Post-acne Erythema: A Systematic Review of Randomized Controlled Trials on the Comparative Efficacy and Safety of Interventions Across Clinical, Instrumental, and Patient-Reported Outcomes.

@article{alhussain2026postacne,
  title = {{Post-acne Erythema: A Systematic Review of Randomized Controlled Trials on the Comparative Efficacy and Safety of Interventions Across Clinical, Instrumental, and Patient-Reported Outcomes.}},
  author = {Ahmed Alhussain and Mohammad Majrashi and Khalid Omar AlMubarak and Rayan Faleh Alqahtani and Nasir Abdullah Al Melhem and Shahad Saad S AlShammari and Thamer M Mubarah and Ghadeer A Alameer and Fatima Mohammed Al-Sawad and Hadeel Hesham Buali and Raghad Khalid Alenezi and Mohammed A Ababtain and Bader Ahmed Sabei and Abdulelah F Alshehri},
  journal = {Cureus},
  year = {2026},
  month = sep,
  doi = {10.7759/cureus.116495},
  url = {https://europepmc.org/article/MED/42894818},
  note = {CC BY},
}

TY  - JOUR
TI  - Post-acne Erythema: A Systematic Review of Randomized Controlled Trials on the Comparative Efficacy and Safety of Interventions Across Clinical, Instrumental, and Patient-Reported Outcomes.
AU  - Ahmed Alhussain
AU  - Mohammad Majrashi
AU  - Khalid Omar AlMubarak
AU  - Rayan Faleh Alqahtani
AU  - Nasir Abdullah Al Melhem
AU  - Shahad Saad S AlShammari
AU  - Thamer M Mubarah
AU  - Ghadeer A Alameer
AU  - Fatima Mohammed Al-Sawad
AU  - Hadeel Hesham Buali
AU  - Raghad Khalid Alenezi
AU  - Mohammed A Ababtain
AU  - Bader Ahmed Sabei
AU  - Abdulelah F Alshehri
PY  - 2026
DA  - 2026/09/18
JO  - Cureus
DO  - 10.7759/cureus.116495
UR  - https://europepmc.org/article/MED/42894818
AB  - Post-acne erythema (PAE) is a persistent acne sequela without an established standard treatment. This systematic review evaluated the comparative efficacy and safety of interventions tested in randomized trials. PubMed/MEDLINE, Scopus, and Web of Science were searched from inception through August 1, 2026. Randomized parallel-group and split-face trials reporting erythema outcomes were eligible. Risk of bias was assessed with the Cochrane Risk of Bias 2 (RoB 2) tool. Heterogeneity precluded meta-analysis, and available findings were synthesized narratively. Nine trials involving 301 participants contributed 11 pairwise comparisons. Against untreated or blank controls, favorable effects were reported for picosecond alexandrite laser, narrow-spectrum vascular intense pulsed light (IPL), and non-cross-linked hyaluronic acid mesotherapy. A 577-nm semiconductor laser showed interim instrumental benefit, but blinded assessors found no final between-side difference. In active-treatment and add-on comparisons, narrow-spectrum IPL was favored over broad-spectrum IPL, neodymium-doped yttrium aluminum garnet (Nd) laser added to low-dose isotretinoin was favored over isotretinoin alone, and 577-nm pro-yellow laser was favored over topical brimonidine. Botulinum toxin type A was favored over broadband light at the earliest assessment only. Fractional laser and pulsed dye laser did not differ significantly, while delicate pulsed light and Q-switched 1064-nm Nd laser showed no sustained difference at the final assessment. Adverse events were mild and transient, although pigmentation and blistering occurred with one broad-spectrum IPL protocol. Five trials had some concerns, and four had high overall risk of bias. Trials suggested potential benefits, but small samples, heterogeneity, short follow-up, and reporting limitations precluded identification of a preferred treatment. Larger, prospectively registered trials using blinded assessment and standardized outcomes are needed.
SN  - 2168-8184
ER  -