Efficacy of topical Nigella sativa L. with vinegar in the treatment of acne vulgaris

Acne vulgaris is a chronic inflammatory skin condition that primarily affects the pilosebaceous unit, leading to the development of non-inflammatory lesions such as comedones and inflammatory lesions like papules, pustules and nodules. These lesions typically appear on the face, neck and upper trunk. With an estimated 650 million people affected worldwide, acne is the 8^th most prevalent disease globally.

Acne vulgaris arises from a combination of factors, including genetic predisposition, hormonal changes, bacterial colonization by Cutibacterium acnes and environmental influences such as diet, climate and psychological stress.

Notably, conventional treatments for acne, including benzoyl peroxide, antibiotics and retinoids, while effective, often come with side effects such as dryness of the lips and nasal mucosa, and conjunctivitis. This prompts a continuing need for safer alternatives. In this regard, traditional systems of medicine, such as Unani, offer potential solutions.

Unani is an ancient system of medicine that originated in Central Asia, evolved from the teachings and principles of the Greek physician Hippocrate. In Unani medicine, acne  vulgaris is referred to as "Buthūr-i Labaniyya" and is attributed to imbalances in bodily humors. Treatments focus on the use of natural compounds with antimicrobial, anti-inflammatory and detoxifying properties. Among the recommended remedies are

Kalonji (Nigella sativa) and Sirka (vinegar), which are believed to target the underlying causes of acne.

In a new study published in the Journal of Dermatologic Science and Cosmetic Technology, a tea of researchers in India assessed the efficacy and safety of a topical formulation combining Kalonji and Sirka for the treatment of mild to moderate acne vulgaris. The formulation was compared with a 5% benzoyl peroxide.

The study, conducted as a prospective, open-label randomized controlled trial, enrolled 43 participants aged 13–40 years, over a 28-day treatment period. Participants were divided into two groups: one group applied a liniment of Kalonji powder and vinegar, while the other used benzoyl peroxide gel.

The results suggests that the formulation may have therapeutic potential as an alternative acne treatment. Nonetheless, despite the study's strengths, including its rigorous design and validated outcome measures, there were limitations such as a small sample size, short duration and lack of blinding, which may have introduced bias.

The researchers recommended future research with larger sample sizes, longer follow-up periods and blinded designs. Additionally, advanced methodologies like genomics and metabolomics can be used to gain deeper insights into the mechanisms of action.

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Contact the author: Nazim Husain, Regional Research Institute of Unani Medicine, Silchar, Assam 788014, India, nazimcrium@gmail.com

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