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INTRODUCTION In the past 25 years, numerous topical and systemic drugs have been developed for the treatment of acne vulgaris. The voluminous amount of clinical trial information has become increasingly difficult for individual physicians to monitor. Clinical trials are a science no different than any other aspect of medicine. There has been improvement in the design and performance of clinical trials in the past several years. Currently, most authoritative opinions fully support the need for studies to be performed under the CONSORT and Cochrane principles. We accept that many studies have not been as rigorously performed in the past as trials done in 2002. But to discard such studies is inappropriate, because they were done well according to the standards of the time. Thus, for the time being, clinical opinion, based in part on formal discussion among expert colleagues with an interest in acne and a logical analysis of the literature, is not unreasonable as the basis for a Consensus Recommendation. Such recommendations highlight the indications for use of medications and the optimal approach to the management of specific clinical problems. Overall, the goal is to provide a comprehensive overview of rational therapy, which can form the basis for more uniform therapeutic strategies throughout the world, enhanced patient compliance, and more effective use of healthcare resources. Several sets of guidelines have been developed for the treatment of acne during the past decade, including a practice guideline for the Oral Treatment of Acne in France (1999), Canadian Acne Treatment Guidelines (1995), German Guidelines for Acne Treatment (2001), Treatment of Acne Vulgaris: Guidelines for Primary Care Physicians (1991), and Guidelines of Care for Acne Vulgaris from the American Academy of Dermatology (1990). However, advances in medicine occur relatively rapidly, and practice guidelines may be out of date shortly after they are issued. Thus, there is a continuing need to update existing recommendations so that recent advances in therapy can be brought to the attention of physicians in a timely manner. In recognition of this need, this supplement to the Journal of the American Academy of Dermatology has been developed by a panel of physicians and researchers in the field of acne, working together as a Global Alliance to Improve Outcomes in Acne. The mission of this group is to develop consensus recommendations for the treatment of acne, which are evidence-based when possible, and which include input from numerous countries. The members of the group represent a broad list of international dermatologists with a special interest in acne and reflect a wide range of experiences and opinions. The activities of the group have been coordinated by Dimensional Healthcare, Inc, and funded by an educational grant from Galderma. As might be expected, some of the physicians involved in the development of this document have past or current, direct or indirect financial |
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