Botanical and Phytochemical Therapy of Acne: A Systematic Review

Abstract

Acne is prevalent among adolescents and adults with significant psychological effects. Standard oral and topical therapies can have significant side effects including skin irritation, gastrointestinal upset, and the development of drug-resistant bacteria. The use of botanicals and phytochemicals in dermatological products is increasingly popular, and many patients are turning to these alternative therapies for treatment of acne. This study aimed to systematically review clinical studies that have investigated the use of botanical agents in the treatment of acne. PubMed and Embase databases were searched in March 2013 for trials assessing botanical therapies in the treatment of acne vulgaris. Data from these trials are presented, and methodology of each study is assessed. Twenty-three trials met inclusion criteria. Interventions included plant extracts, herbal formulations, and phytochemicals. All studies reported favorable results, and several showed equal or superior treatment to standard therapies. No serious adverse events were reported. Few studies were methodologically rigorous. Each botanical was studied in only one or two trials. Botanicals are promising therapies for acne vulgaris although further research is warranted, especially with regard to severe acne and acne resistant to conventional therapy. There is a need for standardized methods for grading acne and assessing therapeutic effects.

Treatment of acne with tea tree oil (melaleuca) products: A review of efficacy, tolerability and potential modes of action

“…However, this generalisation must be considered within the context of the overall quality of these studies. Trial quality is often acknowledged as a limitation of studies assessing alternative products [23].…”

Anacardium occidentale L. extract in cosmetic formulations: benefits for oily skin

“…Their characterization and study of their applications are essential for effective and safe use in topical formulations (18) . The findings obtained in the present in vitro assay demonstrate that the CAE presents antioxidant activity.…”

“…A caracterização e estudo de suas aplicações são essenciais para o uso eficaz e seguro em formulações tópicas (18) . Os resultados obtidos no presente ensaio in vitro demonstram que o CAE apresenta actividade antioxidante.…”

A Critical Approach to Evaluating Clinical Efficacy, Adverse Events and Drug Interactions of Herbal Remedies

“…Key information of some of them, published in the 2013–2015 years, are summarized in Table . Furthermore, other recently published systematic reviews provided evidence of efficacy for black cohosh ( Cimicifuga racemosa ) in menopausal women (Ulbricht and Windsor, ), Dang Shen ( Codonopsis pilosula ) for chronic obstructive pulmonary disease and some botanical preparations for dermatological conditions (Fisk et al , ; Fisk et al , ) but failed to show clear beneficial effects for pomegranate ( Punica granatum ) in the prevention and treatment of cardiovascular diseases (Vlachojannis et al , 2015), for Hibiscus sabdariffa in lowering serum lipids (Aziz et al , 2013) and for saw palmetto ( Serenoa repens ) in patients with benign prostatic hyperplasia (Tacklind et al , ). In several instances, the available evidence is limited by the poor methodological quality and risk of bias of the included studies, so claims of effectiveness appear to rely largely on poor‐quality evidence and firm conclusions cannot be drawn.…”