Acnes are the most prevalent skin condition that 85% of youngsters experience today, making it the world’s eighth most prevalent disease. Even though acne is not life-threatening it can affect an individual’s psychological, social, and emotional consequences.1,2 Acne can last throughout adulthood and typically affect the most prominent oil glands, such as the face and neck. Seborrhea, inflammatory lesions, comedones, extreme sebum production, and the presence of bacteria for example Cutibacterium acnes, Staphylococcus epidermidis, and Malassezia furfur in the follicles are all characteristics of acne hence, these bacteria could be targeted for acne therapy. The severity of the condition decides the mode of treatment to be followed, accordingly mild to moderate infections, is treated topically by application of benzoyl peroxide, Clindamycin, and retinoid.3 Despite their efficacy in treating mild to moderate acne vulgaris, these topical therapies are known to be irritating and have a history of poor tolerability and patient adherence. Systemic treatment is recommended for moderate to severe acne, i.e., acne resistance to topical therapy, and acne covers a comprehensive body area. Systemic treatment mainly includes oral antibiotics, retinoids, and hormonal treatment. Antibiotics used for long periods of time cause organisms to become unresponsive to the drugs.4 This multifaceted adaptation is impacted by the organism’s susceptibility to the therapy as well as host factors including hormone levels and stress levels. Treatment of acne with these anti-microbials has been linked to the development of resistance to these drugs by P. acne, leading to treatment failure.5 Discovering effective, safe, low-cost antiacne treatments is critical to overcoming these constraints. To address this problem, herbal therapeutic alternatives have been investigated.

Traditional Thai medicine has used the herbal ball to address a number of ailments, including acne. Herbs have such a long history in ancient India that they are even referenced in the Vedas, an ancient Hindu sacred text. Ayurveda and Unani, two ancient herbal medicine systems, use natural remedies and plants to address diseased conditions.6 Although herbal medicines may seem unfamiliar to western healers and physicians, the bulk of currently prescription pharmaceuticals still contain plant extracts. The need for Indian herbal remedies, which are valued by nations worldwide, has led to this traditional kind of therapy’s rapid expansion—an annual growth rate of about 30%.7,8 Even though herbal therapies might seem unfamiliar to western healers and medical professionals, the bulk of today’s prescription drugs still contain plant extracts.9 Many herbs mentioned in traditional literature have been widely used to treat several skin- related problems, such as Centella asiatica, Ocimum gratissimum, and Azadirachta indica.10–12 These herbs exhibit antiacne activity due to their anti-inflammatory, antioxidant, and antibacterial properties. Traditional eastern medicine known as the herbal ball or herbal compress massage ball is widely used in Thailand.13 To prepare the herbal ball, various herbs with anti-oxidant, anti-inflammatory, and anti-microbial properties are combined and firmly wrapped in a square piece of fabric to make a herbal compress ball.14 The herbal massage ball is heated with the use of steam. Multiple illnesses, including acne, have been treated with the help of the herbal ball compress.

The herbal extracts were modified and created as polyherbal formulations because they cannot be utilised directly for the treatment.10 However, the herbal ball needs to be applied repetitively for treating chronic conditions like acne, which is not practical as it is a tedious and time-consuming process. Hence there is a need to incorporate the herbal ball extract into a suitable topical formulation. The current work attempts to develop topical formulations using herbal ball extract of Centella asiatica, Ocimum gratissimum and Azadirachta indica that could be utilized as an alternative of the traditional herbal ball for acne treatment.