by Commission Directive 2000/6/EC (Twenty-fourth Commission Directive 2000/6/EC, 2000).
Often performed with pharmaceutical products diverted from their pharmacological use, VD may
cause severe dermatological and systemic side effects. Some of these complications are impaired
wound healing and wound dehiscence, nephropathy, a "fish odor" syndrome, a steroid addiction
syndrome, endocrinologic complications of corticosteroids, including suppression of
hypothalamic-pituitary-adrenal axis, a predisposition to infections and a broad spectrum of
cutaneous disorders such as dyschromia, exogenous ochronosis, acne and hypertrichosis,
prominent striae, tinea corporis, pyoderma, erysipelas, scabies, and contact dermatitis (Morand
et al., 2007).
In front of the current depigmentation craze, the present work aims at investigating whether and
which herbs were or are still used in Rwanda for skin whitening; this may give hints at herbal
treatments possibly advantageous compared to current products. As ethnopharmacological
inquiries have been shown to be a most reliable approach to drug discovery (Fabricant and
Farnsworth, 2001; Telefo et al., 2011), this method may also clue at pharmacological compounds
active on skin, possibly to be developed as future cosmetics. As proposed by (Fleurentin and
Balansard, 2002), the methodological approach used in this study is limited to field work,
conducting surveys among traditional healers to identify the use of depigmenting plants.

3
2. Material and methods
2.1. Study area and population
The present investigation was conducted in Rwanda, a Central African country, considering all
five provinces (North, South, East, West provinces and Kigali city), covering 2 districts per
province (Fig.1) (Huye, Muhanga, Rusizi, Rubavu, Musanze, Gicumbi , Bugesera, Nyagatare
Nyarugenge and Gasabo) and 5 tradipraticians per district. These representative districts were
chosen to cover traditional medicine realities on the whole Rwandan territory.
In Rwanda, many traditional healers are grouped into associations under the supervision of the
Ministry of Health in collaboration with the Institute of Scientific and Technological Research
(IRST). Before starting our investigation, we surveyed the various associations of traditional
healers. In districts where there are traditional healers' associations, these associations selected
five representatives, deemed to "know the voluntary depigmentation", to participate in the
interviews, to report their experience but also the herbs used by their association members. In the
three districts where there is no association (Rusizi, Nyagatare and Gicumbi), we selected 5
traditional healers, based on their local reputation on the use of herbal cosmetics. As voluntary
depigmentation is more practiced in town, we furthermore contacted 11 traditional healers in the
town of Kigali, to yield a total of 61 informants.

4
 Nyagatare

Musanze
Gicumbi

Rubavu

Gasabo

Nyarugenge
Muhanga

Bugesera

Huye
Rusizi

Fig.1. Map of Rwanda, districts of interviewed traditional healers

2.2. Questionnaire
The study followed principles laid out in the Declaration of Helsinki (World Medical
Association, 2008). In Rwanda, only one national language, Kinyarwanda, is spoken throughout
the country. As most practitioners do not speak other languages, interviews were held in
Kinyarwanda, a language mastered by the first author.
The questionnaires were divided into three sections: (i) personal information such as name, age,
sex, civil status, studies level, location and nationality of the traditional practitioner; (ii) their
knowledge and eventual practice record regarding voluntary depigmentation and skin disorders;
(iii) their practice of depigmentation, recipes or plants used, plant parts, harvest area, preparation
methods, dosage, route of administration and eventual other associated practices.

5
In all instances, informed consent was obtained from the respondents to divulge information and,
when consent was refused, no question whatsoever was forced on the individual.
2.3. Collection of herbal samples and plant identification
Interviewed traditional health practitioners indicated the vernacular names of plants claimed to
be useful in depigmentation and skin disorders treatment (Table 2). For every cited herb, the part
of the plant actually used was obtained from the informant; morphological examination of
samples, comparing with reference material at the National Herbarium of Rwanda (NHR,
Butare-Rwanda), corroborated the identifications. Table 1 describes (i) the exact plant parts
harvested in the presence of traditional healers; (ii) the identification criteria applied by a trained
local botanist; (iii) the voucher specimens for some of the samples we stored in the herbarium;
and (iv) the consulted literature that confirms the translation between scientific names and
vernacular names indicated by tradipraticians at harvest. All plants were identified based on
identification criteria found in relevant taxonomic literature, including the African Plant
Database and the International Plant Names Index (Flore du Rwanda, vol.I; II; III) (CJB, 2011;
Troupin, 1978, 1983, 1985).The families of flowering plants were classified on the basis of the
APG (Angiosperm Phylogeny Group) III 2009 system (Elspeth et al., 2009; I.P.N.I, 2005).
For the 5 most cited plants, complete herbarium specimens were deposited in Belgium herbaria
as mentioned in (Kamagaju et al., 2013) and in the National Herbarium of Rwanda (Table 2). For
all plants, the conservation status has been verified on the Red List of IUCN (International Union
of Conservation of Nature) on EAPRLA (East African Plant Red Listing Authority) (IUCN,
2012).

6
Table 1: Criteria applied for the identification of harvested samples

Plants Part harvested in the Identification criteria for the harvested part References for the
presence of translation between
Scientific name Local name in traditional healers vernacular and scientific
[Family] Kinyarwanda names
Aloe bukobana Reynolds Igikakarubamba Aerial part: leaves Plant morphology: caulescent, suckering freely to form (Raynal et al., 1985)
[Aloaceae] small dense groups.
Leaves: densely rosulate, lanceolate-attenuate with a
small tip, dull green with slight bloom above, grey-green
below; marginal teeth.
Brillantaisia cicatricosa Ikirogora Stem with leaves and Stem: soft and green. (Rwangabo, 1993;Troupin,
Lindau flowers Leaves: opposite, large, ovate, soft and hairy often 1985; Raynal et al.,1985)
[Acanthaceae] (Nkaka P. 9) (a) cordate at the base but lamina running back down into a
winged petiole; margin coarsely toothed with small and
large teeth.
Flowers: corolla pale to bright blue, mauve, violet or
purple, 2 lipped covered with purplish glandular hairs.
Carica papaya L. Ipapayi Leaves Common plant (Rwangabo, 1993)
[Caricaceae] Leaves: spirally arranged, clustered near apex of trunk; Mukazayire et al., 2011)
hollow, greenish or purplish-green, palmate, deeply 7-
Troupin, 1983)
lobed, glabrous, prominently veined.
Chenopodium ambrosioïdes Umwisheke Stem with leaves Stem: shortly, red and inconspicuously pubescent or (Rwangabo, 1993)
L. puberulous. (Heyndrickx et al., 1992)
[Chenopodiaceae] Leaves: mostly lanceolate, lower with more or less
coarse irregular ascending teeth, upper becoming entire.
Chenopodium ugandae Umugombe Stem with leaves and This plant is present in botanical garden of IRST (Troupin, 1978)
(Aellen) Aellen flowers Stem: green to almost white Rwangabo, 1993)
[Chenopodiaceae] (Kanya JP. 6) (a) Leaves: mostly broadly and shortly rhombic-ovate, the
Vlietinck et al., 1995)
median and lower almost as broad as long, apex of leaf
rounded or acute; Heyndrickx et al., 1992)
Inflorescence: a panicle, usually ample, of very Cos et al., 2002c)
numerous small densely or laxly spicately or rarely Mukazayire et al., 2011)
cymosely arranged dense rounded clusters
("glomerules") of minute grey to greenish flowers Cos et al., 2002a; Cos et
al., 2002b)

7
Citrus aurantifolia Swingle
[Rutaceae]
Dolichopentas longiflora
Oliv. Kårehed & B.Bremer
Synonym: Pentas longiflora
Oliv.
[Rubiaceae]
Entadopsis abyssinica
(Steud. ex. A. Rich.) Gilbert
& Boutique
Synonym: Entada
abyssinica Steud. ex A.
Rich.
[Fabaceae]
Erythrina abyssinica Lam.
ex DC.
[Fabaceae]
Hallea rubrostipulata (K.
Schum.) Leroy Synonym:
Mitragyna rubrostipulata
(K. Schum.) Havil.
[Rubiaceae]
Indimu Part of stem with Common plant (Troupin, 1983)
leaves: branch Stem: with many thorns.
Leaves: ovate, resembling orange leaves.
Isagara Stem with leaves and Plant morphology: 2–3 main stems from a woody (Cos et al., 2002a)
flowers rootstock. Troupin, 1985)
(Kamagaju L. 10) (a) Stem: glabrous to densely covered with whitish or rusty-
Cos et al., 2002b)
orange hairs.
Leaves: leaves paired or in whorls of 3 lanceolate or
rarely ovate-lanceolate, acute at the apex, narrowed at
the base, glabrous to velvety or pubescent, often
ferruginous.
Flowers: white or bluish white or tinged purplish.
Umusange Part of stem with Stem: bark grey to reddish, slightly fissured, and flaking (Rwangabo, 1993)
leaves : branch off in irregular patches. (Vlietinck et al., 1995)
Leaves: alternate, bipinnate, stipules absent; mostly
(Cos et al., 2002c)
linear-oblong, apex round to slightly obtuse and slightly
mucronate, appressed, pubescent above and below. (Cos et al., 2002a)
(Cos et al., 2002b)
Umuko Branch Stem: thickly corky and often spiny; when damaged the (Rwangabo, 1993)
tree exudes a brown, gummy sap. (Troupin, 1983)
Leaves: compound, trifoliolate, alternate; leaflets almost
(Vlietinck et al., 1995)
as broad as long, with the terminal leaflet the largest;
midrib and main veins on the undersurface often bear (Mukazayire et al., 2011)
scattered prickles. (Chagnon, 1984)
Umuzibaziba Branch Stem: the bark is light grey brown, fairly rough and (Rwangabo, 1993)
thick. Leaves: large, in opposite pairs, shiny above and (Vlietinck et al., 1995)
widely oval.
(Mukazayire et al., 2011)
8
Indigofera arrecta Hochst. Umusororo Stem with leaves Leaves: pinnate. (Rwangabo, 1993)
ex A. Rich. (Vlietinck et al., 1995)
[Fabaceae]
(Heyndrickx et al., 1992)
(Cos et al., 2002c)
(Mukazayire et al., 2011)
(Chagnon, 1984)
(Cos et al., 2002a)
(Cos et al., 2002b)
Kotschya aeschynomenoides Umuhanga Stem with leaves Stems: sticky and glandular, densely covered with (Troupin, 1983)
(Welw. ex Baker) Dewit & Umuhunga bristly tubercular-based hairs.
P.A.Duvign. Leaves: compound, oblong to oblong-lanceolate, obtuse
[Fabaceae] and mucronulate at the apex, oblique at the base,
glabrous save for sparse glandular hairs on the main
nerve beneath.
Leptoderris harmsiana Umunyagasozi, Branch Stem: Liana. (Troupin, 1983)
Dunn Umukiryi Leaves: imparipinnate, stipulate; leaflets opposite,
[Fabaceae] stipellate.
Markhamia lutea (Benth.)K. Umusave Branch Common plant (Rwangabo, 1993)
Schum. Stem: bark light brown with fine vertical fissures. (Vlietinck et al., 1995)
[Bignoniaceae] Leaves: compound, often in bunches, thin and wavy,
(Mukazayire et al., 2011)
each leaflet up to 10 cm, wider at the tip, often with
round outgrowths at the base.
Mirabilis jalapa L. Karifuma Stem with leaves Leaves: egg-shaped in outline with broad end at base (Troupin, 1978)
[Nyctaginaceae] (ovate), oblong, or triangular; the leaf tip is acute, base
cordate. The leaf stalks about 4 cm long.
Moringa oleifera Lam. Moringa Branch This plant is present in the botanical garden of IRST Recently introduced plant
[Moringaceae] Stem: brittle, with corky bark.
Leaves: feathery, pale green, compound, tripinnate
Ocimum gratissimum L. var. Umwenya Stem with leaves and This plant is present in botanical garden of IRST (Mukazayire et al., 2011)
gratissimum flowers Stem: erect, round-quadrangular, much branched,
[Lamiaceae] glabrous or pubescent, woody at the base, often with
epidermis peeling in strips.
Leaves: opposite; petiole 2-4.5 cm long, slender,

9
 pubescent; blade elliptical to ovate
Inflorescence: a verticillaster, arranged in a terminal,
simple or branched raceme of about 5-30 cm long
flowers in 6-10-flowered verticillasters, small,
hermaphrodite
Phyllanthus fraternus Uruheza Stem with leaves Leaves: alternate, distichous, almost sessile, whitish (Rwangabo, 1993)
G.L.Webster (Troupin, 1983)
[Euphorbiaceae]
Phytolacca dodecandra Umuhoko Stem with leaves Common plant (Rwangabo, 1993)
L’Hér. Stem: semi-succulent, usually glabrous, more rarely (Troupin, 1978)
[Phytolaccaceae] pubescent.
(Cos et al., 2002b)
Leaves: ovate to broadly elliptic, base rounded to
broadly cuneate, apex acute or rounded. (Vlietinck et al., 1995)
(Heyndrickx et al., 1992)
(Cos et al., 2002c)
(Chagnon, 1984)
(Cos et al., 2002a)
(Cos et al., 2002b)
(Van Puyvelde et al.,
1983)
Protea madiensis Oliv. Umukubagwa, Stem with leaves and Leaves: narrowly to broadly elliptic, ovate or obovate. (Troupin, 1978)
subsp. madiensis igihungeri flowers Flowers: creamy-white; perianth base and claw hairy,
[Proteaceae] (Kamagaju L. 8) (a) limb hairless.
Sesamum angolense Welw. Igonde, Delele, Stem with leaves and Leaves: subsessile or shortly petiolate; lamina cultrate, (Troupin, 1985)
[Pedaliaceae] sope flowers narrowly oblong, narrowly elliptic or oblanceolate, (Vlietinck et al., 1995)
(Kamagaju L. 9) (a) inferior surface white tomentose.
(Heyndrickx et al., 1992)
Flowers: reddish, pink, or pale mauve with darker
markings. (Cos et al., 2002c)
(Cos et al., 2002a)
(Cos et al., 2002b)
Solanum incanum L. Intobo, Branch and fruit Stem: with spines. (Troupin, 1985)
[Solanaceae] Umucucu Leaves: simple, alternate with velvet hairs. (Rwangabo, 1993)
Fruits: rounded and yellow.
(Van Puyvelde et al.,
1983)

10
Spermacoce princeae (K.
Schum.) Verdc.
Synonym: Borreria
princeae SCHUMANN
[Rubiaceae]
Tephrosia vogelii Hook. f.
[Fabaceae]
Tetradenia riparia (Hochst.)
Codd
[Lamiaceae]
Verbena officinalis L.
subsp. officinalis
[Verbenaceae]
Vernonia amygdalina Delile
Synonym: Gymnanthemum
amygdalinum (Delile)
Sch.Bip.ex Walp.
[Asteraceae]
Zehneria scabra (L.f.)
Sonder
[Cucurbitaceae]
(a)
Voucher specimen deposited in the National Herbarium of Rwanda.
Ngingojana Aerial part Common plant
Stem: dark crimson, square, sparsely to densely hairy on (Troupin, 1985)
the angles.
(Rwangabo, 1993)
Leaf: blades 1.2–7 x 0.35–3 cm., elliptic to ovate, acute
at the apex, cuneate at the base, glabrous to pubescent
above, with sparse hairs to pubescent beneath
Flowers: Corolla white or sometimes ringed pinkish;
cylindrical or narrowly funnel-shaped
Ntiruhunwa Stem with leaves Stem: tomentose with long and short white or rusty-
brown hairs.
Leaves: arranged spirally, imparipinnate; stipules
narrowly elliptical to elliptical-oblanceolate.
Umuravumba Branch Stem: smooth, light grey to brown bark. (Rwangabo, 1993)
Leaves: ovate, sometimes round soft and sticky, hairy; (Chagnon, 1984)
veins indented above, prominent below; margin toothed;
leaves exude a spicy scent.
Umugosora Stem with leaves and Leaves: pinnate and lobed. (Rwangabo, 1993)
flowers Flower: lavender-like flower growing up the stem.
Umubirizi Branch Stem: bark light grey or brown, rather rough and (Rwangabo, 1993)
longitudinally flaking. (Cos et al., 2002c)
Leaves: leathery, medium to dark green, with or without
(Mukazayire et al., 2011)
sparse hairs above, with fine, soft, pale hairs below and
conspicuous net-veining lanceolate to oblong. (Chagnon, 1984)
(Cos et al., 2002a)
(Cos et al., 2002b)
Umushishiro Stem with leaves Stem: Glabrous climber. (Troupin, 1983)
Leaves: triangular, cordate at base, hispidulous to (Chagnon, 1984)
densely cinereous-velutinous on the veins beneath,
(Van Puyvelde et al.,
usually drying dark brown.
1983)
11
3. Results and discussion
3.1. Study population

Demographic data of surveyed people may indicate if the study population is biased by our a-
priori requirement of VD knowledge and/or practice. Among the 61 traditional healers
interviewed, 62 % were female. This proportion of women is higher than previously reported
(45 %) in a recent study of Rwandese traditional remedies used for the treatment of liver diseases
(Mukazayire et al., 2011); women indeed appear more concerned and interested in voluntary
depigmentation and skin disorders than men.
Regarding the traditional healers age distribution (Fig.2), most of them are in the range 41 to 70
years; this corresponds to the former study by (Mukazayire et al., 2011). Younger people have
limited knowledge about the use of traditional medicine in general and this is also the case for
cosmetic applications; there appears to be a definite risk of knowledge loss if nothing is done to
identify herbal practices. The younger generation lack of interest in traditional herbal cosmetics
is striking as this is the age class that appears most interested in VD, regularly resorting to
chemical depigmenting agents (Draelos, 2007).

Fig.2. Demographics of interviewed traditional healers.

Most traditional healers claim to be experienced in their work, with 40 % alleging more than 10
years' experience and 21 % more than 20 years; this may contribute to the reliability of collected

12
data. From the 48 traditional healers (79 %) who accepted to state the origin of their art, 56.1 %
received knowledge as a family heirloom, 31.6% were initiated, 10.5 % were "gifted" and 1.8%
had other sources of knowledge (dreams,…). The majority of traditional healers interviewed
(78 %) harvest the plants they use in the bush, but others (22 %), more especially those who live
in cities, have their personal gardens at home; in terms of nature conservation this could be quite
beneficial, reducing anthropic pressure on biodiversity.
Interviewed traditional healers indicate that, although they know many women using herbs
and/or chemical bleaching agents for depigmenting, most of them do not recourse to their
services and trust products purchased from the market. Traditional healers who accepted to
disclose their recipes for skin depigmentation (82 %) precise that they prescribed or used (most
often women) these plants when they were young; others cited recipes are stated to treat skin
diseases with properties of "clarification", "black skin stain removal", in cases of
hyperpigmentation, and/or "skin softening".
3.2. Plants cited by traditional healers
Table 2 lists the plants previously recommended for skin whitening; in fact, according to all
surveyed healers, this is a practice of the past as these herbs are no longer used for this
indication. The five most cited plants (more than 50 % citation), Brillantaisia cicatricosa
Lindau; Chenopodium ugandae (Aellen) Aellen; Dolichopentas longiflora Oliv.; Protea
madiensis Oliv. and Sesamum angolense Welw., are still used in Rwandese traditional medicine
but rather for therapeutic purposes; still related to VD, these uses include removal of pigmented
tasks and restoration of color uniformity to scarred skin. Curiously, the Rwandese traditional
practice of depigmentation proposes only single-herb preparations. This is quite striking as the
general principle of polymedication is a constant in traditional practice, relying on a general idea
that "complex drugs are needed to treat complex (i.e. multifactorial) diseases", a principle
known in Rwanda under the name of "Ifumbi". A previous survey on the Rwandese therapy of
liver diseases also indicated a huge proportion of single-herb preparations (49 % of all herbal
recipes). Regarding their conservation status, all the cited plants are in the category of "Least
Concern" (IUCN, 2012). This information is important for eventually advocating VD through
herbal recipes.

13
Table 2 Herbs (a) reported by respondents

Part used (b)

Vernacular [frequency of Voucher number
Botanical name of plants
name in citation (c)] (National Herbarium of
[Family]
Kinyarwanda (method of Rwanda)
preparation (d))
Aloe bukobana Reynolds
Igikakarubamba L [37 %] (#) Troupin G. 16198
[Aloaceae]
Brillantaisia cicatricosa Lindau
Ikirogora L [50 %] (#) Runyinya B. 290
[Acanthaceae]
Carica papaya L.
Ipapayi L [29 %] (#) Minani V. 115
[Caricaceae]
Chenopodium ambrosioïdes L.
Umwisheke L [17 %] (#) Rugimbana A. 103
[Chenopodiaceae]
Chenopodium ugandae (Aellen) Aellen
Umugombe L [52 %] (#) Auquier P. 2840
[Chenopodiaceae]
Citrus aurantifolia Swingle
Indimu Fr [25 %] (g) Troupin G. 14944
[Rutaceae]
Dolichopentas longiflora Oliv. Kårehed & B.Bremer
Synonym: Pentas longiflora Oliv. Isagara L,R [70 %](#) Mvukiyumwami J. 118
[Rubiaceae]
Entadopsis abyssinica (Steud. ex. A. Rich.) Gilbert
& Boutique Synonym: Entada abyssinica Steud. ex Umusange L [28 %] (#) Troupin G. 5078
A. Rich. [Fabaceae]
Erythrina abyssinica Lam. ex DC.
Umuko Fl [18 %] (#) Troupin G. 10425
[Fabaceae]
Hallea rubrostipulata (K. Schum.) Leroy
Umuzibaziba L [9 %] (#) Auquier P. 2691
[Rubiaceae]
Indigofera arrecta Hochst. ex A. Rich.
Umusororo L [24 %] (#) Reynders 431
[Fabaceae]
Kotschya aeschynomenoides (Welw. ex Baker) Umuhanga L [30 %] (#) Nuyt C. 257
Dewit & P.A.Duvign.
[Fabaceae]
Leptoderris harmsiana Dunn Umunyagasozi, L [20 %] (#) Mvukiyumwami J. 603
[Fabaceae] Umukiryi

Markhamia lutea (Benth.)K. Schum. Umusave Fl [14 %] (#) Rugimbana A. 35

[Bignoniaceae]
Mirabilis jalapa L. Karifuma L [12 %] (#) Troupin G. 14801
[Nyctaginaceae]
Moringa oleifera Lam. Moringa L [15 %] (#) Minani V. 8
[Moringaceae]

14
Ocimum gratissimum L. var. gratissimum Umwenya L [22 %] (#) Bouxin G. 534
[Lamiaceae]
Phyllanthus fraternus G.L.Webster Uruheza L [7 %] (#) Troupin G. 10510
[Phyllanthaceae]
Phytolacca dodecandra L’Hér. Umuhoko L [40 %] (#) Sita P. 4214
[Phytolaccaceae]
Protea madiensis Oliv. subsp. madiensis Umukubagwa, RB [70 %] (?) Troupin G. 15131
[Proteaceae] igihungeri
Sesamum angolense Welw. Igonde, Delele, L [56 %] (#) Radoux M. 4
[Pedaliaceae] sope

Solanum incanum L. Intobo, Fr [35 %] (#) Christiaensen A.R. 307

[Solanaceae] Umucucu

Spermacoce princeae (K. Schum.) Verdc. Ngingojana L [3 %] (#) Rugimbana A. 32

Synonym: Borreria princeae SCHUMANN
[Rubiaceae]
Tephrosia vogelii Hook. f. Ntiruhunwa L [12 %] (#) Radoux M. 2
[Fabaceae]
Tetradenia riparia (Hochst.) Codd Umuravumba L [15 %] (#) Runyinya B. 887
[Lamiaceae]
Verbena officinalis L. subsp. officinalis Umugosora L [6 %] (#) Mvukiyumwami J. 901
[Verbenaceae]
Vernonia amygdalina Delile Umubirizi L [19 %] (#) Troupin G. 10863
Synonym: Gymnanthemum amygdalinum (Delile)
Sch.Bip.ex Walp.
[Asteraceae]
Zehneria scabra (L.f.) Sonder Umushishiro L [13 %] (#) Van Der Veken P.
[Cucurbitaceae] 10343

(a)
All reported recipes are mono-herbal preparations
(b)
L: leaf; RB: root bark; R: root; Fr: fruit; Fl: flower.
(c)
In brackets, frequency of citation (% of responding traditional healers)
(d)
(#), the dry powder is mixed with butter and applied to skin; (g), the juice is squeezed and mixed with body
cream; (?), the supernatant of the root bark infusion is mixed with butter and applied to skin

Regarding the method of preparation for topical use, the plant is most often dried, ground and the
powder is mixed with butter. In Rwandan culture, butter is especially known for many virtues in
skin treatment (Musabyimana, 2006).
A total of 28 plants species belonging to 19 families have been recorded. The Fabaceae family is
the most represented with six plants. Some Fabaceae have already been reported for cosmetic
use, and their skin care reputation in traditional medicine (Table 3).

15
Table 3 Some Fabaceae previously reported (i) as traditional cosmetics and skin care herbals; or
(ii) studied for their inhibitory effects on tyrosinase and/or melanogenesis.
Scientific name Plant organ Inhibition of mushroom references
tyrosinase (%)
Abrus precatorius L. Root n.a. (Scarpa and Guerci, 1987)
Acacia farnesiana (L.) Willd. All parts n.a. (Biavatti et al., 2007)
Arachis hypogaea L. Seed oil n.a. (Athar and Nasir, 2005)
Arisaema speciosum (Wall.) Mart. n.a. (Abbasi et al., 2010)
Astragalus membranaceus (Fisch.) Bunge Root n.a. (Wang et al., 2006)
Bauhinia candicans Benth Bark n.a. (Biavatti et al., 2007)
Bauhinia langsdorffiana Bong. Leaves n.a. (Biavatti et al., 2007)
Bauhinia pulchella Benth. Bark n.a. (Biavatti et al., 2007)
Bowdichia major Mart. Ex Benth Seeds 22 (Baurin et al., 2002)
Butea frondosa Roxb. Ex Willd. Seeds n.a. (Saikia et al., 2006)
(Michel et al., 2011)
Caesalpinia sappan Linn. Heartwood 33.2 (1μg/ml) and 84.5 (Mitani et al., 2013)
(10μg/ml)
Cajanus cajan (L.) Millsp. Seeds n.a. (Saikia et al., 2006)
Cassia hirsuta L. Leaves 10 (Baurin et al., 2002)
Cassia hirsuta L. Root 6 (Baurin et al., 2002)
Cassia occidentalis L. Seeds n.a. (Scarpa and Guerci, 1987)
Cassia verrucosa Vogel Whole n.a. (Biavatti et al., 2007)
plant
Ceratonia siliqua L. Seeds n.a. (Pieroni et al., 2004)
Clitoria ternatea L. Flowers n.a. (Saikia et al., 2006)
Dalea elegans Hook. & Arn. Aerial IC50 = 0.094; 6.61 μg/ml (Chiari et al., 2011)
plant for mono- and
material diphenolase activities of
tyrosinase
Desmodium gangeticium (L.) DC Leaves n.a. (Saikia et al., 2006)
Enterolobium timbouva Mart. Fruits n.a. (Biavatti et al., 2007)
Erythrina crista-galli L. Bark n.a. (Biavatti et al., 2007)
Glycine max (L.) Merr. Seed oil n.a. (Athar and Nasir, 2005)
Glycyrrhiza glabra L. Root n.a. (Scarpa and Guerci, 1987)
(Aburjai and Natsheh, 2003)
Glycyrrhiza uralensis Fisch. Root and 19.6 (Wang et al., 2006)
rhizome
Lens esculenta Moench Seeds n.a. (Saikia et al., 2006)
Lupinus albus L. Seeds n.a. (Pieroni et al., 2004)
Medicago sativa L. Alfalfa oil n.a. (Athar and Nasir, 2005)
Moghania strobilifera Jaume St.Hil. Root n.a. (Saikia et al., 2006)
Myrocarpus frondosus Allemão Wood n.a. (Biavatti et al., 2007)
Parapiptadenia rigida (Benth.) Brenan Gum n.a. (Biavatti et al., 2007)
Phaseolus mungo L. Seeds n.a. (Saikia et al., 2006)
Phaseolus mungo L. Seeds n.a. (Saikia et al., 2006)
Pisum sativum L. n.a. (Aburjai and Natsheh, 2003)
Pithecolobium auaremotemo Mart. Bark n.a. (Biavatti et al., 2007)
Pterocarpus santalinus Blanco Wood n.a.
Pterodon pubescens (Benth.) Benth. Bark n.a. (Biavatti et al., 2007)
Saraca indica L. Wood n.a. (Saikia et al., 2006)
Sesbania grandiflora (L.) Pers. Flowers n.a. (Saikia et al., 2006)
Sophora japonica L. Flowers 54 (Wang et al., 2006)

16
Sophora japonica L. Flowers 64 (Lo et al., 2009)
and flower
buds
Spartium junceum L. Flowers, n.a. (Pieroni et al., 2004)
leaves
Spatholobus suberectus Dunn. Stem 57 (Wang et al., 2006)
Stryphnodendron barbatimao sensu Seeds 52 (Baurin et al., 2002)
Brenan
Stryphnodendron barbatimao sensu Bark 90 (Baurin et al., 2002)
Brenan
Trifolium pretense L. n.a. (Widyarini et al., 2001)
(Aburjai and Natsheh, 2003)
Trigonella foenum graecum L. Seeds n.a. (Saikia et al., 2006)
(Aburjai and Natsheh, 2003)
Vatairea guianensis Aubl. Seeds 26 (Baurin et al., 2002)
Vicia faba L. Fruits n.a. (Pieroni et al., 2004)
Vigna mungo (L.) Hepper Seeds n.a. (Saikia et al., 2006)
Waltheria indica L. Root n.a. (Zongo et al.)

3.3. Traditional uses of the five most cited herbs

Brillantaisia cicatricosa Lindau (Acanthaceae) can unify the complexion of the skin marked by
large black spots. This plant is often cultivated in personal gardens due to its frequent use in
traditional medicinal preparations; the plant is cited as active against leprosy, eczema and
snakebites, as vermifuge, emetic and galactagogue (Van Puyvelde et al., 1988).
According to Rwandan traditional healers, Chenopodium ugandae (Aellen) Aellen
(Chenopodiaceae) is used for the treatment of skin diseases and can decrease the skin
pigmentation; in most case, C. ugandae is cultivated in personal gardens. Previous studies on this
plant showed no antimicrobial (Boily and Van Puyvelde, 1986), acaricidal (Van Puyvelde et al.,
1985) nor antidiarrheal activities (Maikere-Faniyo et al., 1989). C. ugandae has shown toxic
effect on fishes and aquatic insects (Chifundera et al., 1993) and has been recorded in a recipe
against liver diseases (Mukazayire et al., 2011).
Dolichopentas longiflora Oliv. (= Pentas longiflora Oliv.) (Rubiaceae) root bark decoctions are
used in Uganda and Kenya against fever and malaria (Muthaura et al., 2007; Stangelanda et al.,
2011). The dichloromethane and methanol extracts of the roots show an in vitro
antiplasmodial activity (IC50, 0.9 – 3 g/ml) and pyranonaphthoquinones have been isolated
(Endale et al., 2012). Three naphtoquinones (mollugin, pentalongin and isagarin) were isolated
from the root hexane extract (Hari et al., 1991; Van Puyvelde et al., 1998). Our survey indicates
that, in Rwanda, D. longiflora is also traditionally used against skin disease, scabies, skin
mycosis (Pityriasis versicolor).

17
Protea madiensis Oliv. (Proteaceae) root bark is the most frequently cited herb by the Rwandan
traditional healers we surveyed (70 %) and is considered very effective in cases of
hyperpigmentation. The literature shows few studies on this plant. It is used to treat and cure
diarrhea in Uganda (Anokbonggo et al., 1990). Polyphenolic glycosides were isolated from the
genus Protea (Verotta et al., 1999).
According to traditional healers, Sesamum angolense Welw. (Pedaliaceae), called also wild
sesame (Jones et al., 1962), was used in Rwanda by the bride during one month before the
wedding. The leaves were dried, crushed, mixed with butter and applied to the whole body; the
bride had to stay inside the house to avoid tanning by sun exposure. The Sesamum angolense
leaves ethanolic extract shows moderate antiviral activity against the RNA-virus Coxsackie (Cos
et al., 2002b) but not against the human immunodeficiency virus type-1 (HIV-1) (Cos et al.,
2002a). The leaves ethanolic extract is antidiarrheal (Maikere-Faniyo et al., 1989), inhibits
lymphocytes proliferation (Lasure et al., 1995) and is immunomodulatory by acting on the
complement system (Cos et al., 2002c). The leaves methanolic extract shows an anti-
trichomonas activity (Hakizamungu et al., 1992).The dichloromethane root bark extract is
cytotoxic on human colon carcinoma cells (Ic50, 0.875μg/ml) (Chapuis et al., 1988). Lignans
were isolated from the seeds (Bedigian et al., 1985; Jones et al., 1962), naphthoxirenes (Potterat
et al., 1987), iridoids (Potterat et al., 1988) and phenylpropanoid glycosides (Marston et al.,
1988) from the root bark.
In a recent paper (Kamagaju et al., 2013), our team investigated these five most cited herbs for
their effects on melanoma cells viability (MTT test) and pigmentation; modulations of tyrosinase
activity (colorimetry of reaction products, measurement of enzyme activity, TLC-autography;
studies on crude cellular extracts obtained from normal melanocytes and on a mushroom
tyrosinase) and of human melanoma cells melanogenesis were probed. Some of the selected
medicinal plants, notably P. madiensis, clearly show potent tyrosinase inhibitions while one herb
(D. longiflora leaves) significantly increases cell pigmentation; D. longiflora contains potent
growth melanocytes inhibitors.

18
4. Conclusion
Voluntary Depigmentation (VD) is a very common practice in sub-Saharan Africa. This practice
is often performed with pharmaceutical products diverted from their pharmacological use and
those products have many side effects. The aim of our survey was to identify, with the help of
traditional healers, the herbs that are or were used for this purpose. We identified 28 plants
belonging to 19 families that were used in the past for VD, with five plants being cited by at least
50 % of informants. Our study of these plant extracts effect on melanogenesis (Kamagaju et al.,
2013) has confirmed the reliability of the information obtained from traditional healers.
The present survey however indicates that the use of plants for skin lightening is no longer
practiced in surveyed districts; all the plants indicated by traditional healers are those used in the
past. However the 5 most cited plants are still traditionally used for the treatment of skin
diseases, such as skin stains reduction.
For the time being, people prefer VD products sold on the market (pharmaceutics or pseudo-
pharmaceutical cosmetics) as these modern products lighten faster and more intensely than herbs;
the modern practice of VD rapidly spreads despite sometimes severe side effects that are known
but disregarded by the majority of users. There is a definite risk of information loss about
traditional depigmenting practice that may lead to its utter vanishing.
Although the use of the plants for voluntary VD is endangered, plants themselves are not.

Acknowledgements

This work was funded by the Belgium Technical Cooperation (BTC) and partly supported by the
Foundation David and Alice Van Buuren. Both aids are gratefully acknowledged. We are very
grateful for the cooperation of all interviewed traditional healers.

19
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