A comparative study on the effectiveness of herbal extracts vs 2.5% benzoyl peroxide in the treatment of mild to moderate acne vulgaris

J Cosmet Dermatol. 2019 Dec;18(6):1767-1775. doi: 10.1111/jocd.12962. Epub 2019 Apr 23.


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.

Keywords: acne; benzoyl peroxide; herbal extract; mangosteen; niacinamide; tea tree oil.

Publication types

  • Equivalence Trial
  • Randomized Controlled Trial

MeSH terms

  • Acne Vulgaris / diagnosis
  • Acne Vulgaris / drug therapy*
  • Acne Vulgaris / psychology
  • Benzoyl Peroxide / administration & dosage*
  • Benzoyl Peroxide / adverse effects
  • Dermatologic Agents / administration & dosage*
  • Dermatologic Agents / adverse effects
  • Female
  • Humans
  • Male
  • Medication Adherence / statistics & numerical data*
  • Patient Satisfaction
  • Plant Extracts / administration & dosage*
  • Plant Extracts / adverse effects
  • Quality of Life
  • Severity of Illness Index
  • Treatment Outcome
  • Young Adult


  • Dermatologic Agents
  • Plant Extracts
  • Benzoyl Peroxide