In contrast, the response of inflamed-lesion (papules and pustules) was equal between groups receiving EMR and control group. It seems that antioxidant activities of EMR does not cause anti-inflammatory effect on acne, which is contradictive to the finding from an in vitro study.12 The reasons behind this phenomenon might be related to the fact that all patient also received topical retinoic acid on the face. As already known, retinoic acid has become a standard treatment for acne and has a stronger anti- inflammatory effect. This might mask anti-inflammatory effect of EMR, thus rendering a more inferior effect on the area of chest and back. Pharmacokinetic factors of EMR should also be considered as the determinant of the efficacy of EMR, e.g. dosages, duration, and route of administration