Which topical acne treatments perform best? A network meta-analysis

What question did the researchers ask?

The review compared topical acne treatments used for at least eight weeks. It prioritised patient-reported global improvement and withdrawals, alongside lesion counts and clinician ratings.

What did they actually find?

Benzoyl peroxide improved patient-reported acne compared with vehicle. Combinations with adapalene or clindamycin ranked higher than benzoyl peroxide alone, with low absolute withdrawal rates across treatments.

What should you keep in mind?

Overall confidence was low because results were reported inconsistently. The evidence concerns acne rather than every cause of pigmentation, and prescription choice should follow acne severity, pregnancy status, tolerance and scarring risk.

What does this mean for a Highfield consultation?

Treatment choice depends on acne type and severity; pigmentation and other diagnoses require separate assessment. We consider that finding alongside independent guidance, your medical history, examination and priorities. It can support a better-informed decision, but it cannot promise a personal result or decide whether treatment is suitable.