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External Application of Herbal Medicines for Acne Vulgaris: A Systematic Review and Meta Analysis

Journal of Pharmacopuncture. 2020;23(1):8-17 DOI 10.3831/KPI.2020.23.002


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Journal Title: Journal of Pharmacopuncture

ISSN: 2093-6966 (Print); 2234-6856 (Online)

Publisher: Korean Pharmacopuncture Institute

LCC Subject Category: Medicine: Other systems of medicine: Miscellaneous systems and treatments | Medicine: Therapeutics. Pharmacology

Country of publisher: Korea, Republic of

Language of fulltext: English, Korean

Full-text formats available: PDF, HTML, XML



Soo-Hyun Sung (Department of Policy Development, National Development Institute of Korean Medicine, Seoul, 04554, South Korea)

Gwang-Ho Choi (School of Korean Medicine, Pusan National University, Yangsan, 50612, South Korea)

Nam-Woo Lee (School of Korean Medicine, Pusan National University, Yangsan, 50612, South Korea)

Byung-Cheul Shin (Division of Clinical Me dicine, School of Korean Medicine, Pusan National University, Yangsan, 50612, South Korea)


Double blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 10 weeks


Abstract | Full Text

The objective of this systematic review is to critically evaluate the evidence of the effectiveness and safety of external application of herbal medicines (EAHM) for acne vurgalis (AV). English, Chinese and Korean language databases were searched up to May 2018. Randomized clinical trials (RCTs) that reported the effects of EAHM for AV were included and analysed. A total of 10 randomized trials with 656 AV patients were identified. A meta-analysis of two RCTs indicated that EAHM had a significant effect on improving primary outcome ‘global assessment’ compared with placebo (mean difference (MD) = -2.62, confidence interval (CI) = -4.84 to -0.40, p = 0.02). Furthermore, data extracted from two RCTs showed that EAHM significantly reduce primary outcome ‘inflammatory lesion count of acne’ (MD = -1.25, CI = -1.68 to -0.83, p < 0.00001) and ‘non-inflammatory lesion count of acne’ (MD = -1.32, CI = -1.75 to -0.90, p < 0.00001). No significant difference was observed between groups in secondary outcome ‘sebum of skin’ (MD = -0.21, CI = -0.53 to 0.11, p = 0.20) and ‘patient-reported changes in symptom’ (relative risk (RR) = 2.56, CI = 0.43 to 15.22, p = 0.30). No severe adverse events (AEs) were found and no treatment was stopped due to AEs of EAHM. EAHM seems to have affirmative effects, but quality of evidence, and non-standardized use of EAHM make our conclusion weak. Our suggestion is rigorously designed RCTs and standardization of EAHM are required in the future.