Polyherbal Antiacne Gel: <i>In Vitro</i> Antibacterial Activity and Efficacy Evaluation Against <i>Cutibacterium acnes</i>

<i>Acne is a common skin condition that affects people of all ages and can lead to significant physical and psychological distress. The first line of action against acne is topical products, though the most effective are topical antibiotics. In such a scenario, the development of effective and safe herbal formulations for the treatment of acne is of great importance. <i>Rubia cordifolia</i>, <i>Aloe barbadensis</i>, and <i>Allium cepa</i> extracts are rich sources of bioactive metabolites and are safe compared with antibiotics, in addition to being cost effective, sustainable, and eco-friendly. Also, their combination has not been studied for treating acne, and their potential benefits need to be investigated. The present study aimed to develop an effective polyherbal gel formulation of <i>R. cordifolia</i>, <i>A. barbadensis</i>, and <i>A. cepa</i> combined extract for treating acne and validate its effect with reference to conventional antibiotics. Plant materials were extracted in water by the reflux method, and phytochemical analysis was done for flavonoid, anthraquinone, and phenolic contents. The combined extract (<i>R. cordifolia</i>, <i>A. barbadensis</i>, and <i>A. cepa</i> extracts) was formulated in gel. The selected polyherbal gel was evaluated for <i>in vitro</i> antibacterial activity using agar well diffusion against <i>Cutibacterium acnes</i> (<i>P. acnes)</i> culture. Phytochemical analysis of the composite extract revealed the rich presence of flavonoids, phenolics, and anthraquinones. The polyherbal gels showed good physicochemical properties; however, FCEG-4 was selected for further studies. It was found to be effective against <i>C. acnes</i> (MTCC 1951) in agar well diffusion, as it showed a similar zone of inhibition as that of standard. Also, during <i>in vivo</i> studies, FCEG-4 showed comparable efficacy with clindamycin gel. It was concluded from the study that composite extracts incorporated in an aqueous-based gel system were effective in topical therapy of mild acne vulgaris, showing similar efficacy to that of clindamycin cream.</i>