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Acne therapy: a methodologic review.

Harold P Lehmann1, Karen A Robinson, John S Andrews

  • 1Department of Pediatrics, Johns Hopkins School of Medicine and Bloomberg School of Public Health, USA.

Journal of the American Academy of Dermatology
|July 26, 2002
PubMed
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This review of acne treatment studies found significant variability in research methods and reporting over 50 years. Recommendations are provided to improve the quality of future acne clinical trials.

Area of Science:

  • Dermatology
  • Clinical Research Methodology
  • Evidence Synthesis

Background:

  • Acne vulgaris is a prevalent skin condition causing significant physical and psychological distress.
  • Existing evidence for acne treatment lacks systematic review, hindering interpretation of clinical studies.
  • This review addresses the need for a comprehensive evidence-based foundation for acne research and clinical practice.

Purpose of the Study:

  • To systematically review and evaluate the methodological quality of published acne literature.
  • To identify strengths and weaknesses in controlled trials for acne treatment over the past 50 years.
  • To provide a basis for improving future research and clinical interpretation in acne management.

Main Methods:

  • An expert-advised literature synthesis approach was employed.

Related Experiment Videos

  • A structured search of multiple electronic databases (Cochrane CENTRAL, MEDLINE, etc.) identified English-language controlled trials.
  • Data abstraction and quality assessment were performed by at least two independent reviewers.

    • Main Results:

    • 250 articles representing 274 controlled trials published over 50 years were analyzed.
    • A significant proportion of trials (21%) had major weaknesses and no strengths; 47% had both strengths and weaknesses.
    • Inconsistent reporting of patient demographics (age, gender, race, skin type) and lack of standardized outcome measures (acne severity, lesion counts, psychological impact) were noted.
    • Over 140 treatments were evaluated across 251 comparisons, highlighting heterogeneity.

    Conclusions:

    • The acne research literature exhibits substantial heterogeneity across patient characteristics, severity assessment, outcome measures, and treatment comparisons.
    • Methodological inconsistencies limit the interpretability and generalizability of findings.
    • A set of methodological recommendations is proposed to enhance the quality and consistency of future acne research.