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Metformin therapy for acne vulgaris among males and females without polycystic ovary syndrome: a systematic review and meta-analysis

Ahmed Hamad Ahmed Sulaiman, Hyder Osman Mirghani, O. Hamid, Abdelrahman Mohamed Ahmed Abukanna, Hafiz Osman Ibnidris Almisbah, Haider Osman Ibn Idris Elmisbah

Asian Journal of Pharmaceutical and Clinical Research, 2025

214 participants

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 p0.05. Furthermore, extensive controlled trials…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 214 participants or records.

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