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Combination of Aloe Vera Gel, Ultrasound, and Soft Mask Improves Symptoms of Facial Acne

Date 08-13-2021
HC# 072131-670
Aloe Vera (Aloe vera, Asphodelaceae)
Soft Mask
Facial Acne

Zhong H, Li X, Zhang W, Shen X, Lu Y, Li H. Efficacy of a new non-drug acne therapy: aloe vera gel combined with ultrasound and soft mask for the treatment of mild to severe facial acne. Front Med (Lausanne). May 21, 2021;8:662640. doi: 10.3389/fmed.2021.662640.

The symptoms of facial acne, including comedones, inflammatory papules, pustules, cysts, and nodules, can lead to post-inflammatory hyperpigmentation (PIH) and scarring. Moderate to severe acne is treated with topical and systemic medications, which can cause adverse effects and produce unsatisfactory results. Aloe vera (Aloe vera, Asphodelaceae) gel (AVG) has antibacterial, anti-inflammatory, and wound-healing properties. An earlier study reported that AVG treatment combined with the acne medication tretinoin reduced non-inflammatory and inflammatory acne lesions; however, more than 70% of patients reported adverse effects such as scaling, burning, and erythema. These authors conducted a randomized, double-blind study to evaluate the efficacy of AVG combined with ultrasound (US) and the external application of an acne soft mask in patients with mild to severe facial acne.

Thirty-two males and 32 females aged 20-35 years with mild to severe facial acne and PIH were enrolled in the study, conducted at the Third Military Medical University in Chongqing, China. Inclusion criteria included the following: The patients had not received hydroquinone, other depigmenting medication, or light treatment during the month before the study; they did not have any blood system or serious underlying diseases; and they had normal immune function.

The patients were randomly allocated to the treatment group (n = 40) and the control group (n = 24). Daily during the first week of treatment, a paramedic cleaned and disinfected the patients' faces before clearing up the inflammatory mediators with a pimple pin. Then, for patients in the treatment group, AVG combined with US (20 W, 50 Hz, and 220 V) was applied to their faces for 10-15 minutes, after which a 2 mm-thick soft mask was applied for 20-30 minutes. The AVG was imported into the epidermis by US because US waves enhance the absorption of the gel's active compounds. The patients' faces were then cleaned. For the next seven weeks, the patients in the treatment group received the combination treatment and soft mask three times weekly. The patients in the control group received a placebo containing the non-drug gel vehicle; their faces were cleaned three times weekly. The two-month treatment period was followed by a one-month follow-up period.

Papules and pustules were counted, and the area of hyperpigmented lesions was measured. The patients' faces were photographed before and after treatment. The severity of acne was measured by using a global assessment scale and the PIH Severity Scale. A smart-mirror face detection system used before and after treatment assessed skin roughness and red area. Changes in skin function were analyzed.

In the treatment group, significant decreases were observed in the number of facial papules (P < 0.01) and in hyperpigmented areas (P < 0.01 for both) from baseline to the end of the study. No improvement was seen in the control group.

Significant increases in the proportion of facial red area were seen in the treatment group (P < 0.05) compared with no change in the placebo group. An increase in red area indicated improved blood circulation.

Skin roughness improved significantly in the treatment group (P < 0.05) and remained the same in the control group throughout the study.

An efficacy evaluation revealed a 40% effective rate and a 60% marked effective rate in the treatment group at the end of the study. The effective rate of the control treatment was 16.67%; the invalid rate was 83.33%. The highest average efficacy index was seen in the patients with moderate acne.

No serious adverse effects were reported. In the treatment group, nine patients had mild local reactions (itching, local inflammation, and scattered small abscesses); two patients reported mild pain; one patient had a small area of erythema at the treatment site; and one patient experienced a slight increase in facial pigmentation. Those tolerable effects improved by the end of the study. Adverse effects observed with the use of traditional acne treatment, such as dry skin, chapped skin, gastrointestinal reaction, dizziness, and nausea, were not reported in this study.

This study is limited by its short follow-up period. Extending the follow-up for one to three months longer would allow for the determination of long-term results and assessment of a possible recurrence rate.

"This study suggests that the new non-drug combined therapy significantly improved acne, which provided experimental evidence and treatment guidance for patients with mild to severe acne, especially patients with moderate acne," the authors conclude.

The study was funded by Chongqing Normal University Postgraduate's Research and Innovation Project.

Shari Henson