Comparative Study on the Efficacy of Topical Vs Oral Treatments in Managing Acne Vulgaris, Review of Therapeutic Outcomes and Patient Responses
DOI:
https://doi.org/10.63666/ejsmr.1694-9013.3.I.2025.66Keywords:
Acne vulgaris, topical therapy, systemic therapy, doxycycline, quality of lifeAbstract
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.
References
1. Lynn DD, Umari T, Dunnick CA, Dellavalle RP. The epidemiology of acne vulgaris in late adolescence. Adolesc Health Med Ther. 2016;7:13-25.
2. Tan JK, Bhate K. A global perspective on the epidemiology of acne. Br J Dermatol. 2015;172 Suppl 1:3-12.
3. Collier CN, Harper JC, Cafardi JA, Cantrell WC, Wang W, Foster KW, et al. The prevalence of acne in adults 20 years and older. J Am Acad Dermatol. 2008;58(1):56-9.
4. Williams HC, Dellavalle RP, Garner S. Acne vulgaris. Lancet. 2012;379(9813):361-72.
5. Layton AM, Henderson CA, Cunliffe WJ. A clinical evaluation of acne scarring and its incidence. Clin Exp Dermatol. 1994;19(4):303-8.
6. Halvorsen JA, Stern RS, Dalgard F, Thoresen M, Bjertness E, Lien L. Suicidal ideation, mental health problems, and social impairment are increased in adolescents with acne: a population-based study. J Invest Dermatol. 2011;131(2):363-70.
7. Magin P, Adams J, Heading G, Pond D, Smith W. The psychological sequelae of acne vulgaris: results of a qualitative study. Can Fam Physician. 2006;52(8):978-9.
8. Mallon E, Newton JN, Klassen A, Stewart-Brown SL, Ryan TJ, Finlay AY. The quality of life in acne: a comparison with general medical conditions using generic questionnaires. Br J Dermatol. 1999;140(4):672-6.
9. Fife D. Practical evaluation and management of atrophic acne scars: tips for the general dermatologist. J Clin Aesthet Dermatol. 2011;4(8):50-7.
10. Bhate K, Williams HC. Epidemiology of acne vulgaris. Br J Dermatol. 2013;168(3):474-85.
11. Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945-973.e33.
12. Nast A, Dréno B, Bettoli V, Bukvic Mokos Z, Degitz K, Dressler C, et al. European evidence-based (S3) guideline for the treatment of acne - update 2016 - short version. J Eur Acad Dermatol Venereol. 2016;30(8):1261-8.
13. Degitz K, Ochsendorf F. Pharmacotherapy of acne. Expert Opin Pharmacother. 2017;18(9):825-837.
14. Layton AM, Dreno B, Gollnick HP, Zouboulis CC. A review of the European Directive for prescribing systemic isotretinoin for acne vulgaris. J Eur Acad Dermatol Venereol. 2006;20(7):773-6.
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