Acne vulgaris is a widespread chronic inflammatory skin disorder affecting the pilosebaceous unit. Common among adolescents and young adults, it results in lesions on the face, trunk, and back, often causing psychological distress and scarring. Key contributing factors include hyperkeratinization, sebum overproduction, Cutibacterium acnes proliferation, and inflammation. Standard therapies such as topical retinoids, isotretinoin, and antibiotics are effective but come with drawbacks including irritation, teratogenicity, and rising antibiotic resistance. This has led to increased interest in phytochemicals and herbal alternatives that offer therapeutic efficacy with fewer side effects.
Key Findings
- Pathophysiology & Targets: Acne arises from sebum overproduction, hyperkeratinization, microbial dysbiosis (notably C. acnes), and inflammation. Molecular targets include 5α-reductase, IL-1β, and the Th17 pathway.
- Limitations of Standard Treatments: Conventional drugs like isotretinoin and antibiotics are associated with serious side effects and growing resistance.
- Microbiome Role: Skin microbiota imbalance contributes to acne severity. Some Staphylococcus species can counteract C. acnes proliferation.
- Phytochemical Mechanisms: Plant-based agents show antimicrobial, anti-inflammatory, antioxidant, and sebum-regulating properties.
- Bioactive Compounds: Key compound classes include:
- Organic acids (e.g., salicylic acid, azelaic acid)
- Terpenoids (e.g., ursolic acid, lupeol)
- Alkaloids (e.g., berberine)
- Saponins (e.g., madecassoside)
- Phenolics (e.g., resveratrol, curcumin)
- Flavonoids (e.g., licochalcone A)
- Tannins (e.g., chebulagic acid)
- Clinical Evidence: Studies support the efficacy of green tea, tea tree oil, Aloe vera, berberine, resveratrol, and essential oil blends in reducing acne severity and lesions with fewer adverse effects.
- Advanced Delivery Systems: Emerging nanoformulations (e.g., nanovesicles, phytosomes) enhance phytochemical stability, skin permeability, and clinical outcomes.
Acne vulgaris remains a challenging condition due to its multifactorial origin and the limitations of current treatments. This review underscores phytochemicals as promising alternatives due to their broad-spectrum mechanisms and improved tolerability. They offer antimicrobial, anti-inflammatory, and sebum-regulating effects while minimizing resistance issues. Future work must focus on high-quality clinical trials, optimal formulations, and innovative delivery systems to fully realize their therapeutic potential in acne management.
Link to the study: https://tinyurl.com/ycx4hxje
