Effects and safety of fire needle adjuvant chemical peels therapy in acne vulgaris: a systematic review and meta-analysis

Background Acne vulgaris (AV) is a common skin disease. Fire needle is a method of quickly piercing the local skin lesions with red-hot needles for AV. This work aimed to evaluate the efficacy and safety of fire needle combined with chemical peels for AV. Methods Eight databases including PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Internet, Wanfang, Sinomed, and VIP databases were searched to enrolled randomized controlled trials (RCTs) comparing fire needle therapy combined with chemical peels with chemical peels alone. The risk of bias was evaluated by the Cochrane Collaboration's tool. Statistical analysis was completed by RevMan 5.3 and Stata 14.0. Results Altogether 18 studies including 1213 patients were enrolled. Compared with chemical peels alone, fire needle adjuvant chemical peels therapy improved the total effective rate (RR = 1.37,95% CI [1.26,1.48], p < 0.00001) and skin lesions (MD = -2.11, 95% CI [-2.74, -1.47], p < 0.00001), and reduced the recurrence rate (RR = 0.50,95% CI [0.33,0.76], p = 0.0009).The application of fire needle was associated with few adverse reactions, all of which were well tolerated and transient. Conclusion Fire needle adjuvant chemical peels therapy is effective and safe for AV. Nevertheless, more large-scale, well-designed clinical studies are warranted to provide evidence-based medical support.