Efficacy of Topical Propolis and Aloe vera Gel as an Adjuvant to Benzoyl Peroxide in Moderate Acne Vulgaris: A Randomized Controlled Trial

Background and Aim Acne vulgaris is a common skin disorder with a substantial psychosocial burden. Definitive therapies, such as benzoyl peroxide, often cause side effects, including skin irritation and dryness, despite their efficacy against acne vulgaris. Propolis and Aloe vera , recognized for their bactericidal, immunomodulatory, and hydrating properties, may serve as potential adjunctive therapeutic agents. This study evaluated the efficacy and potency of a combination of propolis and A. vera extracts with 5% benzoyl peroxide compared with 5% benzoyl peroxide monotherapy for the treatment of acne vulgaris. Experimental Procedure Based on the Hayashi criteria, a double‐blind, randomized, active‐controlled clinical trial was conducted with 72 participants aged 15–29 years, with Grade II and III acne vulgaris. The participants were divided into intervention and control groups. The outcome evaluation included bacterial load, inflammatory biomarkers, and hyperpigmented lesions assessed using a skin analyzer over an 8‐week period. Key Results The intervention group presented significant reductions in Cutibacterium acnes load (23.00 ± 2.63 log10 copies/mL vs. 28.32 ± 3.50 in the control group, p < 0.001), inflammatory biomarkers (TNF‐α: 22.43 ± 4.60 vs. 25.90 ± 3.67 log10 copies/ng RNA in the control group; IL‐6: 8.5% vs. 6.9% reduction in the control group), and hyperpigmentation (96% vs. 34% in the control group, p < 0.01). Conclusion and Implications Compared with benzoyl peroxide monotherapy, the combination of propolis and A. vera extracts showed an adjunctive effect when used with benzoyl peroxide by reducing the bacterial load, suppressing inflammatory biomarkers, and effectively diminishing hyperpigmented lesions. Moreover, this combination may mitigate the adverse effects commonly associated with benzoyl peroxide, as reported in various studies.