Complementary and Alternative Methods for Treatment of Acne Vulgaris: a Systematic Review

Abstract

Purpose of Review

To review the current literature regarding complementary and alternative treatment options for acne vulgaris.

Recent Findings

Acne vulgaris is an increasingly prevalent disease worldwide. While conventional methods of treatment are still primarily used to treat acne, complementary and alternative methods of treatment are becoming utilized in conjunction or in place of prescription medications.

Summary

Studies have shown comparable benefit of Complementary and Alternative Medicine (CAM) therapies to conventional treatment. Oral green tea extract was a moderately effective treatment of inflammatory acne without significant side effects. Nicotinamide oral and topical preparations demonstrated efficacy in the treatment of moderate inflammatory acne without significant side effects. Oral zinc gluconate was not as effective as oral minocycline in the treatment of inflammatory acne. CAM therapy has relatively few reported side effects for acne vulgaris, and is mildly effective in treatment of inflammatory and comedonal acne. More studies are needed for further comparison of CAM modalities with each other as well as with conventional treatment.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.

    Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, van Rompay M, et al. Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA. 1998;280:1569–75.

    CAS  Article  Google Scholar 

  2. 2.

    Rakel D. Integrative medicine. 3rd ed. Philadelphia: Elsevier; 2012.

    Google Scholar 

  3. 3.

    Use of Complementary Health Approaches in the U.S.: National Health Interview Survey. 9/24/2017. https://nccih.nih.gov/research/statistics/NHIS/2012/key-findings

  4. 4.

    Baron SE, Goodwin RG, Nicolau N, et al. Use of complementary medicine among outpatients with dermatologic conditions within Yorkshire and South Wales, United Kingdom. J Am Acad Dermatol. 2005;52:589–94.

    Article  Google Scholar 

  5. 5.

    Ong CK, Petersen S, Bodeker GC, Stewart-Brown S. Health status of people using complementary and alternative medical practitioner services in 4 English counties. Am J Public Health. 2002;92:1653–6.

    Article  Google Scholar 

  6. 6.

    Lee GBW, Charn TC, Chew ZH, Ng TP. Complementary and alternative medicine use in patients with chronic diseases in primary care is associated with perceived quality of care and cultural beliefs. Fam Pract. 2004;21:654–60.

    CAS  Article  Google Scholar 

  7. 7.

    Ben-Arye E, Ziv M, Frenkel M, et al. Complementary medicine and psoriasis: Linking the patient’s outlook with evidence-based medicine. Dermatology. 2003;207:302–7.

    CAS  Article  Google Scholar 

  8. 8.

    Johnston GA, Bilbao RM, Graham-Brown RA. The use of complementary medicine in children with atopic dermatitis in secondary care in Leicester. Br J Dermatol. 2003;149:566–71.

    CAS  Article  Google Scholar 

  9. 9.

    Jensen P. Alternative therapy for atopic dermatitis and psoriasis: Patient-reported motivation, information source and effect. Acta Dermato-Venereologica. 1990;70:425–8.

    CAS  PubMed  Google Scholar 

  10. 10.

    Global, regional, and national disability adjusted life years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories. 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1260–1344.

  11. 11.

    Centre for evidence-based medicine; http://www.cebm.net

  12. 12.

    Mahmood T, Akhtar N, Khan BA, Khan HM, Saeed T. Outcomes of 3% green tea emulsion on skin sebum production in male volunteers. Bosn J Basic Med Sci. 2010;10(3):260–4.

    Article  Google Scholar 

  13. 13.

    • Forest JM, Rafikhah N. Oral aqueous green tea extract and acne vulgaris: a placebo-controlled study. Asian J Clinl Nutr. 2014;6(2):41–6. Green tea extract is hypothesized to be an anti-inflammatory agent. This study showed total acne lesions and inflammed acne lesions decreased significanly in green tea extract group. However, there was no significant difference in the reduction of noninflammatory acne lesions between treatment and control groups.

  14. 14.

    Lu PH, Hsu CH. Does supplementation with green tea extract improve acne in post-adolescent women? A randomized, double-blind, and placebo controlled clinical trial. Complement Ther Med. 2016;25:159–63.

    CAS  Article  Google Scholar 

  15. 15.

    Yoon JY, Kwon HH, Min SU, Thiboutot DM, Suh DH. Epigallocatechin-3-gallate improves acne in humans by modulating intracellular molecular targets and inhibiting P. Acnes. J Investig Dermatol. 2013;133(2):429–40.

    CAS  Article  Google Scholar 

  16. 16.

    • Weltert Y, Chartier S, Gibaud C, et al. Double-blind clinical assessment of the efficacy of a 4% nicotinamide gel (Exfoliac® NC gel) versus a 4% erythromycin gel in the treatment of moderate acne with a predominant inflammatory component. Nouvelles Dermatologiques. 2004;23(1):385–94. Study found that 4% Nicotinamide gel could be a comparable to 1% Clindamycin gel for moderate inflammatory acne.

  17. 17.

    Shalita AR, Smith JG, Parish LC, Sofman MS, Chalker DK. Topical nicotinamide compared with clindamycin gel in the treatment of inflammatory acne vulgaris. Int J Dermatol. 1995;34(6):434–7.

    CAS  Article  Google Scholar 

  18. 18.

    • Dreno B, Moyse D, Alirezai M, Amblard P, Auffret N, Beylot C, et al. Mulicenter randomized comparative double-blind controlled clinical trial of the safety and efficacy of zinc gluconate versus minocycline hydrochloride in the treatment of inflammatory acne vulgaris. Dermatology. 2001;203(2):135–40. Authors found that clinical success, defined as more than two-thirds decrease in inflammatory lesions found significant difference (p<0.001) for Zinc gluconate and Minocycline Hydrochloride was 31.2% and 63.4% respectively.

    CAS  Article  Google Scholar 

  19. 19.

    Sharquie KE, Noaimi AA, Al-Salih MM. Topical therapy of acne vulgaris using 2% tea lotion in comparison with 5% zinc sulphate solution. Saudi Med J. 2008;29(12):1757–61.

    PubMed  Google Scholar 

  20. 20.

    Shafiq Y, Naqvi BS, Rizwani G, et al. Anti-acne activity of Casuarina equisetifolia bark extract: a randomized clinical trial. Banglad J Pharmacol. 2014;9(3):337–41.

    Article  Google Scholar 

  21. 21.

    Hassoun LA, Ornelas JN, Sivamani RK. Cedarwood oil as complementary treatment in refractory acne. J Altern Complement Med. 2016 Mar;22(3):252–3.

    Article  Google Scholar 

  22. 22.

    Meier L, Stange R, Michalsen A, Uehleke B. Clay jojoba oil facial mask for lesioned skin and mild acne—result of a prospective, observational pilot study. Forsch Komplementmed. 2012;19(2):75–9.

    Article  Google Scholar 

  23. 23.

    Da Silva AG, Puziol PF, Leitao RN, et al. Application of the essential oil from copaiba (Copaifera langsdorffii Desf.) for acne vulgaris: a double blind, placebo controlled clinical trial. Altern Med Rev. 2012;17(1):69–75.

    PubMed  Google Scholar 

  24. 24.

    Appiah S, Lawley B, Vu M, Bell C, Jones H. Evaluation of the effectiveness of Eladi Keram for the treatment of acne vulgaris: a randomised controlled pilot study. Europ J Integrat Med. 2017;12:38–43.

    Article  Google Scholar 

  25. 25.

    Lim HS, Chun SM, Soung MG, Kim J, Kim SJ. Antimicrobial efficacy of granulysin-derived synthetic peptides in ance vulgaris. Int J Dermatol. 2015;54(7):853–62.

    CAS  Article  Google Scholar 

  26. 26.

    Han SM, Lee KG, Pak SC. Effects of cosmetics containing purified honeybee (Apis mellifera L.) venom on acne vulgaris. J Integr Med. 2013;11(5):320–6.

    Article  Google Scholar 

  27. 27.

    Bilgili SG, Ozkol HU, Karadag AS, Calka O. The use of complementary and alternative medicine among dermatology outpatients in eastern Turkey. Hum Exp Toxicol. 2014;33(2):214–21.

    CAS  Article  Google Scholar 

  28. 28.

    Bartenjev I, Oremovic L, Rogi Butina M, et al. Topical effectiveness of a cosmetic skincare treatment for acne-prone skin: a clinical study. Acta Dermatovenerol Alp Pannonica Adriat. 2011;20(2):55–62.

    PubMed  Google Scholar 

  29. 29.

    Malhi HK, Tu J, Riley TV, Kumarasinghe SP, Hammer KA. Tea tree oil for mild to moderate acne; a 12 week uncontrolled, open-label, phase II pilot study. Australas J Dermatol. 2017;58(3):205–10.

    Article  Google Scholar 

  30. 30.

    Dreno B, Castell A, Tsankov N, Lipozencic J, Serdaroglu S, Gutierrez V, et al. Interest of the association retinaldehyde/glycolic acid in adult acne. J Eur Acad Dermatol Venereol. 2009;23(5):529–32.

    CAS  Article  Google Scholar 

  31. 31.

    Niren NM, Torok HM. The nicomide improvement in clinical outcomes study (NICOS): results of an 8 week trial. Cutis. 2006;77(1 Suppl):17–28.

    PubMed  Google Scholar 

  32. 32.

    Orafidiya LO, Agbani E, Oyedele A, et al. The effect of Aloe vera gel on the anti-acne properties of the essential oil of Ocimum gratissimum Linn leaf—a preliminary clinical investigation. Int J Aromather. 2004;14(1):15–21.

    CAS  Article  Google Scholar 

  33. 33.

    Polakova K, Fauger A, Savag M, Jourdan E. A dermacosmetic containing bukachiol, Ginkgo boliba extract and mannitol improves the efficacy of adapalene in patients with acne vulgaris: result from a controlled randomized trial. Clin Cosmet Investig Dermatol. 2015;8:187–91.

    CAS  PubMed  PubMed Central  Google Scholar 

  34. 34.

    Ali A, Akhtar N. The safety and efficacy of 3% cannabis seeds extract cream for reduction of human cheek skin sebum and erythema content. Pak J Pharm Sci. 2015;28(4):1389–95.

    CAS  PubMed  Google Scholar 

  35. 35.

    Miglani A, Raj KM. Prospective, non-randomised, open-label study of homeopathic Zingiber officinale (ginger) in the treatment of acne vulgaris. Foc Altern ComplemTherap. 2014;19(4):191–7.

    Article  Google Scholar 

  36. 36.

    Khan BA, Akhtar N. Clinical and sebumetric evaluation of topical emulsions in the treatment of acne vulgaris. Postepy Dermatol Alergol. 2014;31(4):229–34.

    Article  Google Scholar 

  37. 37.

    Semprini A, Braithwaite I, Corin A, et al. Randomised controlled trial of topical kanuka honey for the treatment of acne. BMJ Open. 2016;6(2):e009448.

    Article  Google Scholar 

  38. 38.

    Kim KS, Kim YB. Anit-inflammatory effect of Keigai-rengyo-to extract and acupuncture in male patients with acne vulgaris: a randomized controlled pilot trial. J Altern Complement Med. 2012;18(5):501–8.

    Article  Google Scholar 

  39. 39.

    Rubin MG, Kim K, Logan AC. Acne vulgaris, mental health and omega-3 fatty acids: a report of cases. Lipids Health Dis. 2008;7:36.

    Article  Google Scholar 

  40. 40.

    Yang M, Moclair B, Hatcher V, Kaminetsky J, Mekas M, Chapas A, et al. A randomized, double-blind, placebo-controlled study of a novel pantothenic acid-based dietary supplement in subjects with mild to moderate facial acne. Dermatol Ther. 2014;4(1):93–101.

    Article  Google Scholar 

  41. 41.

    Lone AH, Habib S, Ahmad T, Anwar M. Effect of polyherbal Unani formulation in acne vulgaris: a preliminary study. J Ayurveda Integr Med. 2012;3(4):180–3.

    Article  Google Scholar 

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Correspondence to Hania K. Flaten.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Capsule summary

• CAM for acne vulgaris is utilized worldwide but limited studies investigate their safety and effectiveness.

• This article reviews evidence of CAM in treating acne and comparisons of CAM with conventional treatment.

• CAM is a widely used and occasionally effective avenue of treatment in patients wishing for natural therapies.

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Marous, M.R., Flaten, H.K., Sledge, B. et al. Complementary and Alternative Methods for Treatment of Acne Vulgaris: a Systematic Review. Curr Derm Rep 7, 359–370 (2018). https://doi.org/10.1007/s13671-018-0230-0

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Keywords

  • Acne vulgaris
  • Complementary treatment
  • Alternative treatment