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Acne vulgaris is a common and complex skin condition affecting the majority of adolescents globally. It involves excess sebum production, bacterial imbalance and inflammation occurring simultaneously, which makes single-drug conventional treatments often insufficient. Traditional Chinese medicine has addressed acne for centuries through pattern-based prescribing, yet the biological mechanisms behind these treatments have not been fully explained in modern scientific terms.
This systematic review searched a major Chinese academic database for studies published between 2014 and 2024, cross-referencing prescription records with pharmacological and clinical research to evaluate the effectiveness and safety of Chinese herbal formulas for acne. A bibliometric analysis of over 1,200 prescriptions was conducted to identify the most consistently used herbs.
The review found that classical and contemporary compound herbal formulas appear to act on multiple aspects of acne simultaneously — regulating oil production, supporting healthy skin bacteria balance, and reducing inflammation. Eight core herbs were identified as central to common prescriptions. Key active compounds within these herbs, including glycyrrhizin, baicalein, paeoniflorin and cryptotanshinone, were found to interact with several important biological signalling pathways involved in acne development, including those governing sebum synthesis, bacterial biofilm formation and skin barrier repair.
The authors propose a research framework for integrating whole-formula holistic effects with the targeted actions of individual compounds to guide future traditional Chinese medicine-based acne therapy development.
Conclusion: This review provides a scientifically grounded basis for understanding how Chinese herbal formulas may address acne through multiple biological mechanisms, though further clinical validation remains necessary.
Source: Gong J, Zhang J, Li Y and colleagues. Journal of ethnopharmacology (2026). View on PubMed (PMID 42061568) · doi:10.1016/j.jep.2026.121786