ABSTRACT
Objectives: There is an association between Acne vulgaris and insulin resistance and metabolic syndrome. Although metformin was effective in
polycystic ovary syndrome (PCOS) patients, its effects on acne vulgaris among males and females without PCOS are scarce. The study aimed to assess
the impact of metformin on acne vulgaris among males and females without PCOS.
Methods: We searched seven databases including Scopus, Web of Science, PubMed, Google Scholar, MEDLINE, EBSCO, and Cochrane Library. We
conducted the literature search during October and November of 2024 and the articles were included from inception up to the most recently published
research. We used the keywords metformin, doxycycline, tetracycline, isotretinoin, acne vulgaris, acne severity, inflammatory lesions, non-inflammatory
lesions, and Global Acne Grading System. A checklist was used to collect the information analyzed by the RevMan System 5.4 (United Kingdom).
Results: Out of a hundred and forty-eight studies identified, we screened 27 full texts, and only five studies were found eligible to be included in the
meta-analysis. The studies included 214 patients with study duration of 2–6 months. Metformin was effective in reducing global acne severity scores.
However, it was inferior to doxycycline, tetracycline, and isotretinoin, odd ratio, 1.16, 95% CI, 0.37–1.94, Chi-square, 3.95, and p=0.004, and odd ratio,
3.75, 95% CI, 1.85–5.65, Chi-square, 98.32, and p<0.001, respectively.
Conclusion: Metformin was effective in acne vulgaris treatment among males and females without PCOS, p<0.05, but not superior to other systemic
therapies. p>0.05. Furthermore, extensive controlled trials are recommended.
Keywords: Acne vulgaris, Metformin, Doxycycline, Tetracycline, Isotretinoin.