Efficacy of topical medications for the treatment of moderate acne: A systematic review of randomized controlled trials
DOI:
https://doi.org/10.33448/rsd-v15i4.50852Keywords:
Skin Diseases, Acne Vulgaris, Drug Theraphy.Abstract
Acne vulgaris is a chronic inflammatory condition affecting approximately 85% of young people, with mild to moderate acne being the most prevalent form. In the pharmacological field, topical medications are the most commonly used alternatives for acne treatment, aiming to reduce the number of lesions. The objective of this study was to evaluate which class of topical medication is more effective: conventional (clindamycin, erythromycin, retinoids, and benzoyl peroxide) or conservative (probiotics, prebiotics, salicylic acid, azelaic acid, or moisturizers with ceramides). To this end, a systematic search was conducted in the PubMed, Embase, and Web of Science databases, according to the PRISMA strategy. 20.597 records were located, of which 27 randomized clinical trials were fully eligible, with a total sample of 6.202 patients. The results demonstrated that conventional interventions have a faster and more potent action, with reductions in total lesions exceeding 70%. The use of tazarotene combined with clindamycin also stood out, with a 71% reduction in just 28 days. The conservative class, especially supramolecular salicylic acid and multi-target dermocosmetics, showed comparable efficacy to traditional standards (average reduction of ~54%), but with significantly superior local tolerability. Probiotics and prebiotics proved effective in overall improvement (50%), although with a slower clinical response. It is concluded that the conventional class is more effective in the immediate numerical reduction of lesions, while the conservative class presents itself as a viable and strategic alternative by balancing clinical efficacy with a lower profile of adverse events, favoring adherence to treatment.
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