Complementary therapies for acne: do they hit the spot?

What a misery acne can be and few teens escape it completely. It can last well into adulthood too. There are many treatments available, both over-the-counter and on prescription. Many people look to alternatives to medical treatment, such as herbal preparations and changes to their diet. Are they any good? A team from The Cochrane Skin Group set out to find out.

Their new Cochrane review brought together the best available evidence from randomised controlled trials on complementary therapies for acne. There are 35 trials (over 3000 people) looking at herbal medicine, acupuncture, wet cupping, diet, purified bee venom, and tea tree oil.

Here’s what they found:

  • Low- versus high-glycaemic load diets were compared. There was no clear evidence of a difference between groups in the number of non-inflammatory lesions after 12 weeks  (2 studies combined). The low glycaemic load diet showed a benefit on inflammatory and total skin lesions in the one study with usable results
  • Single trials found that tea tree oil and bee venom reduced total skin lesions
  • 31 trials gave mixed results about whether complementary therapies might reduce the number of skin lesions
  • No serious adverse events (side effects) were reported. Some people taking herbal medicines had nausea, diarrhoea and stomach upsets; acupuncture needles caused itching, redness and/or pain and tea tree oil users reported itchiness, dryness, and flaking of the skin
  • Groups taking Ziyin Qinggan Xiaocuo Granule or minocycline showed no difference in the number of people with remission (2 studies combined)

How good is the evidence?

There were a lot of problems with these studies, in the way they were designed and carried out and in reporting. The evidence is very weak, coming mostly from single, low quality trials, at high risk of bias. Future trials must be better designed and reported if they are to be useful for those making choices about treatment.

As with some over-the-counter treatments for other ailments, which I wrote about in this recent blog, we’re left not knowing whether these treatments are likely to help or harm. If you’re looking for more information about acne, you might find these NHS Choices pages helpful.

Links:

Cao H, Yang G, Wang Y, Liu JP, Smith CA, Luo H, Liu Y. Complementary therapies for acne vulgaris. Cochrane Database of Systematic Reviews 2015, Issue 1. Art. No.: CD009436. DOI: 10.1002/14651858.CD009436.pub2.

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Sarah Chapman

About Sarah Chapman

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Sarah's work as a Knowledge Broker at Cochrane UK focuses on disseminating Cochrane evidence through social media, including Evidently Cochrane blogs, blogshots and the ‘Evidence for Everyday’ series for nurses, midwives, allied health professionals and patients. A former registered general nurse, Sarah has a particular interest making evidence accessible and useful to practitioners and to others making decisions about health. Before joining Cochrane, Sarah also worked on systematic reviews for the University of Oxford and the Royal College of Nursing Institute, and obtained degrees in History from the University of Oxford and in the history of women’s health and illness in early modern England (MPhil., University of Reading).

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