Title: | The efficacy and safety of non-pharmacological therapies for the treatment of acne vulgaris: A systematic review and best-evidence synthesis |
Author(s): | Vries, F.M.C. de; Meulendijks, A.M.; Driessen, R.J.B. ; Dooren, A.A. van; Tjin, E.P.M.; Kerkhof, P.C.M. van de |
Publication year: | 2018 |
Source: | JEADV : Journal of the European Academy of Dermatology and Venereology, vol. 32, iss. 7, (2018), pp. 1195-1203 |
ISSN: | 0926-9959 |
DOI: | https://doi.org/10.1111/jdv.14881 |
Publication type: | Article / Letter to editor |
Please use this identifier to cite or link to this item : https://hdl.handle.net/2066/193304 ![]() |
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Subject: | Radboudumc 5: Inflammatory diseases RIHS: Radboud Institute for Health Sciences |
Organization: | Dermatology |
Journal title: |
JEADV : Journal of the European Academy of Dermatology and Venereology
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Volume: | vol. 32 |
Issue: | iss. 7 |
Page start: | p. 1195 |
Page end: | p. 1203 |
Abstract: |
BACKGROUND: Acne vulgaris is a multifaceted skin disorder, affecting more than 85% of young individuals worldwide. Pharmacological therapy is not always desirable because of the development of antibiotic resistance or the potential risk of adverse effects. Non-pharmacological therapies can be viable alternatives for conventional therapies. However, sufficient evidence-based support in the efficacy and safety of non-pharmacological therapies is lacking. OBJECTIVE: To assess the efficacy and safety of several non-pharmacological therapies in the treatment of acne vulgaris. METHODS: A systematic literature review, including a best-evidence synthesis, was performed to identify literature. Three electronic databases were accessed and searched for studies published between January 2000 and May 2017. RESULTS: Thirty-three eligible studies were included in our systematic review. Three main types of non-pharmacological therapies were identified laser- and light-based therapies, chemical peels and fractional microneedling radiofrequency. The majority of the included studies demonstrated a significant reduction in acne lesions. However, only seven studies had a high methodologic quality. Based on these seven trials, a best-evidence synthesis was conducted. Strong evidence was found for glycolic acid (10-40%). Moderate evidence was found for amino fruit acid (20-60%), intense pulsed light (400-700 and 870-1200 nm) and the diode laser (1450 nm). Initially, conflicting evidence was found for pulsed dye laser (585-595 nm). The most frequently reported side-effects for non-pharmacological therapies included erythema, tolerable pain, purpura, oedema and a few cases of hyperpigmentation, which were in most cases mild and transient. CONCLUSION: Circumstantial evidence was found for non-pharmacological therapies in the treatment of acne vulgaris. However, the lack of high methodological quality among included studies prevented us to draw clear conclusions, regarding a stepwise approach. Nevertheless, our systematic review including a best-evidence synthesis did create order and structure in resulting outcomes in which a first step towards future research is generated.
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