Non-pharmacologic treatment for acne vulgaris

Abstract

Early rapid treatment of acne vulgaris is mandatory for improving the psychological behavior of acne patients and to avoid the occurrence of post acne scars that are still more frustrating and challenging condition in their treatment up till now. The current first line of treatment of acne vulgaris is the conventional pharmacological therapy including; keratolytics, topical or oral antibiotics, retinoids, and hormonal agents. Meanwhile, the use of this pharmacological therapy is not always beneficial because of poor compliance of the patients, occurrence of side effects of drugs and antibiotic resistance to Cutibacterium (C.) acne with high rate of recurrence. Therefore, non-pharmacological treatment is developed as safe and effective options for treating acne vulgaris. They are applied either as independent treatment modality, an adjunct to pharmacological therapy, or as maintenance therapy. There is no sufficient data on the classification of this treatment category. This review discusses the non-pharmacological therapy in management of acne vulgaris besides efficacy and safety of each type of treatment modality. The most commonly applied non-pharmacological therapies are diet control, counseling, dermocosmetics, comedo extraction, chemical peeling, cryotherapy, chemical peels, platelets rich plasma (PRP), botulinum neurotoxin A (BoNTA), light-based therapy and laser and photodynamic therapy (PDT). Regarding lasers and light sources, they can be subclassified according to their mechanism of action into devices targeting levels of C. acnes, function of the sebaceous unit, or both.