Comparative Study on the Efficacy of Topical Vs Oral Treatments in Managing Acne Vulgaris, Review of Therapeutic Outcomes and Patient Responses

Abstract

Background: Acne vulgaris is a chronic inflammatory skin disorder associated with significant physical, psychological, and quality-of-life impairment. Although topical and systemic therapies are widely used for moderate-to-severe acne, comparative evidence evaluating their efficacy, safety, and impact on quality of life remains limited.

Objective: To compare the clinical efficacy, safety profile, and quality-of-life outcomes of topical therapy versus systemic therapy in patients with moderate-to-severe acne vulgaris.

Methods: A prospective, randomized, single-blind study was conducted among 360 patients aged 16–40 years with moderate or severe acne vulgaris. Participants were randomized into three groups: topical therapy, systemic therapy, and combination therapy. Clinical outcomes were assessed using Investigator’s Global Assessment (IGA), lesion count reduction, Dermatology Life Quality Index (DLQI), and Acne-QoL scores over 24 weeks.

Results: All treatment groups showed significant clinical improvement. Systemic and combination therapies resulted in significantly greater reductions in inflammatory and total lesion counts compared with topical therapy alone (p<0.001). Combination therapy achieved the highest IGA success rate (78.3%). Quality-of-life scores improved significantly across all groups and correlated positively with clinical improvement. Topical therapy demonstrated superior tolerability.

Conclusion: Systemic therapy provides greater short-term efficacy in moderate-to-severe acne, while topical therapy offers a safer alternative. Combination therapy yields optimal clinical and quality-of-life outcomes. Individualized treatment selection is essential.