{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:09:27Z","timestamp":1790809767169,"version":"4.1.0"},"reference-count":64,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,10,9]],"date-time":"2020-10-09T00:00:00Z","timestamp":1602201600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Evidence Based Medicine"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The effects of topical azelaic acid, salicylic acid, nicotinamide, sulfur, zinc, and fruit acid (alpha\u2010hydroxy acid) for acne are unclear. We aimed to assess the effects of these topical treatments by collecting randomized controlled trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched The Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS up to May 2019. We also searched five trials registers. Two review authors independently extracted data and assessed risk of bias. Meta analyses were performed by using Review Manager 5 software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included a total of 49 trials involving 3880 participants. In terms of treatment response (measured using participants\u2019 global self\u2010assessment of acne improvement, PGA), azelaic acid was probably less effective than benzoyl peroxide (RR\u00a0=\u00a00.82, 95% CI 0.72\u20100.95). However, there was probably little or no difference in PGA when comparing azelaic acid to tretinoin (RR\u00a0=\u00a00.94, 95% CI 0.78\u20101.14). There may be little or no difference when comparing salicylic acid to tretinoin (RR\u00a0=\u00a01.00, 95% CI 0.92\u20101.09). There were no studies measured PGA when evaluating nicotinamide. With respect to alpha\u2010hydroxy acid, there may be no difference in PGA when comparing glycolic acid to salicylic\u2010mandelic acid (RR\u00a0=\u00a01.06, 95% CI 0.88\u20101.26). We were uncertain about the effects of sulfur and zinc. Adverse events associated with these topical treatments were always mild and transient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Moderate\u2010quality evidence was available for azelaic acid and low\u2010 to very\u2010low\u2010quality evidence for other topical treatments. Risk of bias and imprecision limit our confidence in the evidence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jebm.12411","type":"journal-article","created":{"date-parts":[[2020,10,9]],"date-time":"2020-10-09T14:25:01Z","timestamp":1602253501000},"page":"275-283","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Evidence\u2010based topical treatments (azelaic acid, salicylic acid, nicotinamide, sulfur, zinc, and fruit acid) for acne: an abridged version of a Cochrane systematic review"],"prefix":"10.1111","volume":"13","author":[{"given":"Haibo","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Dermatology, Jinling Hospital Nanjing University School of Medicine  Nanjing PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyan","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Sir Run Run Shaw Hospital Zhejiang University School of Medicine  Hangzhou PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Xia","sequence":"additional","affiliation":[{"name":"Nottingham China Health Institute The University of Nottingham Ningbo  Ningbo PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jinling Hospital Nanjing University School of Medicine  Nanjing PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanjian","family":"Liu","sequence":"additional","affiliation":[{"name":"Cochrane China, West China Hospital Sichuan University  Chengdu PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Sang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Jinling Hospital Nanjing University School of Medicine  Nanjing PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Peinemann","sequence":"additional","affiliation":[{"name":"Pediatric Oncology and Hematology, Children's Hospital University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0846.2011.00542.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12149"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.12266"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.5070\/D34HP8N68P"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2010.375"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2016.5538"},{"issue":"8","key":"e_1_2_8_8_1","first-page":"475","article-title":"Acne vulgaris: diagnosis and treatment","volume":"100","author":"Oge LK","year":"2019","journal-title":"Am. 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