Abstract:
Acne is a common skin condition. Patients with mild to moderate acne can be treated with topical antibiotics such as clindamycin. In case patients who use topical antibiotics for a long time may lead to bacterial resistance conditions, skin dryness and skin irritation. Centella asiatica has anti-inflammatory property, bacteriostatic effect on Propionibacterium acnes, decrease follicular epidermal hyperproliferation and increase would healing process. Therefore Centella will be useful to treat patients with acne vulgaris. To compare the efficacy of 5% Centella asiatica gel versus 1% clindamycin gel, we enrolled 30 patients ages 12-45 (27.85 ± 4.37) with mild to moderate acne. In this prospective, split-face, randomized, double-blind clinical trial, patients were randomly allocated to receive either 5% centella gel or 1% clindamycin gel apply each side of face twice daily. The efficacy was evaluated by total number of inflammatory acnes and non-inflammatory acnes lesions, the global acne grading system scores (GAGS) and adverse effects at 1, 2, 4, 8 and 12 week of study and also patients satisfaction at the end of study. Twenty-six patients were able to complete the study. We found that the number of inflammatory acnes were lower on the side that treated with 5% centella gel in 8 and 12 weeks of study with statistically significant (p = 0.009 and 0.040 respectively). Non-inflammatory acnes in both sides decreased over time with no statistically significant between both sides. The GAGS scores also decreased continuously in both sides and GAGS scores were lower on the 5% centella gel side with statistically significant at 8 weeks of study (p = 0.026). Patients satisfaction between two group were similar. Adverse effects on the 5% centella gel side were minimal including burning sensation that limited to the period of application. Burning sensation, itching and skin dryness were reported in 1% clindamycin gel side. We conclude that 5% centella gel is more effective than 1% clindamycin gel in the treatment of mild to moderate acne vulgaris. 5% centella gel is safe and has only minor adverse effects. These results suggest that topical 5% centella gel can be used as alternative treatment for acnes.