Oral Isotretinoin for Acne Has Substantial Effect on Health-Related Quality of Life

Dermatology-specific and acne-specific instruments have better sensitivity in assessing successful treatment interventions than generic instruments.

Oral isotretinoin has the most beneficial effects compared with other acne treatments on health-related quality of life, according to a study published in the Journal of the European Academy of Dermatology and Venereology.

Members of the European Academy of Dermatology and Venereology task force sought to examine which acne treatment had the best influence on HRQoL among patients with acne. A literature search was conducted to locate publications on acne treatment in which HRQoL of patients was evaluated as an outcome measure. A total of 37 papers were ultimately identified and included for further analysis.

The results of the analysis demonstrated that oral isotretinoin had the greatest effect on HRQoL among patients with acne.

A number of other treatments also demonstrated significantly better effects on the HRQoL of patients with acne compared with placebo, including norethindrone acetate/ethinyl estradiol, topical clindamycin phosphate/benzoyl peroxide, and adapalene/benzoyl peroxide.

Dermatology-specific and acne-specific instruments demonstrated much better sensitivity to successful treatment intervention than did generic HRQoL instruments. The Dermatology Life Quality Index questionnaire was the most commonly used HRQoL instrument.

Moreover, another dermatology-specific instrument called Skindex-29; the acne-specific questionnaires Acne-Specific Quality of Life Questionnaire, Acne Quality of Life Scale, and Cardiff Acne Disability Index; and the generic instrument Short Form 36 Health Survey were all used more than 1 time.

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A number of different problems were encountered by the researchers. Absence of clear numeric data on HRQoL before and after treatment was the most common reason blamed for exclusion of publications on acne treatment in this analysis. In addition, authors frequently reported only baseline data and changes without clear numeric data after particular treatment. Moreover, the absence of any data on separate items of HRQoL questionnaires in selected papers rendered it nearly impossible to analyze the effects of a particular treatment on different features of HRQoL.

Furthermore, the included studies varied with respect to duration and number of patients enrolled. Participants of the studies included in the analysis might have different acne severity and baseline HRQoL scores.

Despite these limitations, the study authors concluded that oral isotretinoin had the most influence on HRQoL of patients with acne.

Disclosures: For full list of author disclosures, please see original article.


Chernyshov PV, Tomas-Aragones L, e al. Which acne treatment has the best influence on health-related quality of life? Literature review by the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes [published online May 5, 2018]. J Eur Acad Dermatol Venereol. doi: 10.1111/jdv.15048