Traditional chinese medicine practices in the clinical management of acne vulgaris : a review

Abstract

Background: Current pharmaceutical drugs used in the management of acne carry a risk of numerous adverse-effects of varying severity, leading to decreased patient treatment adherence. Given the high prevalence of acne vulgaris, there exists a significant demand for alternative treatment modalities. Numerous studies have suggested that Traditional Chinese Medicine (TCM) may be effective and safe adjunctive treatments which may be considered in patients who are not benefitting or are unable to be treated by conventional pharmaceutical drugs. Objective: The aim of this review was to discuss the efficacy and safety of TCM therapies – including acupuncture, cupping, auricular acupuncture and herbal medicine – in the treatment of acne vulgaris; proposing a future prospective open study to investigate the efficacy of bleeding-cupping therapy in the clinical management of acne. Design: An evidence-based review of literature (June 1997 – June 2017) from the following electronic databases: PubMed, Cochrane database of systematic reviews, Science Direct and Hydi. Only abstracts/literature in the English language was included. A combination of the following keywords was used: ‘acne’, ‘TCM’, ‘acupuncture’, ‘cupping’, ‘auricular’, ‘herbal medicine’. Patients: Diagnosis of acne vulgaris (i.e. papulopustular/inflammatory acne); regardless of age, gender or ethnicity. Main outcome measures: Significantly reduced acne lesion counts and/or significantly improved acne severity with various TCM treatments. Results: Sixteen studies were included in this review; the methodological quality of which was generally poor in terms of randomization, blinding and outcome measures. All studies show TCM therapies may reduce acne lesion counts and/or improve acne severity. Conclusions: TCM therapies appear to be effective and safe in the management of acne vulgaris. They may be used as stand-alone treatment or in conjunction with other established therapeutic methods. However, further large-scale rigorously designed trials are necessary in order to confirm these findings and integrate TCM therapies more widely.