The quality of evidence is downgraded by study limitations, inconsistency and imprecise results.
A Cochrane review [Abstract] 1 included 35 studies with a total of 3227 subjects. The categories of CAM included herbal medicine, acupuncture, cupping therapy, diet, purified bee venom (PBV), and tea tree oil.
Diet. For the outcome 'Change in inflammatory and non-inflammatory lesion counts', 2 studies that compared a low- with a high-glycaemic-load diet (LGLD, HGLD) at 12 weeks were combined. No clear evidence of a difference between the groups in change in non-inflammatory lesion counts was found (MD -3.89, 95% CI) -10.07 to 2.29, P = 0.10, 75 participants, 2 trials). However, data from 1 of these 2 trials showed benefit of LGLD for reducing inflammatory lesions (MD -7.60, 95% CI -13.52 to -1.68, 43 participants, 1 trial) and total skin lesion counts (MD -8.10, 95% CI -14.89 to -1.31, 43 participants, 1 trial).
Tree oil. Data from a single trial showed potential benefit of tea tree oil compared with placebo in improving total skin lesion counts (MD -7.53, 95% CI -10.40 to -4.66, 60 participants, 1 trial) and acne severity scores (MD -5.75, 95% CI -9.51 to -1.99, 60 participants, 1 trial).
Bee venom. One trial showed pollen bee venom to be better than control in reducing numbers of skin lesions (MD -1.17, 95% CI -2.06 to -0.28, 12 participants, 1 trial).
Other interventions. Results from the other 31 trials showed inconsistent effects in terms of whether acupuncture, herbal medicine, or wet-cupping therapy were superior to controls in increasing remission or reducing skin lesions.
Adverse effects. Twenty-six of the 35 included studies reported adverse effects; they did not report any severe adverse events, but specific included trials reported mild adverse effects from herbal medicines, wet-cupping therapy, and tea tree oil gel.
Date of latest search: 2014-01-20
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