Topical Application of Arnica and Mucopolysaccharide Polysulfate Attenuates Periorbital Edema and Ecchymosis in Open Rhinoplasty: A Randomized Controlled Clinical Study

Simsek G, Sari E, Kilic R, Bayar Muluk N.

What this paper says

In 108 rhinoplasty patients randomly assigned to three groups, both arnica cream and mucopolysaccharide polysulfate cream reduced bruising and sped the settling of swelling compared with no cream, with no difference between the two creams.

Overview

Swelling and bruising around the eyes are the most visible part of recovery from open rhinoplasty. The authors tested two topical creams against no treatment in a randomised trial, scoring both effects at set intervals during the first ten days after surgery.

Sections of note

108 patients randomised into three groups of 36 each, all after open rhinoplasty.
Group 1 received arnica cream, group 2 received mucopolysaccharide polysulfate cream, group 3 received no local treatment.
Patients were evaluated on days 2, 5, 7 and 10 after the operation, over 24 hours.
Swelling and bruising were scored on a scale from 0 to 4.
Bruising was significantly less in both treated groups than in the control group on days 1, 5 and 7, p less than 0.005.
Swelling settled more rapidly in both treated groups on the same days, p less than 0.005. Neither swelling nor bruising differed between the two creams, p greater than 0.005. Level of evidence 2.

What it means for a patient

Both creams reduced the visible bruising and shortened how long the swelling lasted.
Neither cream was better than the other, so the choice between them can rest on cost and availability.
Effects were measured up to day 10, so this concerns the visible early recovery rather than the final result.
The control group received nothing rather than a dummy cream, so patients and assessors could tell who was treated, which can influence scoring.

Why this paper matters

Reducing early swelling and bruising is the most requested part of rhinoplasty aftercare, and topical remedies are widely sold with thin evidence. A randomised trial of 108 patients addresses that directly. Because there was no placebo cream and the scoring scale is subjective, the size of the effect is less certain than its direction.

Terms

Arnica: a plant extract used topically with the aim of reducing bruising.
Mucopolysaccharide polysulfate: a topical anticoagulant preparation used to reduce swelling and bruising.
Periorbital: around the eye socket.
Edema: fluid swelling in tissue.
Ecchymosis: bruising, blood visible under the skin.
Control group: participants receiving no treatment, for comparison.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“The purpose of this study was to investigate the effects of local arnica and mucopolysaccharide polysulfate treatment on the regression of postoperative edema and ecchymosis in patients who have undergone open technique rhinoplasty. Method: One hundred eight patients were included in the study. Participants were…”

Excerpt; the full abstract is on PubMed.