A systematic review of 33 studies evaluating nonpharmacological treatments for acne provided what was described as “circumstantial” evidence of efficacy by the authors who conducted the analysis.
The 33 studies evaluated three types of treatments: laser-based and light-based treatments (20), chemical peels (11), and fractional microneedling radiofrequency (2); most were associated with significant reductions in acne lesions in the studies. The evidence for efficacy was “strong” for glycolic acid at concentrations from 10% to 40%, and “moderate” for amino fruit acids at concentrations of 20%-60%, for intense pulsed light (IPL: 400-700 and 870-1,200 nm), and for the diode laser 1450 nm, according to F.M.C. de Vries, MD, of the department of dermatology, Radboud University, Nijmegen, the Netherlands, and coauthors.
However, they added, “although a high rate of statistically significant results was found in most of the studies, indicating efficacy of nonpharmacological therapies, the low methodological quality of the included studies made it difficult to draw clear conclusions.” Most of the studies were limited by factors that included a small number of enrolled participants, short follow-up, and lack of or possibly inadequate blinding in participants and/or clinicians.
Their review of three electronic databases (MEDLINE, Cochrane library, CINAHL) identified the 33 studies evaluating these treatments in 1,404 participants with acne, published between January 2000 and May 2017, which met their inclusion criteria.