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Review
. 2020 Dec 26:2:76-93.
doi: 10.1016/j.jdin.2020.11.001. eCollection 2021 Mar.

Complementary and alternative medicine treatments for common skin diseases: A systematic review and meta-analysis

Virginia A Jones  1 , Payal M Patel  1 , Claire Wilson  1 , Hongnan Wang  2 , Kurt A Ashack  1   3
Affiliations
Review

Complementary and alternative medicine treatments for common skin diseases: A systematic review and meta-analysis

Virginia A Jones et al. JAAD Int. .

Abstract

Background: Complementary and alternative medicine (CAM) treatments are growing in popularity as alternative treatments for common skin conditions.

Objectives: To perform a systematic review and meta-analysis to determine the tolerability and treatment response to CAM treatments in acne, atopic dermatitis (AD), and psoriasis.

Methods: PubMed/Medline and Embase databases were searched to identify eligible studies measuring the effects of CAM in acne, AD, and psoriasis. Effect size with 95% confidence interval (CI) was estimated using the random-effect model.

Results: The search yielded 417 articles; 40 studies met the inclusion criteria. The quantitative results of CAM treatment showed a standard mean difference (SMD) of 3.78 (95% CI [-0.01, 7.57]) and 0.58 (95% CI [-6.99, 8.15]) in the acne total lesion count, a SMD of -0.70 (95% CI [-1.19, -0.21]) in the eczema area and severity index score and a SMD of 0.94 (95% CI [-0.83, 2.71]) in the scoring of atopic dermatitis score for AD, and a SMD of 3.04 (95% CI [-0.35, 6.43]) and 5.16 (95% CI [-0.52, 10.85]) in the Psoriasis Area Severity Index score for psoriasis.

Limitations: Differences between the study designs, sample sizes, outcome measures, and treatment durations limit the generalizability of data.

Conclusions: Based on our quantitative findings we conclude that there is insufficient evidence to support the efficacy and the recommendation of CAM for acne, AD, and psoriasis.

Keywords: AD, atopic dermatitis; AV, aloe vera; CAM, complementary and alternative medicine; CCO, coconut oil; GT, green tea; PASI, psoriasis area and severity index; SCORAD, scoring of atopic dermatitis; SMD, standardized mean difference; SSO, sunflower seed oil; TCS, topical corticosteroid; TLC, total lesion count; TTO, tea tree oil; acne vulgaris; aloe vera; atopic dermatitis; coconut oil; colloidal oatmeal; complementary alternative medicine; curcumin; eczema; green tea; honey; meta-analysis; natural ingredients; psoriasis; shea butter; sunflower seed oil; systematic review; tea tree oil; turmeric; witch hazel.

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Conflict of interest statement

None disclosed.

Figures

Fig 1
Fig 1
Cochrane risk-of-bias summary: the authors' judgments about the studies. Studies included within the systematic review mostly ranged from low risk to some concerns except for one high-risk study per the risk-of-bias assessment.
Fig 2
Fig 2
The PRISMA flow diagram. PRISMA, Preferred reporting items for systematic reviews and meta-analyses.
Fig 3
Fig 3
Forest plots assessing treatments for total lesion count reduction in acne. A, Plot for green tea versus control. B, Plot for TTO versus control. CI, Confidence interval; SD, standard deviation; Std, standardized; TTO, tea tree oil.
Fig 4
Fig 4
Forest plots assessing the treatments for EASI and SCORAD reduction in atopic dermatitis. A, Plot for colloidal oatmeal versus control measuring EASI improvement. B, Plot for SSO versus control measuring SCORAD improvement. CI, Confidence interval; EASI, eczema area and severity index; Oats, oatmeal; SCORAD, scoring of atopic dermatitis; SD, standard deviation; SSO, sunflower seed oil; Std, standardized.
Fig 5
Fig 5
Forest plots assessing the treatments for PASI reduction in psoriasis. A, Plot for aloe vera versus control. B, Plot for turmeric versus control. CI, Confidence interval; PASI, psoriasis area and severity index; SD, standard deviation; Std, standardized.
See this image and copyright information in PMC

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