Acne vulgaris is a multifaceted skin condition that affects more than 85% of young people worldwide. Drug therapy is not always desirable, because of the risk of developing antibiotic resistance or the potential for various side effects. Non-drug therapies may be viable alternatives to conventional ones, but there is not enough supporting evidence of their efficacy and safety. A review of the literature was therefore carried out to assess the efficacy and safety of various non-drug therapies in the treatment of acne.
33 studies were taken into account, on the basis of which 3 main types of non-drug therapy were identified: lasers and light-based treatments, chemical peels and fractional radiofrequency microneedling. Most of the studies considered showed a significant reduction in acne lesions, but only 7 of them were of high methodological quality, and a synthesis of the best available evidence was carried out on the basis of these.
Solid evidence was found for glycolic acid, moderate evidence for amino-fruit acid, IPL and diode lasers, and initially conflicting evidence was found for pulsed light lasers. The side effects most often reported with non-drug therapies include erythema, tolerable pain, purpura, oedema and a few cases of hyperpigmentation, but in most cases these were mild and transient. Circumstantial evidence was therefore found for non-drug therapies in the treatment of acne, but the lack of high methodological quality among the studies examined prevented clear conclusions about a possible stepwise approach. Nevertheless, this review has created order and structure in the results achieved so far, taking a first step towards future research.
