Interventions for acne scars

Hay, Rania Abdel; Shalaby, Khalid; Zaher, Hesham; Hafez, Vanessa; Chi, Ching‐Chi; Dimitri, Sandra; Nabhan, Ashraf; Layton, Alison

doi:10.1002/14651858.cd011946.pub2

Cited by 43 publications

(24 citation statements)

References 81 publications

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“… 25 Second, this review did not investigate the effects of chemical peeling for acne scarring although chemical peels are used clinically for this indication. 26 Finally, as previously discussed, the absence of a standardised peeling regimen limits the translation of our findings to clinical practice.…”

Section: Discussionmentioning

confidence: 81%

Chemical peels for acne vulgaris: a systematic review of randomised controlled trials

et al. 2018

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ObjectiveWe evaluated current evidence from randomised controlled trials (RCTs) regarding the effectiveness of chemical peeling for treating acne vulgaris.MethodsStandard Cochrane methodological procedures were used. We searched MEDLINE, Cochrane Central Register of Controlled Trials and EMBASE via OvidSP through April 2017. Reviewers independently assessed eligibility, risk of bias and extracted data.ResultsTwelve RCTs (387 participants) were included. Effectiveness was not significantly different: trichloroacetic acid versus salicylic acid (SA) (percentage of total improvement: risk ratio (RR) 0.89; 95% CI 0.73 to 1.10), glycolic acid (GA) versus amino fruit acid (the reduction of inflammatory lesions: mean difference (MD), 0.20; 95% CI −3.03 to 3.43), SA versus pyruvic acid (excellent or good improvement: RR 1.11; 95% CI 0.73 to 1.69), GA versus SA (good or fair improvement: RR 1.00; 95% CI 0.85 to 1.18), GA versus Jessner’s solution (JS) (self-reported improvements: RR 1.00; 95% CI 0.44 to 2.26), and lipohydroxy acid versus SA (reduction of non-inflammatory lesions: 55.6%vs48.5%, p=0.878). Combined SA and mandelic acid peeling was superior to GA peeling (percentage of improvement in total acne score: 85.3%vs68.5%, p<0.001). GA peeling was superior to placebo (excellent or good improvement: RR 2.30; 95% CI 1.40 to 3.77). SA peeling may be superior to JS peeling for comedones (reduction of comedones: 53.4%vs26.3%, p=0.001) but less effective than phototherapy for pustules (number of pustules: MD −7.00; 95% CI −10.84 to −3.16).LimitationsThe methodological quality of the included RCTs was very low to moderate. Meta-analysis was not possible due to the significant clinical heterogeneity across studies.ConclusionCommonly used chemical peels appear to be similarly effective for mild-to-moderate acne vulgaris and well tolerated. However, based on current limited evidence, a robust conclusion cannot be drawn regarding any definitive superiority or equality among the currently used chemical peels. Well-designed RCTs are needed to identify optimal regimens.

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Section: Discussionmentioning

confidence: 81%

Chemical peels for acne vulgaris: a systematic review of randomised controlled trials

et al. 2018

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“…A wide range of interventions (e.g., laser resurfacing, dermabrasion) for the latter are available, but they may not be suitable or affordable for all patients [ 18 ]. Furthermore, a recent Cochrane review concluded that quality evidence to support the first-line use of any invasive procedure in the treatment of acne scars was lacking, and whether any short-term benefit would translate to long-term effects is unclear [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Prevention and Reduction of Atrophic Acne Scars with Adapalene 0.3%/Benzoyl Peroxide 2.5% Gel in Subjects with Moderate or Severe Facial Acne: Results of a 6-Month Randomized, Vehicle-Controlled Trial Using Intra-Individual Comparison

et al. 2018

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BackgroundVery few clinical trials have investigated the effect of topical acne treatment on scarring.ObjectivesOur objective was to evaluate the efficacy of adapalene 0.3%/benzoyl peroxide 2.5% gel (A0.3/BPO2.5) in atrophic acne scar formation in patients with acne.MethodsIn this multicenter, randomized, investigator-blinded, vehicle-controlled study, subjects with moderate or severe facial acne (Investigator’s Global Assessment [IGA] score 3 or 4; ≥ 25 inflammatory lesions; ten or more atrophic acne scars) applied A0.3/BPO2.5 or vehicle daily per half face for 24 weeks. Subjects with acne requiring systemic treatment were excluded. Assessments included investigator atrophic acne scar count, Scar Global Assessment (SGA), acne lesion count, IGA, skin roughness and skin texture, subject self-assessment of clinical acne-related scars and satisfaction questionnaire, tolerability, and safety.ResultsIncluded subjects (n = 67) had mainly moderate acne (92.5% IGA 3); mean scores at baseline were approximately 40 acne lesions and 12 scars per half face. By week 24, the change from baseline in total scar count was − 15.5% for A0.3/BPO2.5 versus + 14.4% for vehicle (approximately 30% difference), with a mean of 9.5 scars versus 13.3 per half face, respectively (p < 0.0001). For SGA at week 24, a total of 32.9% with A0.3/BPO2.5 versus 16.4% with vehicle (p < 0.01) were clear/almost clear. Inflammatory acne lesions decreased by 86.7% for A0.3/BPO2.5 versus 57.9% for vehicle (p < 0.0001), and 64.2 versus 19.4% of subjects, respectively, were IGA clear/almost clear (p < 0.0001) at week 24. Treatment-related AEs were reported by 20.9% for A0.3/BPO2.5 versus 9% for vehicle side, most commonly skin irritation (14.9 vs. 6%, respectively).ConclusionsTopical A0.3/BPO2.5 prevented and reduced atrophic scar formation. Scar count increased with vehicle (+ 14.4%) but decreased with A0.3/BPO2.5 (− 15.5%) over 24 weeks.Trial registryClinicalTrials.gov identifier NCT02735421.

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“…Acne scarring is a frequent complication of acne, and patients often lack effective and safe methods for managing this condition. 15 The resulting scars may negatively impact on an affected person's psychosocial and physical well-being. It has been reported that acne can result in psychological distress and have profound effects on the patients’ self-esteem, which may lead to anxiety, depression, diminished self-confidence and communication difficulties.…”

Section: Introductionmentioning

confidence: 99%

The prevalence of acne in Mainland China: a systematic review and meta-analysis

Chen

Liu

et al. 2017

BMJ Open

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IntroductionAcne, a very common skin disease, can result in psychological distress and sustain impairment in quality of life. Data on the prevalence of acne and the differences in gender, region and age are limited. The aim of this review is to estimate the prevalence of acne in Mainland China comprehensively and to quantify its association with gender, region and age.MethodsWe searched electronic databases with predetermined search terms to identify relevant studies published between 1 January 1996 and 30 September 2016. We pointed out repeated results using Note Express software and evaluated the studies for inclusion. Two independent reviewers extracted the data, followed with statistical analyses using Comprehensive Meta-Analysis software version 2.0. A random effects model was adopted to calculate the overall pooled prevalence and to merge categories, including gender (males and females), region (Northern China and Southern China) and age (primary and secondary students: 7–17 years old; undergraduates: 18–23 years old; overall: no limits of age) for subgroup analyses. Logistic meta-regression analysis was used to clarify the associations between acne and the predictors age, gender and region using OR and their associated 95% CI.Results25 relevant studies were included in this meta-analysis. The overall pooled prevalence rates of acne were 39.2% (95% CI 0.310 to 0.479). The prevalence rates in different age groups were 10.2% overall (95% CI 0.059 to 0.171), 50.2% for primary and secondary students (95% CI 0.451 to 0.554), and 44.5% for undergraduates (95% CI 0.358 to 0.534); by gender, the prevalence rates were 35.7% for females (95% CI 0.275 to 0.448) and 39.7% for males (95% CI 0.317 to 0.482); and by region, the prevalence rates were 34.2% for Northern China (95% CI 0.242 to 0.458) and 46.3% for Southern China (95% CI 0.374 to 0.555). The associations between acne and the predictors age, gender and region were statistically significant.ConclusionsIn Mainland China, primary and secondary students exhibited higher prevalence rates than undergraduate students; males had higher prevalence rates of acne than females; and the prevalence rates of acne in Southern China was higher than Northern China.

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Interventions for acne scars

Cited by 43 publications

References 81 publications

Chemical peels for acne vulgaris: a systematic review of randomised controlled trials

Chemical peels for acne vulgaris: a systematic review of randomised controlled trials

Prevention and Reduction of Atrophic Acne Scars with Adapalene 0.3%/Benzoyl Peroxide 2.5% Gel in Subjects with Moderate or Severe Facial Acne: Results of a 6-Month Randomized, Vehicle-Controlled Trial Using Intra-Individual Comparison

The prevalence of acne in Mainland China: a systematic review and meta-analysis

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