{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T20:46:48Z","timestamp":1766436408292,"version":"3.48.0"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004160","name":"Mazandaran University of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004160","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Acne vulgaris adversely impacts quality of life, requiring safer alternatives to conventional treatments. This study explores a facial mask combining Bentonite's detoxifying and\n                      <jats:italic>Alcea sulphurea<\/jats:italic>\n                      's anti\u2010inflammatory properties, rooted in Traditional Persian Medicine (TPM). It aims to evaluate its efficacy in reducing acne severity and enhancing patient satisfaction, integrating traditional and modern therapeutic approaches.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This add\u2010on randomized, controlled clinical trial included 60 patients with moderate acne, recruited through purposive sampling in Sari from October 2022 to November 2023. Participants were randomly allocated into intervention (Bentonite\u2010Alcea mask\u2009+\u2009Azithromycin 250\u2009mg) and placebo (placebo\u2009+\u2009Azithromycin 250\u2009mg). Outcomes, including lesion count, acne severity, and satisfaction, were assessed at baseline, 4\u2009weeks, and 8\u2009weeks. Data analysis was conducted using SPSS version 16.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty people completed the study (30 persons in both group). The mean and standard deviation of the age in control group was 24\u2009\u00b1\u20098.03\u2009years and in placebo group was 19.03\u2009\u00b1\u20097.03 and 46 subjects (76.7%) were female. TLC and ASI in the fourth and eighth weeks in control group were significantly less than in placebo group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The percentage of relatively satisfied and very satisfied participants in the intervention group was significantly higher than the control group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Bentonite\u2010based facial mask with\n                      <jats:italic>Alcea sulphurea<\/jats:italic>\n                      extract had no serious side effects. The intervention group exhibited significant reductions in TLC (total lesion count) (55.45%\u2009\u00b1\u200921.74%) and ASI (Acne Severity Index) (66.33%\u2009\u00b1\u200927.15%) from baseline to 8\u2009weeks (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), outperforming the placebo group. Patient satisfaction was notably higher in the intervention group, with 43.3% being very satisfied compared to 3.3% in the placebo group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      A facial mask based on Bentonite and\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>A. sulphurea<\/jats:italic>\n                      <\/jats:styled-content>\n                      extract effectively reduces acne severity and enhances patient satisfaction. These findings suggest its potential as a natural alternative or adjunct to conventional acne treatments.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>Iranian registry: IRCT20220403054395N1<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocd.70586","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T11:16:13Z","timestamp":1764933373000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Therapeutic Effects of a Bentonite\u2010Based Facial Mask With\n                    <i>Alcea sulphurea<\/i>\n                    Extract on Acne Severity and Patient Experience: Add\u2010On Randomized Controlled Clinical Trial"],"prefix":"10.1111","volume":"24","author":[{"given":"Sara","family":"Salimi","sequence":"first","affiliation":[{"name":"Student Research Committee Mazandaran University of Medical Sciences  Sari Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moloud","family":"Fakhri","sequence":"additional","affiliation":[{"name":"Traditional and Complementary Medicine Research Center, Addiction Institute Mazandaran University of Medical Sciences  Sari Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2617-9961","authenticated-orcid":false,"given":"Majid","family":"Saeedi","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutics, Faculty of Pharmacy Mazandaran University of Medical Sciences  Sari Iran"},{"name":"Pharmaceutical Sciences Research Center, Institute of Herbal Medicines and Metabolic Disorders Mazandaran University of Medical Sciences  Sari Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1499-7668","authenticated-orcid":false,"given":"Seyyed Mobin","family":"Rahimnia","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutics, Faculty of Pharmacy Mazandaran University of Medical Sciences  Sari Iran"},{"name":"Pharmaceutical Sciences Research Center, Institute of Herbal Medicines and Metabolic Disorders Mazandaran University of Medical Sciences  Sari Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3870-0382","authenticated-orcid":false,"given":"Armaghan","family":"Kazeminejad","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine Mazandaran University of Medical Sciences  Sari Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5452-514X","authenticated-orcid":false,"given":"Mahmood","family":"Moosazadeh","sequence":"additional","affiliation":[{"name":"Gastrointestinal Cancer Research Center, Non\u2010Communicable Disease Institute Mazandaran University of Medical Sciences  Sari Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7367-1484","authenticated-orcid":false,"given":"Emran","family":"Habibi","sequence":"additional","affiliation":[{"name":"Medicinal Plants Research Centre, Institute of Herbal Medicines and Metabolic Disorders Mazandaran University of Medical Sciences  Sari Iran"},{"name":"Centre for Natural Products Discovery, School of Pharmacy and Biomolecular Sciences Liverpool John Moores University  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0843-5151","authenticated-orcid":false,"given":"Assie","family":"Jokar","sequence":"additional","affiliation":[{"name":"Traditional and Complementary Medicine Research Center, Addiction Institute Mazandaran University of Medical Sciences  Sari Iran"},{"name":"Department of Persian Medicine. 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