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Review: Oral Isotretinoin Is Best Treatment for Acne

Meta-analysis reveals triple therapies containing topical retinoid, benzoyl peroxide, and antibiotic are next best

By Lori Solomon (HealthDay News) | July 27, 2023

THURSDAY, July 27, 2023 (HealthDay News) -- The most effective treatment for acne is oral isotretinoin, according to a review published in the July/August issue of the Annals of Family Medicine.

Chung-Yen Huang, M.D., from the National Taiwan University Hospital in Taipei, and colleagues conducted a systematic literature review to identify randomized controlled trials comparing the efficacy of pharmacological therapies for acne vulgaris in patients of any age and sex and with a treatment duration of two or more weeks.

Based on 221 included trials (37 interventions and 65,601 patients), the researchers found the most effective treatment was oral isotretinoin (mean difference, 48.41), followed by triple therapy containing a topical antibiotic, a topical retinoid, and benzoyl peroxide (mean difference, 38.15) and by triple therapy containing an oral antibiotic, a topical retinoid, and benzoyl peroxide (mean difference, 34.83). Oral or topical antibiotics or topical retinoids, as monotherapies, have comparable efficacy for inflammatory lesions. However, oral or topical antibiotics have less effect on noninflammatory lesions.

"Acne is an extremely common skin disease with an estimated global prevalence of 9.4 percent and an annual cost of 3 billion dollars in the United States. Measured by disability-adjusted life years, the global burden from acne is ranked the second highest among all cutaneous diseases worldwide," the authors write. "Our study provides the most comprehensive evidence to date about common pharmacological interventions for acne vulgaris with analyses of both percentage and absolute reduction in lesion counts and detailed comparisons for each intervention."

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