Evidence-based topical treatments (azelaic acid, salicylic acid, nicotinamide, sulfur, zinc, and fruit acid) for acne: an abridged version of a Cochrane systematic review (2024)

Liu, H., Yu, H., Xia, J., Liu, L., Liu, G., Sang, H., & Peinemann, F. (2020). Evidence-based topical treatments (azelaic acid, salicylic acid, nicotinamide, sulfur, zinc, and fruit acid) for acne: an abridged version of a Cochrane systematic review. Journal of Evidence-Based Medicine, 13(4), 275-283. https://doi.org/10.1111/jebm.12411

Liu, Haibo ; Yu, Haiyan ; Xia, Jun et al. / Evidence-based topical treatments (azelaic acid, salicylic acid, nicotinamide, sulfur, zinc, and fruit acid) for acne : an abridged version of a Cochrane systematic review. In: Journal of Evidence-Based Medicine. 2020 ; Vol. 13, No. 4. pp. 275-283.

@article{e50d9a043e65487d8b3ac81daa10dbb7,

title = "Evidence-based topical treatments (azelaic acid, salicylic acid, nicotinamide, sulfur, zinc, and fruit acid) for acne: an abridged version of a Cochrane systematic review",

abstract = "Objective: The effects of topical azelaic acid, salicylic acid, nicotinamide, sulfur, zinc, and fruit acid (alpha-hydroxy acid) for acne are unclear. We aimed to assess the effects of these topical treatments by collecting randomized controlled trials. Methods: We searched The Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS up to May 2019. We also searched five trials registers. Two review authors independently extracted data and assessed risk of bias. Meta analyses were performed by using Review Manager 5 software. Results: We included a total of 49 trials involving 3880 participants. In terms of treatment response (measured using participants{\textquoteright} global self-assessment of acne improvement, PGA), azelaic acid was probably less effective than benzoyl peroxide (RR=0.82, 95% CI 0.72-0.95). However, there was probably little or no difference in PGA when comparing azelaic acid to tretinoin (RR=0.94, 95% CI 0.78-1.14). There may be little or no difference when comparing salicylic acid to tretinoin (RR=1.00, 95% CI 0.92-1.09). There were no studies measured PGA when evaluating nicotinamide. With respect to alpha-hydroxy acid, there may be no difference in PGA when comparing glycolic acid to salicylic-mandelic acid (RR=1.06, 95% CI 0.88-1.26). We were uncertain about the effects of sulfur and zinc. Adverse events associated with these topical treatments were always mild and transient. Conclusions: Moderate-quality evidence was available for azelaic acid and low- to very-low-quality evidence for other topical treatments. Risk of bias and imprecision limit our confidence in the evidence.",

keywords = "acne, alpha-hydroxy acid, azelaic acid, nicotinamide, salicylic acid, sulfur, zinc",

author = "Haibo Liu and Haiyan Yu and Jun Xia and Ling Liu and Guanjian Liu and Hong Sang and Frank Peinemann",

note = "Publisher Copyright: {\textcopyright} 2020 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd",

year = "2020",

month = nov,

doi = "10.1111/jebm.12411",

language = "English",

volume = "13",

pages = "275--283",

journal = "Journal of Evidence-Based Medicine",

issn = "1756-5383",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "4",

}

Liu, H, Yu, H, Xia, J, Liu, L, Liu, G, Sang, H & Peinemann, F 2020, 'Evidence-based topical treatments (azelaic acid, salicylic acid, nicotinamide, sulfur, zinc, and fruit acid) for acne: an abridged version of a Cochrane systematic review', Journal of Evidence-Based Medicine, vol. 13, no. 4, pp. 275-283. https://doi.org/10.1111/jebm.12411

Evidence-based topical treatments (azelaic acid, salicylic acid, nicotinamide, sulfur, zinc, and fruit acid) for acne: an abridged version of a Cochrane systematic review. / Liu, Haibo; Yu, Haiyan; Xia, Jun et al.
In: Journal of Evidence-Based Medicine, Vol. 13, No. 4, 11.2020, p. 275-283.

Research output: Journal Publication › Article › peer-review

TY - JOUR

T1 - Evidence-based topical treatments (azelaic acid, salicylic acid, nicotinamide, sulfur, zinc, and fruit acid) for acne

T2 - an abridged version of a Cochrane systematic review

AU - Liu, Haibo

AU - Yu, Haiyan

AU - Xia, Jun

AU - Liu, Ling

AU - Liu, Guanjian

AU - Sang, Hong

AU - Peinemann, Frank

N1 - Publisher Copyright:© 2020 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd

PY - 2020/11

Y1 - 2020/11

N2 - Objective: The effects of topical azelaic acid, salicylic acid, nicotinamide, sulfur, zinc, and fruit acid (alpha-hydroxy acid) for acne are unclear. We aimed to assess the effects of these topical treatments by collecting randomized controlled trials. Methods: We searched The Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS up to May 2019. We also searched five trials registers. Two review authors independently extracted data and assessed risk of bias. Meta analyses were performed by using Review Manager 5 software. Results: We included a total of 49 trials involving 3880 participants. In terms of treatment response (measured using participants’ global self-assessment of acne improvement, PGA), azelaic acid was probably less effective than benzoyl peroxide (RR=0.82, 95% CI 0.72-0.95). However, there was probably little or no difference in PGA when comparing azelaic acid to tretinoin (RR=0.94, 95% CI 0.78-1.14). There may be little or no difference when comparing salicylic acid to tretinoin (RR=1.00, 95% CI 0.92-1.09). There were no studies measured PGA when evaluating nicotinamide. With respect to alpha-hydroxy acid, there may be no difference in PGA when comparing glycolic acid to salicylic-mandelic acid (RR=1.06, 95% CI 0.88-1.26). We were uncertain about the effects of sulfur and zinc. Adverse events associated with these topical treatments were always mild and transient. Conclusions: Moderate-quality evidence was available for azelaic acid and low- to very-low-quality evidence for other topical treatments. Risk of bias and imprecision limit our confidence in the evidence.

AB - Objective: The effects of topical azelaic acid, salicylic acid, nicotinamide, sulfur, zinc, and fruit acid (alpha-hydroxy acid) for acne are unclear. We aimed to assess the effects of these topical treatments by collecting randomized controlled trials. Methods: We searched The Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS up to May 2019. We also searched five trials registers. Two review authors independently extracted data and assessed risk of bias. Meta analyses were performed by using Review Manager 5 software. Results: We included a total of 49 trials involving 3880 participants. In terms of treatment response (measured using participants’ global self-assessment of acne improvement, PGA), azelaic acid was probably less effective than benzoyl peroxide (RR=0.82, 95% CI 0.72-0.95). However, there was probably little or no difference in PGA when comparing azelaic acid to tretinoin (RR=0.94, 95% CI 0.78-1.14). There may be little or no difference when comparing salicylic acid to tretinoin (RR=1.00, 95% CI 0.92-1.09). There were no studies measured PGA when evaluating nicotinamide. With respect to alpha-hydroxy acid, there may be no difference in PGA when comparing glycolic acid to salicylic-mandelic acid (RR=1.06, 95% CI 0.88-1.26). We were uncertain about the effects of sulfur and zinc. Adverse events associated with these topical treatments were always mild and transient. Conclusions: Moderate-quality evidence was available for azelaic acid and low- to very-low-quality evidence for other topical treatments. Risk of bias and imprecision limit our confidence in the evidence.

KW - acne

KW - alpha-hydroxy acid

KW - azelaic acid

KW - nicotinamide

KW - salicylic acid

KW - sulfur

KW - zinc

UR - http://www.scopus.com/inward/record.url?scp=85092157233&partnerID=8YFLogxK

U2 - 10.1111/jebm.12411

DO - 10.1111/jebm.12411

M3 - Article

C2 - 33034949

AN - SCOPUS:85092157233

SN - 1756-5383

VL - 13

SP - 275

EP - 283

JO - Journal of Evidence-Based Medicine

JF - Journal of Evidence-Based Medicine

IS - 4

ER -

Liu H, Yu H, Xia J, Liu L, Liu G, Sang H et al. Evidence-based topical treatments (azelaic acid, salicylic acid, nicotinamide, sulfur, zinc, and fruit acid) for acne: an abridged version of a Cochrane systematic review. Journal of Evidence-Based Medicine. 2020 Nov;13(4):275-283. doi: 10.1111/jebm.12411