Is Oral Isotretinoin More Effective than Antibiotics in the Treatment of Severe Acne in Adults?

Objective: The objective of this selective EBM review is to determine whether or not the use of oral isotretinoin is more effective than oral antibiotics in the treatment of severe acne. Study Design: Review of all English language primary studies published after year 2000. Data Sources: Three randomized control trials all found using PubMed. Outcomes Measured: Total number and percentage change in total acne lesions from baseline at various intervals. Results: A randomized control trial (RCT) by Gollnick et al. (2001) found that oral isotretinoin was more effective than combination therapy involving minocycline in treating severe inflammatory acne, but that isotretinoin caused more negative side effects. In a RCT by Oprica et al. (2007), it was found that oral isotretinoin was more effective than tetracycline in treating acne vulgaris with prolonged significant remission. A RCT by Tan et al. (2014) found that although doxycycline induced earlier reduction in total acne lesions, isotretinoin was still superior in reduction of acne lesions by week 20 of treatment. Conclusions: All three RCT’s included in this study indicate that oral isotretinoin is more effective than oral antibiotic therapies in the treatment of severe acne