This review summarizes important clinical developments in
acne treatment identified in five systematic reviews and two significant primary research studies, published between March 2010 and February 2011. Although evidence showing a direct link between development of bacterial resistance and oral
antibiotic therapy for
acne is not convincing, prescribers can still tailor their practice to minimize future risks by stopping treatment when appropriate, using
benzoyl peroxide, and avoiding combining topical and systemic antimicrobials. A systematic review evaluating combination products containing
benzoyl peroxide did not show convincing evidence that such products are superior to monotherapies. A systematic review of
combined oral contraceptives confirmed their efficacy for
acne in women. However, another systematic review of botanical products for
acne failed to provide any good-quality evidence of benefit. A large, well-reported retrospective cohort study attempted to clarify the potential link between
isotretinoin and depression/suicide. Although suicide risk peaked 6 months after
isotretinoin treatment, an increased risk was present before initiation of
isotretinoin, making it difficult to attribute the increased risk to
isotretinoin alone. However, those with a history of suicide attempts before treatment made fewer new attempts than those whose behaviour started during treatment. This suggests that patients with severe
acne with a history of attempted suicide should not automatically be refused
isotretinoin. Another randomized controlled trial of 60 patients from Korea suggested that low-dose
isotretinoin dose than might provide a better long-term outcome with minimal side-effects for people with moderate
acne.