A comparative study on the effectiveness of herbal extracts vs 2.5% benzoyl peroxide in the treatment of mild to moderate acne vulgaris
Abstract
Background: Although there is a standard guideline for the treatment of acne, it is still a common skin disease, and suboptimal medication adherence is a major reason for treatment failure. Herbal extracts are an interesting alternative medicine because they consist of a variety of active ingredients. Moreover, herbal extracts may have improved therapeutic efficacy because of the combination of various herbs. Objectives: To evaluate the effectiveness of herbal extracts for the treatment of mild to moderate acne vulgaris. Methods: A total of 77 patients were randomized to receive either an herbal extract or 2.5% benzoyl peroxide, which were applied for a period of 12 weeks. Acne lesion counts, adherence, porphyrin counts, the Dermatology Life Quality Index, satisfaction and side effects were assessed. Result: At the 12‐week point, the acne lesion counts decreased, with statistically significant differences from the baseline values in both groups and for all types of acne (P‐value < 0.001). The adherence rate was significantly higher in the patients using the herbal extract than in the patients using 2.5% benzoyl peroxide (P‐value = 0.002). There was no statistically significant difference in terms of porphyrin counts, spot scores, the Dermatology Life Quality Index or satisfaction with efficacy between the groups; however, satisfaction with drug administration was significantly higher in the patients using the herbal extract (P‐value = 0.001). Conclusion: Herbal extracts could be beneficial for anti‐acne pharmaceutical preparations and may be used as an alternative medicine for patients with mild to moderate acne vulgaris who do not adhere to benzoyl peroxide treatment.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Three lower quality studies reported significantly superior improvements in acne lesion counts compared to placebo or comparators.
“Three of the lower quality studies reported significantly superior improvements in the acne lesion counts compared to placebo or comparators”
From International expert consensus recommendations for the use of dermocosmetics in acne. (2025) · cites this paper as [34]
In primarily open-label (four) and one split-face study, use of dermocosmetics was associated with excellent or good tolerability.
“In primarily open‐label (four) and one split‐face studies, use of dermocosmetics was associated with excellent or good tolerability”
From International expert consensus recommendations for the use of dermocosmetics in acne. (2025) · cites this paper as [34]
Good adherence was reported in two studies of dermocosmetics.
“good adherence was reported in two studies.”
From International expert consensus recommendations for the use of dermocosmetics in acne. (2025) · cites this paper as [34]
The remaining lower quality studies on acne lesion counts had no comparator arms but reported reductions of 40%-95% in acne lesions.
“the remainder had no comparator arms but reported reductions of 40%–95% in acne lesions.”
From International expert consensus recommendations for the use of dermocosmetics in acne. (2025) · cites this paper as [34]
Cites
Dermatology Life Quality Index (DLQI)-a simple practical measure for routine clinical use
Finlay, A. Y., & KHAN, G. K. (1994) · Clinical and Experimental Dermatology · doi:10.1111/j.1365-2230.1994.tb01167.x · Cited by 5,610 · see citing works
Antibacterial and Antifungal Properties of Essential Oils
Kalemba, D., & Kunicka‐Styczyńska, A. (2003) · Current Medicinal Chemistry · doi:10.2174/0929867033457719 · Cited by 1,939 · see citing works
Sample Size Calculations in Clinical Research
Chow, S., Wang, H., & Shao, J. (2003) · CRC Press eBooks · doi:10.1201/9780203911341 · Cited by 813 · see citing works
Sample Size Calculations in Clinical Research
Chow, S.-C., Wang, H., & Shao, J. (2007) · doi:10.1201/9781584889830 · Cited by 562 · see citing works
The effect of niacinamide on reducing cutaneous pigmentation and suppression of melanosome transfer
Hakozaki, T., Minwalla, L., Zhuang, J., Chhoa, M., Matsubara, A., Miyamoto, K., Greatens, A., Hillebrand, G. G., Bissett, D. L., & Boissy, R. E. (2002) · British Journal of Dermatology · doi:10.1046/j.1365-2133.2002.04834.x · Cited by 492 · see citing works
Scholz, C. F. P., & Kilian, M. (2016) · INTERNATIONAL JOURNAL OF SYSTEMATIC AND EVOLUTIONARY MICROBIOLOGY · doi:10.1099/ijsem.0.001367 · Cited by 463 · see citing works
Status of surfactants as penetration enhancers in transdermal drug delivery
Yasir, M., Som, I., & Bhatia, K. (2012) · Journal of Pharmacy And Bioallied Sciences · doi:10.4103/0975-7406.92724 · Cited by 303 · see citing works
A comparative study of tea‐tree oil versus benzoylperoxide in the treatment of acne
Bassett, I. B., Barnetson, R. S. C., & Pannowitz, D. L. (1990) · Medical Journal of Australia · doi:10.5694/j.1326-5377.1990.tb126150.x · Cited by 286 · see citing works
Role of Tyrosinase as the Determinant of Pigmentation in Cultured Human Melanocytes
Iozumi, K., Hoganson, G. E., Pennella, R., Everett, M. A., & Fuller, B. B. (1993) · Journal of Investigative Dermatology · doi:10.1111/1523-1747.ep12476630 · Cited by 267 · see citing works
Medication Adherence to Multidrug Regimens
Marcum, Z. A., & Gellad, W. F. (2012) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2012.01.008 · Cited by 266 · see citing works
A review of applications of tea tree oil in dermatology
Pazyar, N., Yaghoobi, R., Bagherani, N., & Kazerouni, A. (2013) · International Journal of Dermatology · doi:10.1111/j.1365-4632.2012.05654.x · Cited by 252 · see citing works
The Leeds revised acne grading system
O'brien, S., Lewis, J. B., & Cunliffe, W. (1998) · Journal of Dermatological Treatment · doi:10.3109/09546639809160698 · Cited by 226 · see citing works
(2007) · PubMed · Cited by 223 · see citing works
Jooya, A., Siadat, A., Iraji, F., & Enshaieh, S. (2007) · Indian Journal of Dermatology, Venereology and Leprology · doi:10.4103/0378-6323.30646 · Cited by 165 · see citing works
Effect of Garcinia mangostana on inflammation caused by Propionibacterium acnes
Chomnawang, M. T., Surassmo, S., Nukoolkarn, V. S., et al. (2007) · Fitoterapia · doi:10.1016/j.fitote.2007.02.019 · Cited by 140 · see citing works
Comparing 2.5%, 5%, and 10% benzoyl peroxide on inflammatory acne vulgaris
Mills, O. H., Kligman, A. M., Pochi, P., & Comite, H. (1986) · International Journal of Dermatology · doi:10.1111/j.1365-4362.1986.tb04534.x · Cited by 138 · see citing works
Hammer, K. A. (2014) · International Journal of Antimicrobial Agents · doi:10.1016/j.ijantimicag.2014.10.011 · Cited by 132 · see citing works
Gollnick, H. P. M., Draelos, Z., Glenn, M. J., Rosoph, L. A., Kaszuba, A., Cornelison, R., Gore, B., Liu, Y., Graeber, M., & for the Adapalene-BPO Study Group (2009) · British Journal of Dermatology · doi:10.1111/j.1365-2133.2009.09209.x · Cited by 128 · see citing works
Benzoyl peroxide: a review of its current use in the treatment of acne vulgaris
Sagransky, M. J., Yentzer, B. A., & Feldman, S. R. (2009) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656560903277228 · Cited by 118 · see citing works
Niacinamide-containing facial moisturizer improves skin barrier and benefits subjects with rosacea.
Draelos, Z. D., Ertel, K. D., & Berge, C. A. (2005) · PubMed · Cited by 87 · see citing works
(2002) · Cited by 72 · see citing works
HUGHES, B. R., Norris, J. F. B., & Cunliffe, W. J. (1992) · Clinical and Experimental Dermatology · doi:10.1111/j.1365-2230.1992.tb00196.x · Cited by 71 · see citing works
Medical Adherence to Acne Therapy: A Systematic Review
Snyder, S. N., Crandell, I., Davis, S., et al. (2014) · American Journal of Clinical Dermatology · doi:10.1007/s40257-014-0063-y · Cited by 68 · see citing works
Complementary/Alternative Medicine in Dermatology
Ernst, E., Pittler, M. H., & Stevinson, C. D. (2002) · American Journal of Clinical Dermatology · doi:10.2165/00128071-200203050-00006 · Cited by 59 · see citing works
Seidler, E. M., & Kimball, A. B. (2010) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2009.07.052 · Cited by 58 · see citing works
Hajheydari, Z., Saeedi, M., Morteza‐Semnani, K., & Soltani, A. (2013) · Journal of Dermatological Treatment · doi:10.3109/09546634.2013.768328 · Cited by 49 · see citing works
Youn, S. W., Kim, J., Lee, J. E., Kim, S. O., & Park, K. C. (2009) · Skin Research and Technology · doi:10.1111/j.1600-0846.2009.00360.x · Cited by 39 · see citing works
An exploratory study of adherence to topical benzoyl peroxide in patients with acne vulgaris
Yentzer, B. A., Alikhan, A., TEUSCHLER, H. V., et al. (2009) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2008.11.019 · Cited by 37 · see citing works
Pikuła, M., Żebrowska, M. E., Pobłocka‐Olech, L., et al. (2013) · Pharmaceutical Biology · doi:10.3109/13880209.2013.826246 · Cited by 35 · see citing works
A comparative study of benzoyl peroxide and clindamycin phosphate for treating acne vulgaris
Swinyer, L. J., Baker, M. D., Swinyer, T., & Mills, O. H. (1988) · British Journal of Dermatology · doi:10.1111/j.1365-2133.1988.tb03472.x · Cited by 32 · see citing works
Draelos, Z. D., Baumann, L., Fleischer, A. B., et al. (2012) · PubMed · Cited by 26 · see citing works
Andrès, P., Pernin, C., & Poncet, M. (2008) · PubMed · Cited by 23 · see citing works
Önder, M. (2008) · Cited by 21 · see citing works
Follicular fluorescence quantity to characterize acne severity: a validation study
Richter, C., Trojahn, C., Dobos, G., Blume‐Peytavi, U., & Kottner, J. (2016) · Skin Research and Technology · doi:10.1111/srt.12286 · Cited by 14 · see citing works
The importance of photoprotection and moisturization in treating acne vulgaris.
Bowe, W. P., & Kircik, L. (2014) · PubMed · Cited by 9 · see citing works
A Noninferiority Margin for Acne Lesion Counts
Gerlinger, C., Städtler, G., Götzelmann, R., et al. (2008) · Drug Information Journal · doi:10.1177/009286150804200608 · Cited by 8 · see citing works
Digital fluorescence as a parameter of Propionibacterium acnes suppression needs assessment
Burkhart, C. N. (2001) · International Journal of Dermatology · doi:10.1046/j.1365-4362.2001.01164.x · Cited by 7 · see citing works
Effects of enoxaparin and onion extract on cytokine production in skin fibroblasts
Trzonkowski, P., & Sznitowska, G. (2009) · Cited by 3 · see citing works
Ha, J.-S., Jo, N.-G., Lee, H. K., et al. (1996) · Journal of the Society of Cosmetic Scientists of Korea · Cited by 3 · see citing works
Pikuła, M., Żebrowska, M. E., Trzonkowski, P., et al. (2009) · Central European Journal of Immunology · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
International expert consensus recommendations for the use of dermocosmetics in acne.
Thiboutot, D., Layton, A. M., Traore, I., Gontijo, G., Troielli, P., Ju, Q., Kurokawa, I., & Dreno, B. (2025) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/jdv.20145 · Cited by 32 · see citing works
- Authors
- Lubtikulthum, P., Kamanamool, N., & Udompataikul, M.
- Affiliations
- Srinakharinwirot University (TH)
- Corresponding author
- Udompataikul, Montree
- Venue
- Journal of Cosmetic Dermatology
- Publisher
- Wiley
- Published
- 2019-04-23
- Volume
- 18
- Issue
- 6
- Pages
- 1767-1775
- ISSN
- 1473-2130 (ISSN-L)
- 1473-2165
- OpenAlex
- W2941798570
- Cited by
- 23
- References
- 41
- Citations by year
- 2025: 4 · 2024: 1 · 2023: 4 · 2022: 6 · 2021: 4 · 2020: 3 · 2019: 1
- FWCI
- 3.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Cosmetic Dermatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Srinakharinwirot University
- Topics
- Health Sciences › Medicine › Dermatology › Acne and Rosacea Treatments and Effects
- Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
- Health Sciences › Medicine › Dermatology › Dermatologic Treatments and Research
- Keywords
- acne, plant extracts, benzoyl peroxide, medication adherence, acne lesion count, Dermatology Life Quality Index, patient satisfaction, complementary and alternative medicine
- MeSH terms
- Acne Vulgaris, Benzoyl Peroxide, Dermatologic Agents, Female, Humans, Male, Plant Extracts, Quality of Life, Severity of Illness Index, Treatment Outcome, Drug Monitoring, Patient Satisfaction, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
