A comparative study on the effectiveness of herbal extracts vs 2.5% benzoyl peroxide in the treatment of mild to moderate acne vulgaris

Abstract

Background Although there is a standard guideline for the treatment of acne, it is still a common skin disease, and suboptimal medication adherence is a major reason for treatment failure. Herbal extracts are an interesting alternative medicine because they consist of a variety of active ingredients. Moreover, herbal extracts may have improved therapeutic efficacy because of the combination of various herbs. Objectives To evaluate the effectiveness of herbal extracts for the treatment of mild to moderate acne vulgaris. Methods A total of 77 patients were randomized to receive either an herbal extract or 2.5% benzoyl peroxide, which were applied for a period of 12 weeks. Acne lesion counts, adherence, porphyrin counts, the Dermatology Life Quality Index, satisfaction and side effects were assessed. Result At the 12‐week point, the acne lesion counts decreased, with statistically significant differences from the baseline values in both groups and for all types of acne (P‐value < 0.001). The adherence rate was significantly higher in the patients using the herbal extract than in the patients using 2.5% benzoyl peroxide (P‐value = 0.002). There was no statistically significant difference in terms of porphyrin counts, spot scores, the Dermatology Life Quality Index or satisfaction with efficacy between the groups; however, satisfaction with drug administration was significantly higher in the patients using the herbal extract (P‐value = 0.001). Conclusion Herbal extracts could be beneficial for anti‐acne pharmaceutical preparations and may be used as an alternative medicine for patients with mild to moderate acne vulgaris who do not adhere to benzoyl peroxide treatment.

An overview of treatment options for mild‐to‐moderate acne based on American Academy of Dermatology, European Academy of Dermatology and Venereology, and Italian Society of Dermatology and Venereology guidelines

“…In both groups there was a statistically significant reduction in lesions with improvement in DLQI. However, the rate of adhesion and satisfaction was to a greater extent in the group that used herbal extracts 22 …”

“…21 A clinical study in 71 patients with moderate and mild acne compared the application of herbal extracts with BPO gel at 2.5% for 12 weeks. 22 Results were evaluated in terms of acne lesions, adherence to treatment, porphyrin count, and dermatology life quality index (DLQI). In both groups there was a statistically significant reduction in lesions with improvement in DLQI.…”

“…However, the rate of adhesion and satisfaction was to a greater extent in the group that used herbal extracts. 22…”

Complementary and alternative medicine treatments for common skin diseases: A systematic review and meta-analysis

“…Likewise, TTO treatment resulted in a statistically significant reduction of the mean total number of inflammatory and noninflammatory lesions. 17,19 Although TTO was associated with a slower onset of action compared with the control, 17 it was associated with fewer side effects. 17,19 Similarly, GT lotion treatment yielded a statistically significant reduction in the TLC and severity index.…”

“…17,19 Although TTO was associated with a slower onset of action compared with the control, 17 it was associated with fewer side effects. 17,19 Similarly, GT lotion treatment yielded a statistically significant reduction in the TLC and severity index. 5 Lastly, kanuka honey showed little improvement of the investigator's global assessment acne score, and several participants experienced worsening acne with this treatment.…”