Topical Epidermal Growth Factor in Acne Vulgaris and Acne-Related Sequelae

BACKGROUNDAcne vulgaris (AV) is a common chronic inflammatory skin disorder, particularly among adolescents and young adults, and its management remains limited by variable treatment response, poor adherence, and treatment-related adverse effects.

AIMSThis review critically evaluates the mechanistic rationale, clinical evidence, safety considerations, and formulation challenges relating to topical epidermal growth factor (EGF) in active acne vulgaris and acne-related sequelae.

METHODSPubMed was searched from database inception through June 30, 2026, using predefined MeSH and free-text terms related to AV, acne scarring, epidermal growth factor, EGF receptor (EGFR) signaling, keratinocytes, sebocytes, inflammation, skin-barrier repair, wound healing, and topical delivery. PubMed-indexed articles were selected through title-and-abstract screening followed by full-text assessment. Human acne-related studies were prioritized, while relevant preclinical studies were included to evaluate mechanistic, safety, and formulation-related evidence. Owing to substantial heterogeneity in study design and indication, evidence was synthesized narratively rather than quantitatively.

RESULTSPreclinical studies suggest that EGF/EGFR signaling may influence keratinocyte inflammation, migration, proliferation, and tissue repair; however, most of this evidence derives from non-acne cellular or wound-healing models. Direct clinical evidence for active acne is limited to two small, short-term split-face studies that reported preliminary within-study improvements in lesion-related outcomes. Separate small studies have evaluated topical EGF-containing formulations for established atrophic acne scars or recombinant human EGF (rhEGF) as an adjunct to fractional laser treatment. These studies do not demonstrate prevention of new acne scars, and evidence from scar or post-procedural settings cannot be extrapolated to active acne treatment. Heterogeneity in study design, formulation, indication, outcome assessment, and follow-up prevents firm conclusions regarding clinically meaningful efficacy, comparative effectiveness, or long-term safety. The single-database, English-language narrative-review methodology also limits the comprehensiveness and certainty of the synthesis.

CONCLUSIONSAvailable studies provide preliminary biological rationale and limited clinical signals for topical EGF in acne-related care, but the evidence is insufficient to establish clinically meaningful efficacy or an evidence-based therapeutic role in active acne vulgaris. Evidence for topical EGF serum used alone on established atrophic scars remains weak, whereas the comparatively broader evidence concerns rhEGF as an adjunct after fractional laser treatment for established scars. Even in this procedural setting, heterogeneous protocols and limited evidence certainty preclude routine recommendation. Topical EGF should therefore remain investigational, and larger randomized controlled trials using standardized formulations, active comparators, indication-specific outcomes, and longer safety follow-up are required.

Abstract from Crossref