Lack of research into widely used acne treatments could be limiting their effectiveness

There are many products that are publicised as cures for acne, often at considerable expense to both consumers and the health-care system, but there is very little evidence of which ones work best and for whom. Few studies have compared treatments against each other in terms of effectiveness and safety. Furthermore, concerns that the long-term use of antibiotics to treat acne might contribute to bacterial resistance increases the urgency to test treatment regimens and to develop more effective non-antibiotic therapies, according to a Seminar, published Online First in The Lancet.

"The large number of products and product combinations, and the scarcity of comparative studies, has led to disparate guidelines with few recommendations being evidence-based", explains lead author Hywel Williams from the Centre of Evidence-Based Dermatology, University of Nottingham, Nottingham, UK. As a result, even recent guidelines (including those from the Global Alliance to Improve Outcomes in Acne and the American Academy of Dermatology) are based on the opinion of experts. This is of concern because without evidence to support practice recommendations, there is the potential for .

Although acne affects almost all young people to some degree, relatively little is known about its causes and treatment. Factors such as diet, sunlight, and skin hygiene have all been implicated, but supportive evidence is lacking. Acne suffers could be going to great lengths to change their lifestyles and it might make no difference at all, explain the authors.

According to the Seminar: "Almost half of recently published acne trials contain serious flaws that could be overcome by better reporting... The absence of trials with active comparators is a significant handicap to shared making. Clinical trials of cost-effectiveness of different strategies for initial treatment and of acne are needed."

This lack of well-conducted research to test over-the-counter and prescription therapies is putting patients at risk of ineffective treatment and makes treatment decisions for patients and doctors very difficult. This has prompted the Institute of Medicine in the USA to target comparative-effectiveness research on acne therapy as one of the top 100 targets for national research.

There is also considerable concern that the overuse of antibiotics to treat acne will lead to the development of resistance, especially since they are used for long periods at low doses. The authors suggest restricting the use of antibiotics as maintenance treatment because alternatives such as benzoyl peroxide might work just as well.

The authors conclude by calling for new research into the comparative effectiveness of common topical and systemic therapies and to improve the understanding of the natural history, specific types, and triggers of , and how treatment affects the course of this poorly understood disease.

More information: Journal paper: www.thelancet.com/journals/lan… (11)60321-8/abstract

add to favorites email to friend print save as pdf

Related Stories

How the drug isotretinoin zaps acne

Mar 03, 2008

The most potent drug available for the treatment of acne is 13-cis retinoic acid (13-cis RA; also known as isotretinoin); however, little is known about the mechanism by which it acts.

Recommended for you

Drug research and development more efficient than expected

Feb 27, 2015

Drug R&D costs have increased substantially in recent decades, while the number of new drugs has remained fairly constant, leading to concerns about the sustainability of drug R&D and question about the factors that could ...

Use new meningitis vaccines only for outbreaks

Feb 26, 2015

(AP)—A U.S. panel on Thursday recommended that two new meningitis vaccines only be used for rare outbreaks, resisting tearful pleas to give it routinely to teens and college students.

New antibiotic avycaz approved

Feb 26, 2015

(HealthDay)—The combination antibiotic Avycaz (ceftazidime-avibactam) has been approved by the U.S. Food and Drug Administration to treat adults with complicated infections of the intra-abdominal area or urinary tract, ...

Tagging drugs to fight counterfeit medicines

Feb 25, 2015

The U.S. and other countries are enacting rules to clamp down on the sales of fake pharmaceuticals, which pose a public health threat. But figuring out a system to track and authenticate legitimate drugs still faces significant ...

User comments

Adjust slider to filter visible comments by rank

Display comments: newest first

dirk_bruere
not rated yet Aug 30, 2011
Aspirin dissolved in conc green tea applied topically twice a day

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.