The Efficacy of a Herbal Syrup (Containing Plum, Jujube, Yellow Myrobalan, Golden Shower, Tamarind, Honey) in the Treatment of Mild to Moderate Acne Vulgaris: A Triple-Blinded Randomized Clinical Trial

Background: Many patients, chiefly teenagers, seek effective treatment for acne vulgaris. Besides topical treatments, antibiotics, and anti-androgens, herbal treatments have been used against it. Objectives: This study aims to evaluate the effects of an herbal combination based on Prunus domestica L., Tamarindus indica L., Terminalia chebula L., Ziziphus jujube L., and Cassia fistula L. on acne vulgaris. Methods: This randomized, triple-blind, placebo-controlled, two-arm parallel trial was conducted in patients with mild-to-moderate acne vulgaris. Patients were randomized, 55 in each group, to receive either herbal syrup or placebo (10 cc every 8 hours) for 12 weeks and were followed for 4 weeks. The severity of acne and participants' psychological status was assessed by acne severity index (ASI) and Cardiff acne disability index (CADI), respectively. Results: No significant changes were observed up to the sixth week of treatment in both groups (P >= 0.05). From 6 weeks to 12 weeks, the outcomes indicated a significant reduction in the mean number of comedones (P < 0.030), papules (P < 0.045), pustules (P < 0.026), nodules (P < 0.044), and ASI (P < 0.001) in the herbal syrup group compared to the placebo group. Nevertheless, this did not continue after 4 weeks of follow-up (16th week). Conclusions: The herbal syrup could be an alternative treatment in patients with mild to moderate acne vulgaris. Indeed, more clinical trials are needed to confirm its efficacy and safety.